Understanding Dementias: Types, Signs, and Strategies for Cognitive Health

Dementia is a term used to refer to several neurological conditions that affect memory, thinking, and the ability to perform everyday activities. It’s important to know the different types, recognize their signs early and implement strategies to slow down cognitive decline.

What are the different types of dementia?

Alzheimer’s disease accounts for 60-80% of dementia cases and is characterized by the buildup of amyloid plaques and tau protein tangles in the brain. This buildup alters neuronal function, leading to a progressive decline in memory and cognitive abilities and the onset of neuropsychiatric symptoms.

Vascular dementia, on the other hand, arises from decreased blood flow to the brain, often due to stroke or small vessel disease, resulting in a gradual decline in cognitive function associated with the affected area.

Lewy body dementia is characterized by the presence of Lewy bodies, which are abnormal protein deposits in the brain. This type of dementia is characterized by changes in cognitive abilities, visual hallucinations, and symptoms associated with Parkinson’s disease, such as rigidity and tremors.

Frontotemporal dementia primarily affects the frontal and temporal lobes, leading to significant changes in personality, behaviour, and language skills. Compared to other forms of dementia, it typically manifests at an earlier age, usually between the ages of 45 and 65.

Mixed dementia is a term used when two or more types of dementia coexist, most often Alzheimer’s disease combined with vascular dementia, resulting in a mixture of symptoms from both conditions. In addition, there are other types of dementia, including Parkinson’s disease dementia, Huntington’s disease, and Creutzfeldt-Jakob disease, each presenting unique clinical features.

What are the signs and symptoms?

Dementia symptoms can vary depending on the type and how far it’s progressed, but some common signs include memory loss, like forgetting recent events, names, or places; increased difficulty with tasks that require planning, organizing, or problem-solving; language problems with trouble finding the right words, following conversations, or understanding what’s being said. Disorientation and confusion about time, place, or even identity are also common.

Behavioural change is a key symptom as well, expressed in mood swings, depression, anxiety, agitation, or even apathy. People suffering from dementia might make poor decisions or take risks they usually wouldn’t, and it is normal to show a decrease in their motivation or interest in hobbies and social activities.

How can we prevent or delay dementia?

Some risk factors that are modifiable have been identified, representing at least 40% of dementias worldwide (202 Lancet Commission Report). Those factors are identified along the life span, such as insufficient education in early childhood; hypertension, obesity, hearing loss, head trauma and alcohol abuse in adulthood, and in older people, smoking, depression, physical inactivity, social isolation, diabetes and environmental pollution.

Regardless of our age, we can always act and take care of those aspects that help prevent dementia. For example, monitoring blood pressure to detect hypertension, knowing that for adults, it is essential to maintain systolic blood pressure at 130 mmHg or less to help delay or prevent dementia.

In cases of hearing loss, using hearing aids, since hearing impairment induces changes in brain function and structure, accelerating cognitive decline due to a lack of mental stimulation.

Quitting smoking, even at an advanced age in life and reducing excessive alcohol consumption to reduce the risk of dementia associated with them. Alcohol consumption of less than 21 units per week is associated with a lower risk of dementia (where 1 unit is equivalent to 10 ml).

Addressing depression to reduce the likelihood of developing dementia related to this condition and staying mentally, physically and socially active during adulthood and for as long as our health allows.

Participating in different groups or communities and maintaining relationships with friends and family is medicine. Decreased social interaction in older adults is correlated with a higher risk of dementia.

Doing regular exercise and keeping a balanced diet are very important as well. We know that regular physical activity reduces risks related to obesity, diabetes and cardiovascular health and the Mediterranean diet, according to the WHO, reduces the risk of cognitive decline or dementia. And if possible, choose to live in areas with less air pollution.

Written by: Ana Gomez