Dementia: what it is, types, symptoms and how to diagnose

Dementia, called major or mild neurocognitive disorder in DSM-V, corresponds to a progressive change in areas of the brain, resulting in changes in memory, behavior, language and personality, directly interfering in the person's quality of life.

Dementia can be interpreted as a set of signs and symptoms related to brain changes that can have different causes, being more often associated with aging.

According to the cause and symptoms presented by the person, dementia can be classified into several types, the main ones being:

1. Alzheimer's

Alzheimer's is the main type of dementia and is characterized by progressive degeneration of neurons and impaired cognitive functions. The development of Alzheimer's is a consequence of a set of factors, such as genetics, aging, physical inactivity, head trauma and smoking, for example.

Main symptoms: Alzheimer's symptoms develop in phases, the initial symptoms being related to difficulty finding words and making decisions, lack of attention and impaired memory, concentration, attention and reasoning. Here's how to identify Alzheimer's symptoms.

How the diagnosis is made: The diagnosis of Alzheimer's is made by assessing the symptoms presented by the patient and clinical and family history. In addition, the neurologist can request tests that allow brain changes to be identified, in addition to analysis of cerebrospinal fluid to check the accumulation of beta-amyloid proteins that occurs in Alzheimer's.

It is also recommended to perform reasoning tests, which must be done by the neurologist or geriatrician, in order to verify brain impairment. See how the Alzheimer's rapid test is done.

2. Vascular dementia

Vascular dementia is the second most common type of dementia, behind Alzheimer's, and happens when the blood supply of the brain is impaired due to cerebrovascular or cardiovascular problems, resulting in brain changes and, consequently, dementia. For this reason, the main cause of this type of dementia is stroke. Better understand what vascular dementia is, its symptoms and how to treat it.

Main symptoms: In this type of dementia there is great cognitive impairment, making it very difficult for the person to perform simple daily activities, resulting in dependence. In addition, with the progression of the disease, the person may become malnourished, be more susceptible to infections and have difficulty swallowing, for example.

How the diagnosis is made: The diagnosis of vascular dementia is made by means of neurological imaging tests, such as magnetic resonance and computed tomography, in which brain alterations are verified due to the decrease in blood supply to the brain.

3. Parkinson's dementia

Parkinson's dementia arises as Parkinson's disease worsens, being a consequence of changes that occur at the brain level, as there are changes related to the person's cognition and behavior. It is more common in people over 50 years of age and its cause is still not well established, however it is known that there is wear on regions of the brain responsible for the production of neurotransmitters.

Main symptoms: In addition to the characteristic symptoms of Parkinson's, such as tremors and muscle stiffness, there is a progressive loss of memory and alteration of reflexes due to the wear and tear of brain regions responsible for the production of neurotransmitters. See what are the first symptoms of Parkinson's.

How the diagnosis is made: The diagnosis of Parkinson's disease is made by the neurologist by means of signs and symptoms presented by the patient and by imaging tests, such as magnetic resonance imaging and computed tomography of the skull, for example. In addition, blood tests may be ordered that may exclude other diagnostic hypotheses.

4. Senile dementia

Senile dementia occurs more frequently in people over 65 years of age and is characterized by progressive and irreversible loss of intellectual functions, such as memory, reasoning and language, and is therefore one of the main causes of disability in the elderly. This type of dementia is usually the result of neurodegenerative diseases, such as Alzheimer's or Parkinson's disease, for example.

In addition, it may be the result of frequent use of some medications, such as sleeping pills, anti-depressants and muscle relaxants, for example. Learn more about senile dementia.

Main symptoms: The main symptoms related to senile dementia are disorientation, memory loss, difficulty making decisions, forgetting simple things, weight loss, urinary incontinence, difficulty driving or doing activities alone, such as shopping, cooking or showering, for example.

How the diagnosis is made: The diagnosis of this type of dementia is made through laboratory tests, to exclude other diseases, and imaging tests, such as computed tomography of the skull and magnetic resonance, for example, to assess brain functioning. In addition, the diagnosis must be made based on the patient's complete clinical history and tests to assess memory and mental status, as well as the degree of attention, concentration and communication.

5. Frontotemporal dementia

Frontotemporal dementia or DFT is a type of dementia characterized by the atrophy and loss of nerve cells in one or both the frontal and temporal lobes of the brain. The frontal lobes are responsible for regulating mood and behavior, while the temporal lobes are related to vision and speech. So, depending on where brain degeneration occurs, symptoms can vary.

Main symptoms: The main symptoms related to DFT are changes in social behavior, personality variation, changes in language, presenting a limited speech. In addition, the person may repeat phrases spoken by others several times and not remember the names of objects, only being able to describe them.

How the diagnosis is made: FTD is diagnosed by means of a psychiatric evaluation, in which behavioral changes and those related to social perception are verified. In addition, some tests may be ordered, such as brain imaging and electroencephalogram. Find out how the electroencephalogram is made.

6. Pick dementia

Pick's dementia or disease, also known as PiD, is a type of frontotemporal dementia characterized by an excess of Tau proteins in neurons called Pick cups. The excess of proteins usually happens in the frontal or temporal lobes and is one of the main causes of early memory loss, which can start from the age of 40

Main symptoms: Pick's disease has as main symptoms the decrease of the reasoning capacity, difficulty to speak, mental confusion, emotional instability and personality changes.

How the diagnosis is made: The diagnosis of Pick's disease is made through the analysis of behavioral symptoms presented by the person, which is usually done through psychological tests, in addition to imaging tests, such as magnetic resonance imaging, for example. In addition, the doctor may be asked to assess the concentration of Tau protein in fluids of the nervous system, and the collection of cerebrospinal fluid is indicated.

7. Dementia with Lewy bodies

Dementia with Lewy bodies corresponds to the involvement of specific regions of the brain due to the presence of protein structures, known as Lewy bodies, which develop within brain cells and cause their degeneration and death, resulting in dementia. This type of dementia is more common in people over 60 and can happen simultaneously with Alzheimer's disease, for example. Learn how to identify and treat dementia with Lewy bodies.

Main symptoms: People diagnosed with this type of dementia have as main symptoms loss of mental abilities, mental confusion, disorientation, hallucinations, tremors and muscle stiffness. Normally, mental changes appear first and, as there is greater brain involvement, changes in movement appear and mental confusion becomes more serious.

How the diagnosis is made: The diagnosis of dementia with Lewy bodies must be made by a neurologist through the evaluation of symptoms, clinical history of the patient and family and imaging tests, such as computed tomography or magnetic resonance, with the aim of identifying degeneration in some parts of the brain.

8. Alcohol dementia

The association between excessive consumption of alcoholic beverages and a greater predisposition to early dementia is still under study, however it is already proven that excessive consumption of alcoholic beverages interferes with memory, cognitive and behavioral capacity. This is because alcohol can have a harmful effect on nerve cells, altering their functioning and resulting in symptoms of dementia, for example.

In addition, if excessive alcohol consumption is associated with a diet low in vitamin B1, there may be irreversible brain damage. See which foods are rich in vitamin B1.

Main symptoms: Learning difficulties, personality changes, decreased social skills, difficulty in logical thinking and short-term memory changes are characteristic symptoms of dementia caused by alcohol.