What is dementia?
Dementia is a group of symptoms related to memory loss and overall cognitive impairment. Most types of dementias continue to worsen and are usually irreversible. Alzheimer's disease is the most common and well-studied cause of dementia, affecting up to 70% of those diagnosed with dementia. People with dementia often need help taking care of themselves. They may have difficulty communicating with others. Everyday activities, such as grooming, preparing meals, and driving, may become difficult.
What are some signs or symptoms of dementia?
The symptoms of dementia can be different depending on the diagnosis. In most cases, people with dementia have a gradual loss of memory and other cognitive functions. As the disease gets worse, individuals may experience the following:
- difficulty on the job;
- getting lost in familiar areas;
- problems handling personal affairs (e.g., finances, housekeeping, grooming);
- personality changes;
- depression (as the person recognizes his or her deficits);
- significant memory loss;
- difficulty following simple directions;
- decreasing communication skills;
- difficulty swallowing;
- by the final stages, inability to feed themselves, walk independently, or speak intelligibly.
What causes dementia?
Some of the conditions that can cause symptoms of dementia include:
- Alzheimer's disease,
- multiple small strokes (multi-infarct dementia),
- Parkinson's disease,
- Huntington's disease,
- Lewy body dementia,
- frontotemporal degeneration,
- Creutzfeldt-Jakob disease.
Other conditions that can cause dementia or dementia-like symptoms include reactions to medications, metabolic diseases, nutritional deficiencies, infections, poisoning, and brain tumors.
Are there different types of dementia?
There are a number of different types of dementia depending on the cause of the condition. Alzheimer's dementia is the most common type, making up approximately 70% of all diagnosed dementias. Vascular dementia is widely considered the second most common cause, accounting for approximately 17% of all dementia diagnoses. The remaining cases are accounted for by dementia with Lewy bodies, Parkinson's disease, frontotemporal lobar dementia, and mixed dementia types.
How is dementia diagnosed?
A complete medical workup by a physician is necessary to rule out other causes of cognitive impairment and diagnose dementia. Alzheimer's may be diagnosed if there are no other causes found. Without an examination of the brain at autopsy, however, a definitive diagnosis of Alzheimer's cannot be made. A team of professionals may be involved in determining whether a person has dementia. That team may include:
- speech-language pathologists,
- occupational therapists,
- social workers,
- family and caregivers.
The team will ask questions about the person's memory and other problems. Information about how these problems affect daily activities will also be collected. A number of tests can be administered to evaluate cognitive functioning. A diagnosis and treatment plan is determined from evaluation results.
What treatments are available for people with dementia?
Several medications exist that seem to slow down the progression of symptoms, but they do not reverse the disease. Many people with dementia, particularly those in the early stages, may benefit from behavioral interventions to help the person recall important information or perform daily activities.
What do speech-language pathologists do when working with people with dementia?
Speech-language pathologists (SLPs) play a central role in the screening, assessment, diagnosis, and treatment of persons with dementia. SLPs manage the cognitive, communication, and swallowing deficits associated with dementia. SLPs help individuals with dementia function at the highest level of independence throughout the underlying disease course. Specifically, they treat the cognitive aspects of communication, including attention, memory, sequencing, problem solving, and executive functioning. An SLP can help the person with dementia use strategies to preserve communication and cognitive functioning for as long as possible. Examples of strategies include:
- using written cues for completing tasks or to assist memory recall,
- developing "memory books" to help recall personal information,
- training family members or caregivers in how to communicate better with the person with dementia.
If the individual has swallowing problems, the SLP can work with the person to ensure safe swallowing. This may include teaching compensatory strategies or altering the person's diet so that he or she can eat without risk of choking or illness.
The ultimate goal of any intervention is to preserve the person's quality of life for as long as possible.
What can I do to communicate better with a person with dementia?
There are things that caregivers can do to help the person with dementia function more effectively in his or her daily life. Useful techniques include:
- repeating key information when talking with the person to help him or her maintain focus;
- giving the person choices rather than asking open-ended questions (e.g., "Would you like coffee or tea?" instead of "What do you want to drink?");
- keeping information and questions short and simple;
- using written cues for activities (such as how to get dressed or how to prepare a simple meal);
- reminding the person about appointments or to take medications;
- for the family and caregivers, attending support groups to learn how others cope with the stresses of caring for someone with dementia or using adult daycares or respite care services to help prevent caregiver burnout.
What other organizations have information about dementia?
The following list is not exhaustive and inclusion does not imply endorsement of the organization or the content of the website by ASHA.