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What is dementia?

What is dementia?Dementia describes a group of symptoms that affect memory, thinking and social skills. Dementia is not a single disease.

On the contrary, there are many types. Alzheimer's dementia, the most common type, is responsible for about 60% to 80% of all dementias. Vascular dementia, which occurs as a result of a stroke, is the second most common type of dementia. 
As a word meaning, dementia is derived from the Latin word mens, meaning mind. Dementia, on the other hand, means the loss of the mind. However, dementias, especially Alzheimer's dementia, do not occur at once, the symptoms appear gradually and are progressive. Some dementias, on the other hand, occur due to a lack of a substance in the body or a side effect of a substance or drug. This type of dementia is usually not progressive and has a return.
Why does dementia occur?
The brain has many different regions, each of which is responsible for different functions (memory, judgment and movement, for example). When cells in a certain area are damaged, that area cannot perform its normal functions.
Dementia disease is caused by damage to brain cells. This damage inhibits the ability of brain cells to communicate with each other. When brain cells are unable to communicate normally, thinking, behavior, and emotions can be affected.
Different types of dementia are associated with certain types of brain cell damage in certain areas of the brain. For example, in Alzheimer's disease, high levels of certain proteins inside and outside brain cells make it difficult for brain cells to stay healthy and communicate with each other. The brain region called the hippocampus is the center of learning and memory in the brain, and brain cells in this region are often the first to be damaged in Alzheimer's disease. That's why memory loss is often one of the first symptoms of Alzheimer's.

What are the types of dementia?
Progressive (progressive) dementias can be listed as follows:
* Alzheimer's Disease: Although not all the causes of Alzheimer's disease are known, experts know that a small percentage of them are associated with mutations of three genes that can be passed from parent to child. While several different genes are likely involved in Alzheimer's disease, an important gene that increases the risk is apolipoprotein E4 (APOE). In patients with Alzheimer's disease, protein clumps called beta amyloid plaques and fibrous structures consisting of tau protein accumulate in their brains. These clumps are thought to damage healthy neurons and the fibers that connect them.
 Vascular Dementia: This second most common type of dementia is caused by damage to the vessels that supply blood to your brain. The most common symptoms of vascular dementia include difficulties with problem solving, slow thinking, difficulty focusing and organization. These tend to be more pronounced than memory loss.
* Lewy Body Dementia: Lewy bodies are abnormal balloon-shaped protein stacks found in the brain. Common signs and symptoms include; moving while dreaming during sleep, seeing things that don't exist (visual hallucinations), focus and attention problems.
* Frontotemporal Dementia: This disease is a group of diseases caused by the breakdown (degeneration) of nerve cells in the frontal and temporal lobes of the brain, in which areas related to personality, behavior and language are generally involved. Common symptoms are behavior and personality change, impaired thinking, judgment, language and movement.
* Mixed dementia: Autopsy studies of brains aged 80 years and older with dementia show that many factors can coexist, such as Alzheimer's disease, vascular dementia, and Lewy body dementia. Studies are ongoing to determine how mixed dementia affects symptoms and treatments.

What is the frequency of dementia?
According to the World Health Organization (WHO) data; There are about 50 million dementia patients worldwide, 60% of whom live in low- and middle-income countries. There are about 10 million new cases of dementia every year. With the aging of society, it is estimated that the total number of dementia patients will reach 82 million in 2030 and 152 million in 2050.
What are the symptoms of dementia?
The most obvious symptom of dementia is the forgetting of newly received information. In addition, in order for a person to be considered a dementia patient, impairment of at least two of the following functions must be observed:
* Communication and language,
* Ability to focus and pay attention,
* Reasoning and judgment,
* Visual perception.
If you observe memory problems in yourself or someone close to you, or a disorder in the above-mentioned thinking skills, you need to see a specialist as soon as possible to determine the cause. Although the symptoms indicate an irreversible dementia; early diagnosis allows a person to make the most of the available treatments. It also gives you time to plan for the future.

What are the symptoms of dementia by stages?
The symptoms of dementia can be classified into early stage middle stage and late (final) stage.
Early stage: The early stage of dementia is often overlooked because it Decays very slowly. Common symptoms are as follows:
* forgetfulness,
* not being able to keep track of time,
* getting lost in familiar places.
Intermediate stage: As dementia progresses to the intermediate stage, the signs and symptoms become more pronounced and restrictive. These symptoms are
* forgetting recent events and people's names,
* getting lost at home,
* experiencing increasing difficulties with communication,
* need help with personal care,
* it can be listed as experiencing behavioral changes, including navigation and repetitive questioning.
Late stage: The late stage of dementia is close to total dependence and immobility. Memory disorders are serious, and physical signs and symptoms become more pronounced. Symptoms include:
* being unaware of time and space,
* having difficulty recognizing relatives and friends,
* not being able to do personal care without help,
* difficulty walking,
* experiencing behavioral changes that can increase aggression.

How is dementia diagnosed?
There is no specific test for the diagnosis of dementia. Your doctor may apply a test with questions to you after a detailed clinical examination. If he suspects other diseases, he may order a blood test or brain imaging tests. 

Is there a cure for dementia?
Most types of progressive dementia are incurable, but there are a number of ways to manage the signs and symptoms.

The following are used to temporarily improve the symptoms of dementia.
* Cholinesterase inhibitors: A number of drugs, such as donepezil, rivastigmine, or galantamine, work by increasing the levels of certain chemical messengers that are active in the memory and decision-making process. Although primarily used to treat Alzheimer's disease, these drugs can also be given to other dementias such as vascular dementia, Parkinson's disease dementia and Lewy body dementia. Side effects can be nausea, vomiting and diarrhea. Other possible side effects include a Decelerated heartbeat, fainting, and sleep disturbances.
* Memantine: Works by regulating the activity of glutamate, another chemical messenger involved in brain functions such as learning and memory. In some cases, memantine is prescribed with a cholinesterase inhibitor.
* Other medications: Your doctor may prescribe medications to treat other symptoms or conditions, such as depression, sleep disorders, hallucinations, parkinsonism, or agitation.

* You can get help from a specialist to learn how to make your home safer and cope with changing behavior. The goal is to prevent accidents such as falls, manage behaviors and prepare you for the progression of dementia.
* Landscaping: Reducing clutter and noise makes it easier for dementia patients to focus and work. Objects that may threaten security, such as knives and car keys, may need to be hidden.
* Simplification of tasks: You need to divide tasks into easier steps and focus on success, not failure.

Can dementia be prevented?
There is no sure way to prevent dementia, but some changes in living standards can delay the onset of dementia or slow its progression.
* Keep your mind active: Mentally stimulating activities such as reading, solving puzzles, and playing word games can delay the onset of dementia and reduce its effects.
* Be physically and socially active: Physical activity and social interaction can delay the onset of dementia and reduce its symptoms. Move more and aim for 150 minutes of exercise a week.
* Quit smoking: Some studies have shown that smoking in middle age and older can increase your risk of dementia and blood vessel (vascular) diseases. Quitting smoking can reduce these risks.
* Get enough vitamins: Some studies show that people with low levels of vitamin D in their blood are more likely to develop Alzheimer's disease and other types of dementia. Vitamin D can be obtained through certain foods, supplements, and sun exposure. Although there are not enough studies on this subject, making sure you get enough vitamin D is a good choice for other health reasons. It may also be useful to take a daily intake of B complex and vitamin C.
* Manage cardiovascular risk factors: Controlling factors such as high blood pressure, high cholesterol, diabetes, and high body mass index (BMI) is important to lower some dementia risks.
* Get other health conditions treated: If you have hearing loss, depression, or anxiety disorders, consult a doctor to treat these problems.

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