Decoding Dementia

January 10, 2012

There are few ailments as mentally exhausting and frustrating for family members and loved ones as dementia. Finding answers and effective treatments can be more of a marathon than a race, and requires enormous amounts of patience and compassion. Read on for helpful insights into this devastating condition from Floyd Memorial’s resident experts; board certified Neurologist/Sleep Specialist Satish Rao, MD, MS, and Psychiatric Home Health Nurse Debbie Crawley, RN.

Does Memory Loss = Dementia?

Talking Homecare

“The number one misconception I hear is that memory loss automatically equals dementia,” explained Dr. Rao. “Memory loss, to an extent, is a normal part of aging. It’s also a common symptom of several other conditions, such as mood disorders, vitamin deficiencies, severe obstructive sleep apnea and even thyroid disorders. My challenge as a neurologist is to tease out all of the patient’s symptoms and their possible causes, so that I can confidently recommend an appropriate course of treatment for their condition.”

Memory Loss & Mood Disorders

Dr. Rao continued, “One of the most common non-dementia causes of memory loss is a mood disorder, particularly severe depression. We call this ‘pseudo dementia’ because the person is so internally focused and controlled by their (depression) disorder that they cease to attend to the outside world, causing their brain to stop recording memories. Because of this, loved ones will often think the condition has evolved into dementia. However, when a mood disorder is suspected, an in-depth test known as neuropsychometric screening can be performed to determine the true cause of the patient’s symptoms. This resource is available locally at the Southern Indiana Rehab Hospital in New Albany, and can be ordered by a primary care physician or a specialist such as myself.”

Memory Loss & Obstructive Sleep Apnea

Severe, untreated Obstructive Sleep Apnea (OSA), a sleep disorder causing breathing to temporarily stop during sleep, can lower the level of oxygen in the blood. When that happens, the brain awakens the body in order to reopen the airway. This may happen hundreds of times throughout the night, causing sufferers to never get the deep sleep their body needs. Dr. Rao elaborated, “This severe sleep deprivation then affects the patient’s ability to sequence their day in a normal pattern and make simple connections. The result is often very similar to dementia, but thankfully, OSA is very easily diagnosed with a simple sleep study, and can be reversed with consistent treatment.”

Satish Rao
“Memory loss, to an extent, is a normal part of aging. My job is to determine if what the patient is experiencing is normal, if there is another underlying problem such as depression or sleep apnea that can be treated or if the patient is experiencing a true dementia disorder that can be delayed by administering drug therapies.”

Satish Rao, MD, MS

Board Certified Neurologist/Sleep Specialist
Floyd Memorial Medical Group-Neurology
Debbie Crawley
“I find that patients, especially those suffering from dementia, can be uncomfortable with the idea of psychiatric services. Therefore, I approach my patients as a medical nurse first by checking their blood pressure and other vitals, giving them a chance to get comfortable with me before addressing their psychiatric needs.”
Debbie Crawley, RN
Psychiatric Home Health Nurse
Floyd Memorial Home Health Care

Common Types of Dementia

Dementia can be categorized into three common categories; Alzheimer’s disease, Lewy Body disease and vascular dementia. A common and unfortunate theme among these conditions is that there is no known cure. However, the field of dementia studies is constantly growing, particularly with the United States’ aging baby boomer population, so advancements and discoveries are happening very frequently.

Alzheimer’s Disease

In the Park“Alzheimer’s disease is the most common type of dementia,” explained Dr. Rao. “But it’s important for loved ones to understand that this condition can only be truly confirmed in post-mortem evaluation of brain tissue, meaning that clinical evaluation of symptoms is all we have for diagnosis, so it is not an exact science. While there is no cure, drug therapies administered early in the disease process can prolong mental decline significantly, so it’s important to consult with your primary care physician immediately once symptoms appear.”

The 10 Warning Signs of Alzheimer’s Disease

  1. Memory changes that disrupt daily life
  2. Challenges in planning or solving problems
  3. Difficulty completing familiar tasks at home, at work or at leisure
  4. Confusion with time and place
  5. Trouble understanding visual images and spatial relationships
  6. New problems with words in speaking or writing
  7. Misplacing things and losing the ability to retrace steps
  8. Decreased or poor judgment
  9. Withdrawal from work or social activities
  10. Changes in mood and personality

Vascular Dementia

Vascular dementia is the second most common form of dementia. It is not a single disease; but is instead a group of syndromes resulting from poor overall vascular health, including high blood pressure over a prolonged period of time, diabetes, cardiovascular disease and smoking, among others. It is often characterized by a step-by-step loss in functioning resulting from multiple strokes, where the patient’s mental status suddenly goes down hill after each stroke. As Dr. Rao stressed, “Vascular dementia is preventable, so early detection and treatment is critical. If you have been diagnosed with a vascular condition, it’s important that you address it immediately in order to prevent permanent damage to the blood vessels and tissues of the brain.”

Lewy Body Disease

Dr. Rao explained the medical basis of dementia caused by Lewy Body Disease (LBD). “LBD is a form of dementia that shares many characteristics with Parkinson’s disease and Alzheimer’s disease. It is especially challenging to diagnose correctly, and like Alzheimer’s disease, can only be diagnosed clinically based on symptoms. Lewy bodies are abnormal protein deposits in the brain that slowly cause cell death, resulting in a decreased ability to comprehend ideas or thoughts, like Alzheimer’s Disease, and decreased motor control, similar to Parkinson’s disease. Symptoms include mental decline, hallucinations while awake as well as during sleep; including acting out of dreams, depression, fluctuating consciousness and difficulty handling the tasks of daily life. Like Alzheimer’s, drug therapies administered early in the disease process can provide potential relief, so it’s important to consult your physician immediately after noticing symptoms.”

Could You or Your Loved One Benefit from Home Health Care Services?

Home Health Care services require a physician referral. If you feel that you or your loved one could benefit from any of the services listed below, speak to your physician about a referral to Floyd Memorial’s Home Health Care Services.

Rehabilitation services, including:

  • Physical therapy
  • Occupational therapy
  • Speech therapy

Home health aid services, including:

  • Bathing assistance
  • Meal preparation
  • Housekeeping services
  • Various other personal care activities

Psychiatric nursing services from CMS-certified registered psychiatric nurses, including:

  • Medication monitoring
  • Screening for anxiety and depression
  • Community resourcemanagement
  • Caregiver education