Types of dementia and their characteristics

The doctor Arsenio Rosado Franco, director of Yucatan Mental Health Instituteaddresses the issue of neurocognitive disorders, which encompass the different types of dementia, that affect older adults, and that in some cases lead them to trigger tragic events such as the one that occurred a couple of days ago, when a man was found dead. 77 years old, who suffered from Alzheimer’s and who two days before had escaped from his home.

The doctor, a specialist in psychiatry, explains that dementias are pathological processes that encompass a deficit in the thinking process, memory, judgment and social skills.

So dementia implies a disorder that has these symptoms in common. The symptoms interfere with higher mental functions, as already mentioned.

These health problems usually appear with aging, and it is estimated that people over 65 years of age already have incipient or developed dementia, while in those over 85 years of age it is estimated that between 15 to 20% have cognitive disorders or dementias.

Types of diseases

It details that there are several types of dementia, and the most common is Alzheimer’s, followed by vascular type dementia, and others such as boxing or post-traumatic dementia that people who play sports such as boxing or American football usually suffer from.

There is also Lewy dementia, and there are other causes that can cause pseudo-dementia.

For example, major depression in old age can appear to be dementia without being it, as can a deficiency of vitamin B6 and B12, vitamin D and folates, whose deficiencies can cause symptoms of dementia, as can uremia.

Effects

The most common thing when these problems occur is the loss of immediate memory, of recent and also past events, difficulty communicating with other people, visual or space difficulties, solving problems or performing complex tasks, planning or organizing things that Before, they easily caused poor motor coordination and confusion regarding space, time and place.

Likewise, personality changes may occur, making the person irritable, obsessive, and very demanding.

If it is possible that Alzheimer’s is a disease that usually appears after the age of 65, and when it appears earlier it is generally genetic.

He highlights that Alzheimer’s does consider genetic factors, since it has been seen in patients with this condition that chromosomes 1, 14 and 21 register changes in the amyloid precursor protein, accumulating and making coils in the gray and white matter of the brain, which causes poor nerve transmission and cell death.

For this reason, the specialist indicates that there is a greater risk of suffering from the disease when parents and grandparents suffered from Alzheimer’s at a young age, that is, less than 60 years old.

Genetic risk can now be determined through laboratory tests from the age of 40 or 50, and consists of a blood test.

So far there is no medication that cures dementia, although the progression can be delayed with medications such as memantine and donepezil.

It is estimated that the evolution of Alzheimer’s is approximately 11 years, but progress can be delayed with existing drugs.

Some specific symptoms of Alzheimer’s are psychomotor agitation, hallucinations, interactivity, impulsivity and aggressiveness.

In the first two to three years, changes occur in memory, judgment and reasoning, and as the child progresses, more changes occur. Four or five years after having the disease is when changes in behavior are recorded, which are generally controlled with medications.

Regarding vascular dementia, which is the second most common cause of dementia, Dr. Arsenio Rosado points out that it may be a little more preventable, since it is caused by micro cerebral infarcts. Fat plaques, diabetes or hypertension, or all three together, cause a lack of cerebral circulation that generates vascular dementia.

The cerebral irrigation areas are affected, especially the small and medium caliber veins.

The way to prevent vascular dementia is by regulating blood sugar levels, limiting fat intake, since obesity and increased fat in the body increase the risk of the condition, so exercise and eat a Mediterranean diet , as well as having the underlying diseases well controlled, can help prevent this type of dementia.

If care is not taken, the disease appears and progresses in stages, there is usually a deterioration and then the condition stops, but cell death gradually increases. Vascular blockages appear and there are different periods in terms of their appearance, it all depends on how much the person takes care of themselves, and the changes they make in their lifestyle, such as the control of diseases such as hypertension, diabetes and dyslipidemias, exercise and the use of anticoagulants if the doctor considers it pertinent.

The psychiatrist specifies that vascular dementia is common, it is estimated that it is present in 1 or 2% of adults over 65 years of age, and in 8% of those over 85 years of age.

Alzheimer’s, which occupies the first place in frequency among dementias, is considered to cover 30% of all dementia cases.

These two are followed by other conditions such as dementia due to Parkinson’s disease, which is subcortical; temporal frontotemporal dementia, which causes personality and behavioral changes; Lewy body dementia, which is similar to Parkinson’s, and causes delusions, hallucinations and some other parkinsonian-type problems, which are treated at a psychiatric level.

Huntington’s disease, also subcortical and of genetic origin, in which neurons degenerate, causes depression, psychosis, motor alterations and athetotic-type movements, as in the so-called St. Vitus’ disease. It also affects memory and language.

If it is dementia due to trauma, it is due to brain damage, which is why it is common in boxers and those who play American football. It usually occurs in those over 50 years of age, due to subdural hematomas.

Older adults who fall and suffer a blow to the head may have the disease, which occurs post-traumatically six months or up to two years after the fall, causing dementia.

Hence, one must be careful with the falls suffered by adults.

The progression of this type of dementia depends on the damage that exists from the traumatic event, so the disease can stagnate or continue to evolve.

Another type of dementia that exists is alcohol dementia, since in these cases there is usually a deficiency of vitamin D and together with alcohol, which is a neurotoxin, causes dementia.

The simple act of stopping drinking and treating the patient with medication helps stop the symptoms, although the damage is not reversed, it does not worsen further.

There is HIV-related dementia, which is estimated to be suffered by 14% of patients with this disease. There is a cognitive deterioration in these people that affects memory, reasoning and social skills.

In general, Dr. Rosado Franco points out that dementia is treated so that there are no other consequences for patients and families.

Geriatricians, neurologists and psychiatrists are those responsible for the diagnosis and treatment of these diseases.

Security measures

He points out that psychoeducation for those who have family members with dementia is important, because if they are at home, security measures must be established in sockets, the kitchen, the safekeeping of knives, house keys, securing the doors and railings, among others.

He points out that in some places tracking chips are already used that are placed in the shoes of people with dementia so that if they go out without the family realizing it, they can find them. Another option is to use a chain with a plate and the data. such as name and telephone number.

Regarding the risk factors that people should take into account to avoid having any type of dementia as much as possible, the expert states that you have to take care of your body weight, because obesity increases the risk rate, you have to take care of yourself. of blows to the head that affect older people to a greater extent, but can also cause damage at a younger age, avoid or reduce alcohol consumption, and take care of the levels of vitamins B6 B12, folates and vitamin D, which It has been seen that if they are low they increase the risk of dementia.

We must not forget that the consumption of certain medications, such as benzodiazepines, can worsen memory problems, so whenever any drug is taken it must be done under medical supervision.— IRIS CEBALLOS ALVARADO