Dementia is not a single disease; the word dementia is used to describe a set of related symptoms caused by damage to the brain. Dementia causes patients to develop progressively worsening symptoms that affect memory, problem-solving ability, emotional stability, and ability to carry out daily activities. Alzheimer’s disease is the most common type of dementia, accounting for 60% to 80% of dementia cases. Other types of dementia include vascular dementia, lewy body disease, alcohol-related dementia, frontotemporal dementia, and HIV-related dementia.
Risk factors of Dementia and Clinical Trials
Dementia is caused by damage to brain cells. Depending on the area of the brain that is damaged, dementia can affect different people differently. Risk factors for dementia also differ depending on the type of dementia. The following are the most common risk factors:- Aging
- Family history/genetics
- Smoking and alcohol use
- Mid-life hearing loss
- Obesity
- Inactivity
- Depression
- Low social contact
- High blood pressure
- Low levels of education
- Traumatic brain injury
- Air pollution
Clinical Features of Dementia
The signs and symptoms of dementia vary widely depending on the type. Symptoms generally start out slowly and then gradually worsen. Dementia results in cognitive and psychological changes such as:- Memory loss
- Difficulty with language and communication
- Difficulty with remembering paths and direction
- Difficulty with problem-solving and reasoning
- Confusion and disorientation
- Personality changes
- Depression
- Paranoia
- Agitation
- Hallucination
- anxiety
Diagnosing of Dementia
Dementia can be difficult to diagnose because of its wide array of symptoms and similarities with other diseases such as delirium and depression. Dementia in its earlier stages may be difficult to distinguish from normal aging. A health practitioner may use brain scans to aid in diagnosis. A brain biopsy can provide a definite diagnosis, but can mostly only be performed post-mortem.Doctors conduct a thorough exam of medical history, genetic history, patient’s symptoms, and a physical examination to reach a diagnosis. Symptoms must be present for at least six months in order for it to be considered dementia.
Treatment and Management of Dementia
Although few types of dementia are reversible, most cannot be cured. Focus is instead on management of symptoms. Doctors may prescribe medication such as cholinesterase inhibitors, memantine, and other medication to treat other symptoms such as depression, sleep disturbances, agitation, and hallucination.However, some research suggests that education and a strong support system of caregivers and family members can improve dementia. Exercise programs have also been found to be beneficial for dementia patients.
Treatment Modalities currently undergoing Clinical Trials
Brain inflammation measurement: Several studies have found that inflammation of the brain contributes to dementia. A clinical trial to test whether two new drugs, 11C-MC1, and 11C-PS13 can help measure the inflammation of the brain using PET imaging (Positron emission tomography) is underway. Being able to measure the inflammation of the brain can help increase understanding of dementia, which in turn paves the way to discover better management or even treatment modalities.Weighted blanket: Some hospitalized patients with dementia can behave with aggression and agitation, making caring for them difficult for their caregivers and family members. A clinical trial to see if something as simple as providing the patients with a weighted blanket can decrease the patients’ agitation level is ongoing. Researchers will provide patients with weighted blankets, whose weights will be based on the patients’ weights, under the supervision of their nurses. Researchers and nurses will then evaluate the patients’ behavior during the morning after the patients have used the weighted blankets.
Community paramedic coaching program: A pilot study to test the feasibility and effectiveness of a community paramedic coaching program for caregivers of persons with dementia is underway. Paramedics will coach participants in 1-2 hour in-house sessions and over the phone for a period of 12 months. Researchers will then evaluate whether this reduces emergency visits to the hospital for the persons with dementia and whether participants will continue through the program for 12 months and consider it helpful and effective.
Innovatively designed memory care room: A memory care room is being reconstructed and retrofitted with innovative designs with the objective of improving the quality of life of patients with dementia and reducing the burden on caregivers. A pilot study to test the room is underway. Patients with dementia will be housed in the newly reconstructed memory care room for 12 months during which their quality of life, sleep quality, the progression of dementia-related symptoms, and mood will be assessed. Researchers will also assess the impact living in the room has on caregivers’ burden.