Common questions about dementia

Clinical Neuropsychologist Nicola Gates answers questions about dementia.

In this article:

• How can a person recognise the early signs of Alzheimer's disease?
• How can I convince mum to get a dementia assessment?
• At what point should a person seek medical help? 
• What is the benefit of early diagnosis of dementia?
• Is there anything I can do to prevent dementia or Alzheimer's disease?
  
• What is meant by the term "brain reserve"?

How can a person recognise the early signs of Alzheimer's disease?

A person may be suffering early Alzheimer’s dementia if they begin to "forget" more often than other people their age, have trouble finding words, or have difficulty carrying out routine tasks, and these difficulties get worse. Ask yourself several questions to assist your medical practitioner:

• When did these difficulties start?
• What was happening at that time?
• What are the types of difficulties being experienced?

Write down as much information as you can to assist an accurate assessment. A differential diagnosis, when all possibilities are explored, is imperative. 

How can I convince mum to get a dementia assessment?

Most people have a regular medical check-up, so treat an assessment of her brain health in the same manner. Make it normal to discuss mental and cognitive health along with bones, bowels, and blood pressure. Present having a neuropsychological assessment as a part of this routine brain check-up.

The first neuropsychological assessment will provide a baseline level of cognitive functioning against which any changes or deterioration can be monitored. In the same way as a resting blood pressure is used to compare changes in blood pressure.

Let her know how the assessment can be helpful in providing information on what are her strengths and weaknesses, how to best manage any difficulties in order to maintain her independence, and how to plan for the future. 

At what point should a person seek medical help? 

Like any medical concern, if you have are worried, go and see your doctor as soon as practical. When a person is complaining of memory problems, or other people are noticing them, first check medical health, then determine if the memory or cognitive difficulties are normal for chronological age or impaired.

There are many medical conditions that can look like dementia but are reversible medical complaints such as other neurological problems (strokes), mental health issues (depression), or other medical complaints such as abnormal liver function, urinary tract infections, medication toxicity, or metabolic disorders.

Your medical practitioner can arrange to have the required medical examinations to be performed and may refer a person to a Neurologist. 

 
What is the benefit of early diagnosis of dementia?

An early diagnosis of dementia is beneficial as it provides information which can help in understanding the changes and difficulties experienced by the person with dementia and witnessed by family. Also at the early stage of dementia the person with the disease will still have the capacity to actively participate in their care planning and make decisions about their future accommodation and care needs.

There are medications available that may be of some initial benefit in the early stage of dementia, however they do not cure the dementia and only help with symptom management.

Support services are also available for the people with the dementia and their families, after a diagnosis has been made. 

Is there anything I can do to prevent dementia or Alzheimer's disease?

According to recent research, there are a number of possible protective factors for Alzheimer's disease.

These factors include physical and mental activity, diet, anti- inflammatory and cholesterol lowering drugs. Recent research which investigates mental activity, indicates that people who engage in brain stimulating activities, appear less at risk of developing dementia than those who follow a more sedentary life with few interests.

Several studies have clearly demonstrated that brain activity helps maintain brain function. These findings support the popular notion "use it or lose it" that now appears right across the media. 

What is meant by the term "brain reserve" and how does it influence or protect against dementia and age related cognitive decline?

The term "brain reserve" describes the idea that a person who has a mentally active brain may have more resistance against dementia. However, the term is not entirely accurate as there is no single "brain reserve".

Moreover, it is the development of new brain cells and connections that actually takes place. Developing new brain cells and connections helps protect against normal brain age related decline, as the brain adapts and grows (neural plasticity) while it ages.

Recent research examines how mental activity may enhance and maintain function, and also prevent dementia. 

Helpful resources 

• For more information about dementia and the Mind Your Mind campaign visit Alzheimer's Australia