This article provides a complete analysis of the types of dementia, the 10 initial symptoms and self-detection methods, and shares the precursors of dementia, the ways to delay the deterioration and the 6 major care priorities to help you better understand dementia.
1. What is dementia? What is the difference between dementia and normal aging?
Hou Hsiao-hsien, an international director who has directed many classic works, is rumored to be suffering from dementia in 2023 and will retire from directing films, causing a shock in the film industry. What exactly is dementia? What is the difference between dementia and normal aging? How can I tell if I have dementia?
Dementia is not a single disease, but a combination of symptoms (syndromes), which not only affects memory, but also affects other parts of cognitive function, including language ability, calculation ability, judgment, attention, spatial sense, abstract thinking ability, etc.
Many family members of people with dementia mistakenly believe that the patient's abnormalities are just normal aging, so they do not seek medical attention in time; However, if you have any of the following symptoms of dementia, you should be vigilant and seek medical advice as soon as possible to clarify the cause and obtain appropriate care.
| The difference between normal aging and dementia | |
| Normal aging | • You may suddenly forget something, but remember it afterwards. • If you take a memory test, you may not be able to fully remember the items in the test. • Ability to maintain independent living. • Occasional forgetting of words. |
| Dementia | • Completely forgetting what was said and done, and not remembering afterwards. • If you take a memory test, you will not be able to remember the items in the test, or even forget that you have taken the test altogether. • Gradual loss of the ability to live independently. • Speech is interrupted or replaced with other words. |
2. What are the types of dementia? Are the causes of different types of dementia the same?
Dementia is mainly caused by lesions in brain neurons, resulting in impaired ability to process information, resulting in the decline of various cognitive functions, and even complete loss and daily life. Depending on the cause of brain lesions, it can be divided into degenerative, vascular, and reversible dementia, but some patients may have two or more causes at the same time, such as Alzheimer's disease (degenerative dementia) and vascular dementia.
(1) Degenerative dementia
Patients with degenerative dementia have long-term deposition of abnormal proteins in the brain, resulting in lesions. The most common types of degenerative dementia are Alzheimer's disease, frontocranial lobe dementia and Lewy body dementia, with Alzheimer's disease accounting for the largest number of cases.
Alzheimer's disease
Alzheimer's disease is a dementia caused by the degeneration of brain nerve cells, and the process of degeneration is irreversible, and the clinical course is about 8~10 years. In the early stage of Alzheimer's disease, the hippocampal gyrus is mainly violated, and when the patient dies, the brain is dissected and there are abnormal age spots and nerve fiber entanglement.
The most obvious early symptoms of Alzheimer's disease are memory loss, such as difficulty recognizing time, place, and people, combined with changes in cognitive function, behavior, or personality.
Frontotemporal dementia
The onset of frontocranial lobe dementia is relatively young, mostly between 50~70 years old, and its brain disorders are mainly frontal lobe or cranial invasion. There are two possible early symptoms of frontocranial lobe dementia, one is an irreconcilable personality change that leads to inappropriate behavioural responses and activities, and the other is a progressive degeneration of language disorders such as difficulty in expression and naming.
Lewy body dementia
Lewy body dementia is the second most common type of degenerative dementia, with the onset of the disease usually occurring after the age of 70, and early symptoms include stiffness, unsteady walking, and repetitive and unexplained falls; In addition, people with dementia with Lewy bodies may also have significant psychiatric symptoms, such as vivid hallucinations, kicking or swinging, yelling during sleep, and emotional instability.
(2) Vascular dementia
Vascular dementia is the second most common type of dementia after degenerative dementia, which is caused by stroke or chronic cerebrovascular disease, which causes poor blood circulation in the brain, resulting in brain cell death and mental decline.
Symptoms of vascular dementia include fluctuations or sudden deterioration of cognitive function, early symptoms include slow movements, unsteady gait, slow reactions, easy falls, and sometimes emotional and personality changes, such as violent emotional ups and downs, becoming melancholy, etc.
(3) Reversible dementia
Reversible dementia refers to the type of dementia that can be recovered after treatment, and there are many causes of this type of dementia, including:
- LACK OF NUTRIENTS SUCH AS VITAMIN B12 AND LUTEIN
- Intracranial lesions such as brain trauma, brain tumors, and atmospheric hydroencephalopathy
- Metabolic abnormalities such as hypothyroidism or electrolyte imbalance
- Syphilis, AIDS and other central nervous system infections
- drug abuse
- Metabolic abnormalities such as hypothyroidism or electrolyte imbalance
- Infection of the central nervous system such as syphilis and AIDS, or poisoning due to drug abuse or alcoholism
Compared with irreversible dementia, reversible dementia often has a more definite cause, and early detection and active treatment can facilitate the recovery of the original life.
3. What are the precursors of dementia? Don't ignore these 10 dementia symptoms!
The early clinical symptoms of dementia vary from person to person, but they usually start with short-term memory loss and forgetfulness. Here are 10 common signs of dementia, if you have any of the following early symptoms of dementia, it may be a sign that you have dementia, and it is recommended to seek further diagnosis from a medical professional as soon as possible.
Precursor/Initial Symptom 1 of Dementia: Memory loss that affects life
Although memory loss can occur with normal aging, the following conditions may be a precursor to dementia and need special attention:
- Ask the same question repeatedly
- Forget important appointments or events
- I can't remember what I've read or heard
- There is a growing need for aids to help you, such as electronic calendars, reminder sticky notes, and even repeated reminders
Predementia/Initial Symptom 2: Difficulty planning or solving things
People with dementia may gradually lose the ability to draw things routinely or follow their plans, such as planning their own trips to the supermarket or cooking according to recipes. In addition, if you gradually begin to lose the ability to live independently, or lose the ability to use daily utensils, such as washing machines and ovens, it may also be a precursor to dementia.
Precursor/Initial Symptom 3 of Dementia: Inability to cope with familiar things
If you start to forget where you usually go, how to get home, or when you go out, you often forget what you should bring with you, or if you are good at things that you are good at suddenly become uncomfortable, such as playing chess, but you gradually start to forget the rules, or your skills have deteriorated significantly, you may have dementia.
Precursor/Initial Symptom 4 of Dementia: Confusion about time and place
Another symptom of dementia is that the cognition of time and space is impaired, unable to distinguish what month it is, the day of the week, or not being able to tell where you are now, and in severe cases, you may even be unable to distinguish the difference between reality and dreams, or lose your sense of reality. Treat the world on TV as reality.
Precursors/Initial Symptoms of Dementia 5: Face blindness, color blindness, imbalance and other conditions
If you start to have trouble remembering other people's faces, your name doesn't match your face, or the colors become blurry, you can't see clearly, or you often fall because you can't see clearly, then it is very likely that you are suffering from dementia, not just memory or vision loss due to aging.
Precursor/Initial Symptom 6 of Dementia: Difficulty in speech or writing
People with dementia experience a reduction in the vocabulary they can use, so they often refer to one thing as another, such as a clock, and do not find themselves wrong. In addition, people with dementia may also have difficulty expressing or writing in their daily speech. Therefore, if there is a mixture of words, misuse, or a problem with daily communication, it may be dementia.
Dementia precursor/initial symptom 7: Inappropriate behaviour
People with dementia deliberately put things in unusual places, or are prone to missing things, but they can't go back and can't remember where they put them, but they think that someone else stole or hid them. Or repeat an action and ask the same question over and over again.
Precursor/Initial Symptom 8 of Dementia: Poor or impaired judgment
People with dementia may also have poor or weakened judgment, such as people who used to love cleanliness suddenly become very messy, or people who were originally very good at managing money have errors in judgment that can be easily avoided.
Precursor/Initial Symptom 9 of Dementia: Lack of social activity
Another early behaviour of people with dementia is that people who were originally socially active may suddenly become disinclined to participate in team activities, social situations, or keep in touch with their friends.
Precursor/Initial Symptoms of Dementia 10: Changes in mood and personality
After suffering from dementia, people with dementia will have changes in their mood and personality, and their emotional ups and downs will be greater than before, becoming more irritable and irritable, and their personality may also become suspicious and suspicious.
4. Is there a precursor to Alzheimer's disease? Refer to the Dementia Self-Test Scale
IN THE PAST, IN ADDITION TO THE ASSESSMENT BASED ON THE MENTAL ASSESSMENT SCALE AND THE OBSERVATION OF CLINICAL COGNITIVE FUNCTION DETERIORATION, THE CONTENT OF AMYLOID PROTEIN AND TAO PROTEIN IN THE CEREBROSPINAL FLUID, POSITRON IMAGING (PET) AND BRAIN MRI WERE ALSO MEASURED.
However, the medical community has recently discovered that the abnormal accumulation of amyloid protein and taolin occurs long before brain atrophy and even dementia symptoms, so more and more institutions have introduced relevant technologies to detect whether there is abnormal protein accumulation in the body at an early stage through simple blood drawing.
FOR THE GENERAL PUBLIC, IF THEY WANT TO QUICKLY CONFIRM WHETHER THEY HAVE DEMENTIA, OR SUSPECT THAT THEIR RELATIVES AND FRIENDS HAVE DEMENTIA, THEY CAN ALSO QUICKLY ASSESS WHETHER THERE IS AUTISM PRECURSOR THROUGH THE AD-8 VERY EARLY DEMENTIA SCREENING SCALE PROVIDED BY THE TAIWAN DEMENTIA ASSOCIATION:
| project | Yes, there is a change | No, no change | I don't know |
| Difficulties in judgment, such as falling into traps or scams, or being unable to make sound decisions. | |||
| Decreased appetite for activities or interests. | |||
| The same questions and statements are repeated. | |||
| It can be difficult to learn how to use tools and equipment such as televisions, stereos, air conditioners, washing machines, microwave ovens, and remote controls. | |||
| Forget the correct year and month. | |||
| It is difficult to handle the property of the review, such as the inability to balance the income and expenditure of the individual and the family. | |||
| Difficulty remembering the agreed time. | |||
| Problems with thinking and remembering. |
After completing the above scale, people can go to the official website of the Dementia Association to view the description of each item and the test results; If there are 2 or more questions on the above scale with the answer of "Yes, there is a change", the subject is advised to receive further examination and treatment from a physician.
- The above scales are for initial screening only and do not represent a formal diagnosis; If in doubt, it is advisable to consult a medical professional.
5. What should I do if I encounter dementia? Ways to prevent dementia and delay dementia are seen at one time
(1) How to prevent dementia?
The exact cause of dementia is still unknown, and dementia can affect anyone, not just the elderly. Specifically, however, people can still avoid risk factors that can lead to dementia in their daily lives, so as to prevent dementia.
In 2017, the World Health Organization (WHO) pointed out that in addition to age, there are 12 risk factors that may contribute to dementia[1]:
- Lack of education
- Lack of exercise
- corpulent
- Eating an unbalanced diet
- Hearing loss
- Head trauma
- hypertension
- diabetes
- Drinking too much alcohol
- smoking
- Middle-aged melancholy
- Insufficient cognitive activity
The brain will remove waste products from the cranial nerves when the human body enters deep sleep, and the results of research have shown that sleep quality problems such as sleep-disordered breathing, sleep wakefulness (waking up halfway through sleep and not being able to fall asleep), and light sleep may interrupt this removal process, causing waste products to continue to accumulate, thereby increasing the risk of neurodegenerative diseases. Therefore, if you don't get enough sleep, waste products may continue to accumulate and eventually affect the cognitive function of the brain. [6]
In addition, recent studies have found that inflammatory bowel diseases (IBD), including ulcerative colitis and Crohn's disease, are associated with more than doubling the risk of developing dementia [2]. In addition, the intestinal flora, led by Escherichia coli, will produce amyloids to increase the stability of the flora itself and reduce the chance of being attacked and destroyed by the human immune system. However, excessive intestinal fungus amylase triggers the activation of the systemic immune system, which in turn enhances the production and deposition of amylase in brain nerve cells, resulting in an increased risk of Alzheimer's disease [3].
Therefore, in order to prevent dementia, it is recommended to start by improving intestinal health, activating the brain in daily life, and avoiding risk factors that cause dementia, so as to reduce the possibility of developing dementia. Here are 3 different ways to prevent dementia through your daily routine.
- Start with your diet
Eat enough fruits, vegetables and protein, minimize sugar, salt and saturated fat, switch to natural starchy foods such as potatoes and sweet potatoes, and drink 6~8 glasses of water a day to help prevent dementia.
In addition, the dietary policy for dementia prevention can also be more probiotics, or refer to the Eastern Mediterranean diet, eat less red meat, more grains, vegetables, fruits, chicken, nuts, fish, olive oil and other healthy oils.
- Exercise regularly
In addition to helping cardiovascular function and circulation, exercise also allows blood and oxygen to flow to the brain. It is recommended to try not to sit for a long time, and should try aerobic exercise more than 3 times a week, such as brisk walking, walking, cycling, swimming, or strengthening exercises such as push-ups, sit-ups, etc.
- Participate in mind-strengthening activities
Engaging in activities that strengthen the mind and use your brain, engaging in games that can prevent dementia, such as playing games that require your brain such as puzzles or cards, reading and writing, participating in social activities, and connecting with family and friends, all of these behaviors help to activate the brain and keep it functioning, helping to reduce the likelihood of developing dementia.
(2) Is there a cure for dementia? Probiotics may be the new hope
At present, there is no way to prevent or restore damaged brain cells for irreversible dementia, and only through drug treatment combined with cognitive training, nostalgia training and other non-drug treatments to maintain the patient's autonomy and quality of life.
FOR REVERSIBLE FORMS OF DEMENTIA, SUCH AS STROKE, SUBDURAL HAEMORRHAGE, OR DEMENTIA CAUSED BY VITAMIN B12 DEFICIENCY, THERE IS A CHANCE TO IMPROVE OR EVEN CURE DEMENTIA BY TREATING THE CAUSE OF DEMENTIA.
In addition, there is also a certain degree of association between the gut and the brain, plant probiotics PS128 It has the potential to treat dementia and other neurological diseases [4], so improving gut health through probiotics may also be a new hope for curing dementia in the future.
6. What should I do if I have a person with dementia? Dementia care focuses on this side
Caring for a person with dementia can be quite challenging, as family members who are familiar with dementia may gradually lose their ability to take care of themselves and their personalities may change to a certain extent as the disease progresses. What should be paid attention to when caring for people with dementia? Here are 6 points to help you work together to keep your family members safe and healthy:
- Create a safe home environment: Dementia increases the risk of falls and injuries due to deterioration of brain function. It is recommended that caregivers can improve the home environment by installing handrails and keeping the floor dry to reduce the risk of falls and injuries at home.
- Establish a regular daily routine: It is recommended that caregivers arrange regular daily activities in daily life at a fixed time to allow patients to establish a habit of physical activity.
- Follow the doctor's instructions for follow-up treatment: If the elders in the family suffer from dementia or have signs of dementia, it is important to take the elders to see a doctor, cooperate with the doctor's instructions for treatment and medication, and follow up regularly; Do not listen to unknown rumours or advertisements that attempt to cure or delay dementia through health food or unknown home remedies.
- Increase social contact: In the early stages of dementia patients, they can still retain their basic mobility skills, and family members can bring their elders to participate in sports, painting classes or art therapy activities, or interact with other residents in the community, which can not only help delay the onset of dementia, but also help the elders to establish contact with the outside world.
- More encouragement, less blame: Elders with dementia are prone to powerlessness, frustration or loss of self-confidence in the face of their gradual incapacity, so when taking care of elders with dementia, in addition to taking them to seek medical treatment and regular check-ups, it is more important to give them warm companionship; When elders with dementia forget or do something wrong, they should use positive and encouraging words to talk to them.
- Provide memory stimulation: When taking care of dementia patients on a daily basis, you can try to place personal items or photos in the patient's daily activity space to provide memory stimulation and increase the memory of the person with dementia for the past life.
7. A new opportunity for people with dementia? Studies have confirmed the potential of psychotropic probiotics
Although there is still no drug to cure irreversible dementia, which can only delay and control the progression of the disease, many studies in recent years have pointed out that there may be some degree of association between the brain and the stomach, and improving gut health may be helpful in helping to control or prevent neurological diseases such as autism and Parkinson's disease. Especially psychoactive probiotics PS23 and PS128has shown potential positive effects on brain health, BDNF (brain-derived neurotrophic factor) and neurodegenerative diseases such as dementia in multiple studies.
BNDF is an important factor in maintaining neuronal health and promoting neuronal production, and is key to maintaining learning, memory, and overall brain function. Psychotropic probiotics can affect brain chemistry by modulating the gut microbiota and may increase brain BDNF production[5]; Supplementation with specific strains of psychobiotic probiotics can increase BDNF levels, which in turn can help improve cognitive function and emotional state[6].
In addition, according to research, the psychobiotic PS23 can effectively delay cognitive decline due to aging. After PS23 supplementation, the memory was improved and anxiety behavior was reduced, showing that PS23 can regulate the intestinal microbiota, and through the influence of the gut-brain axis, reduce inflammation and oxidative stress in the brain, and improve cognitive decline[7]. And another psychobiotic PS128It can regulate neurotransmitters such as dopamine and serotonin, and improve patients' motor function, emotional state, and quality of life by regulating the gut-brain axis [8].
With more and more research on the relationship between probiotics and cranial nerves, psychotropic probiotics are likely to become a new opportunity to prevent or even cure dementia in the future.
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Cited Data :
[1]: World Health Organization Draft global action plan on the public health response to dementia
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[3]：Link between Alzheimer’s disease and gut microbiota is confirmed,Université de Genève,Science Daily,November 13, 2020
[4]：Liu YW, Liu WH, Wu CC, Juan YC, Wu YC, Tsai HP, Wang S, Tsai YC. Psychotropic effects of Lactobacillus plantarum PS128 in early life-stressed and naïve adult mice. Brain Res. 2016 Jan 15; 1631:1-12. doi: 10.1016/j.brainres.2015.11.018. Epub 2015 Nov 24. PMID: 26620542.
[5]：Bercik P, Denou E, Collins J, Jackson W, Lu J, Jury J, Deng Y, Blennerhassett P, Macri J, McCoy KD, Verdu EF, Collins SM. The intestinal microbiota affect central levels of brain-derived neurotropic factor and behavior in mice. Gastroenterology. 2011 Aug; 141(2):599-609, 609.e1-3. doi: 10.1053/j.gastro.2011.04.052. Epub 2011 Apr 30. PMID: 21683077.
[6]：Kobayashi Y, Kuhara T, Oki M, Xiao JZ. Effects of Bifidobacterium breve A1 on the cognitive function of older adults with memory complaints: a randomised, double-blind, placebo-controlled trial. Benef Microbes. 2019 May 28; 10(5):511-520. doi: 10.3920/BM2018.0170. Epub 2019 May 15. PMID: 31090457.
[7]：Cheng LH, Chou PY, Hou AT, Huang CL, Shiu WL, Wang S. Lactobacillus paracasei PS23 improves cognitive deficits via modulating the hippocampal gene expression and the gut microbiota in D-galactose-induced aging mice. Food Funct. 2022 May 10; 13(9):5240-5251. doi: 10.1039/d2fo00165a. PMID: 35438699.
[8]：Lu CS, Chang HC, Weng YH, Chen CC, Kuo YS, Tsai YC. The Add-On Effect of Lactobacillus plantarum PS128 in Patients With Parkinson’s Disease: A Pilot Study. Front Nutr. 2021 Jun 30; 8:650053. doi: 10.3389/fnut.2021.650053. PMID: 34277679; PMCID: PMC8277995.
