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Is It Confusion or Dementia?

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Your elderly parent loses the car keys, or forgets where the car is parked at the grocery store. We've all done things like this periodically, but should you be concerned? Is it momentary confusion or something more severe? Just how do you distinguish between mere confusion and dementia?

Everyone gets confused at times, particularly in this very hectic world we live in today. However, dementia is not just about experiencing occasional memory problems; it also includes impaired language and communication, as well as declines in the ability to focus and reason. If your loved one has two or more of these impairments, he or she might be showing early signs of dementia.

Dementia is a class of diseases characterized by progressive loss of mental function in the brain. Over time, the functional loss is substantial, but the time progression can vary widely from person to person, and is influenced by many factors like age and other conditions.

Memory troubles usually start off as subtle changes that evolve into short-term memory losses. Your loved one might not remember what they had for lunch, but can recall in vivid detail an event that took place 10 years ago. You should be concerned if they repeatedly lose items, are confused about why they came into a particular room, or forget their daily routine. If the elderly person really struggles with finding the right words to explain something, that is likely a warning sign as well. Inability to follow a storyline on a TV show is also a classic early sign.

Depression is an early sign of dementia; people are often described as "emotionally flat". A fairly drastic personality change, let's say from being outgoing to becoming shy can be a sign, and your loved one may begin to lose interest in activities or hobbies, and it may become difficult to get them to go do anything fun or spend time with family and friends. Early stages of dementia can be very fearful, and people usually stick to a routine and are afraid to try new experiences.

There are four main types of dementia: Alzheimer's, Lewy body, Vascular and Frontotemporal. All four types lead to memory loss, impaired judgment and reasoning, behavior and personality changes, and eventually physical decline and death.

Alzheimer's is characterized by memory loss that is disruptive to daily life. Your loved one may find it hard to work with numbers, pay bills, or follow a plan like a recipe. They will likely start having difficulty completing very familiar tasks, and may lose the perspective of time and have trouble judging distances, which is particularly an issue with driving. They'll struggle with language too--calling items by the wrong name, have trouble following a conversation, or forget how to continue a conversation. They might have poor judgment and have trouble retracing their steps when they lose something.

Alzheimer's declines progressively, and also can include personality and behavior changes, as well as trouble speaking or swallowing.

Vascular dementia is caused by changes in the blood flow to the brain, and can have a slow or a rapid onset. Symptoms are similar to Alzheimer's symptoms, and screening tests and a CT scan or MRI to look at brain blood flow can help with the diagnosis.

Lewy body dementia usually has less severe and drastic memory issues than both vascular and Alzheimer's dementia. It is caused by abnormal protein deposits in the brain; alpha-synuclein proteins call Lewy bodies lodge in regions of the brain. People who suffer from Lewy body dementia often have visual hallucinations, and sometimes have rigid or shuffling movements seen with Parkinson's disease.

The final type of dementia is called frontotemporal lobe dementia, and is caused by shrinkage of both the frontal and temporal lobes of the brain. The shrinkage affects the brain's function, and can run in families, usually seen between the ages of 35 and 75. Problems with behaviour and language are usually the first issues that are noticeable, and people often exhibit socially inappropriate behavior.

No matter the type of dementia, there are three stages to the disease:

Mild dementia is characterised by people forgetting words and names, and having trouble learning new information. Planning and doing complicated activities like driving may become impaired.

Moderate dementia has more serious flaws in judgment and greatly defined physical functioning. Wandering and personal hygiene may become issues at this stage. The person can still physically "get around" ok but likely will show serious issues in judgment.

Cases of severe dementia are marked by extensive memory loss and very limited mobility. Swallowing and bladder and bowel control often becomes an issue. People in this stage often have difficulty recognising familiar people, and usually require round-the-clock care.

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