Caring for Individuals with Dementia
Unit 17 - Task 1
P1: Explain the causes of three different types of dementia
- Alzheimer's Disease
Alzheimer's disease is one of the most common forms of dementia,with 944,000 people
estimated to be living with Alzheimers in the UK currently, it is estimated that 1 in 3 people
born this year will have Alzheimers in their lifetime. Despite these statistics, demonstrating
that this is the most common type of dementia, scientists still don't fully understand the
cause. There are theories that suggest Alzheimers is caused by the loss of neurons and
connections within the brain. This loss of neurons occurs when there are buildups of
abnormal proteins in the brain. One of these proteins is called amyloid, deposits and build
ups of this from plaques around brain cells. The other of these proteins is called tau,
buildups and deposits of this are known to cause (neurofibrillary) tangles within brain cells.
Both of these buildups lead to interruptions and lesser effectiveness in the signals that are
passed within the brain and this eventually causes affected areas of the brain to shrink.
This image demonstrates the differences
between a healthy set of neurons and
one of which is affected by Alzheimer's
disease.
Alzheimer's research indicates that there are a range of risk factors that may lead to the
development of Alzheimer's disease. These are: age, family history, cardiovascular disease,
head injury or down syndrome. Age is proven to be a significant risk factor in the
development of alzheimers - a study conducted by the NHS in 2019 suggested that an
individual aged over 65 likelihood of developing alzheimers doubled every 5 years. It can
also be argued that there is a genetic/hereditary component in alzheimers - the risk of
developing it is significantly higher when a direct family member has the disease.
- Vascular Dementia
Vascular dementia is another form of dementia that is fairly common. Within the UK there
are an estimated 150,000 people living with vascular dementia. It is caused by a reduced
blood flow to the brain - when there is a reduced blood flow to the brain (whether through
blood vessels in the brain becoming narrow or becoming blocked) brain cells can begin to
,shrink and die. Some of the known causes of blood flow to the brain becoming impaired
include: smoking, unhealthy diet (high fat), head injury, repeated concussions, high blood
pressure, high cholesterol, diabetes, strokes, family history and age. Another main cause of
vascular dementia is through the hardening of the arteries supplying blood to the brain. This
is called atherosclerosis. Small vessels in the brain can become rigid, inflexible and become
twisted. This limits the brain's ability to effectively transmit signals and electrical impulses
and so areas of the brain may shrink/die. Each of these reasons explain the cause and risk
factors of vascular dementia.
This image demonstrates atherosclerosis
and how it limits the blood flow through
arteries which in turn, lead to reduced
blood flow to the brain.
- Frontotemporal Dementia
Frontotemporal dementia is far less common than other forms of dementia, this type of
dementia refers to the frontal and temporal lobes of the brain becoming affected. These
areas of the brain are responsible for emotion, behaviour and language. There are an
estimated 16,000 people in the UK living with frontotemporal dementia. It has been
researched extensively and is thought to be caused the same way Alzheimer's disease is -
through the build up of the abnormal proteins, tau and amyloid. When this builds up in nerve
cells within the brain, the death of brain cells can occur. It is possible for the death of brain
cells to affect whole areas of the brain and stop that section from functioning. In the case of
frontotemporal dementia, the whole areas of the frontal and temporal lobes become affected
and can lead to symptoms of frontotemporal dementia. Research has concluded that family
history is a huge risk factor in the development of frontotemporal dementia. It was
discovered that roughly 4 out of 10 people with this type of dementia had a direct family link
of another relative having it too. (Research conducted by Bhargava in 2020) Other risk
factors that may lead to the development of this type of dementia include head injuries,
repeated concussions, alcohol abuse, HIV, AIDS and down syndrome.
This image illustrates the
differences between an MRI scan of
an individual with a ‘healthy’ brain
and one of an individual with
frontotemporal lobe dementia.
, There are a range of types of frontotemporal dementia - the two most common types are:
frontal variant - this type affects behaviour and personality, the other is: primary progressive
aphasia - aphasia is defined as difficulty communicating, this form has two subtypes, one of
which is progressive nonfluent aphasia, which affects the ability to speak and semantic
dementia, which affects the ability to use and understand language.
P2: Explain the symptoms of three different types of dementia
- Alzheimer's Disease
Alzheimer's disease is a progressive disease, this means that over time, symptoms may
become more severe, more debilitating and more noticeable. Alzheimers typically
progressed slowly, in 3 stages - early (mild), middle (moderate) and late (severe). However,
alzheimers affects people in different ways and so not everyone will have the same
symptoms or progress through the stages the same. On average, a person with alzheimers
can live from 4-8 years after their diagnosis but in some cases can live up to 20 years. This
is because changes in the brain occur due to Alzheimer's long before any noticeable
symptoms occur, this time period in which there are changes occuring in the brain without
any symptoms is called preclinical Alzheimer's disease.
Early Stage Alzheimer's (Mild)
In early stages of dementia, an individual may be able to function independently, they may
still be able to work, drive and partake in all their usual social activities. However, this person
may feel as though he or she is struggling a little with their memory, this may include
forgetting familiar words, symptoms may not be hughley noticeable at this stage. Common
symptoms and difficulties include: remembering the right words or names, difficulty
remembering names when introduced to new/unfamiliar people, forgetting material that was
just viewed, losing or misplacing a valuable item and having increased difficulty planning or
organising things.
Middle stage Alzheimer's (moderate)
This stage of alzheimers is usually the longest and can last for many years. As the individual
progresses through this stage,they may need increasing levels of care - for example, from
living independently to living with a family member. Symptoms present within this stage of
alzheimers are more noticeable, the person may get frustrated and angry in unexpected
situations - this may present as refusing to bathe, eat or get dressed. Damage caused to
their nerve cells can also lead to difficulty for the person to express thoughts and routine
tasks without aid.
Common symptoms and difficulties include: being forgetful of personal history, experiencing
confusion as to where they are and what day it is, being withdrawn or frustrated, especially
in socially challenging situations, requiring help to choose clothes suitable for the season,
changes in sleeping patterns such as insomnia, an increased tendency to wander and
become lost and showing behavioural changes, partially compulsive/repetitive behaviour.
People in the stage of dementia can still participate in the activities they want to do, but with
some assistance.
Late stage Alzheimer’s (severe)
In this stage of dementia, symptoms are severe, individuals may lose all ability to converse,
participate in activities and ultimately, care for themselves at all. An individual may still be
able to speak some words and phrases, but that may be out of context or difficult to
understand. Symptoms of this stage may include: loss of awareness to what is going on