Dementia is one of the most common mental health diagnoses among older adults. At The Pavilion in Williamsburg, Virginia, we treat seniors with mental health conditions. We want their families to understand how dementia presents and how to help their loved ones maintain the best possible quality of life.

What is Dementia?

Dementia is a broad category that refers to:

• Impaired thought
• Memory issues
• Difficulty with decision making

There are several more specific conditions that fall under the umbrella of dementia, the most common and well-known of which is Alzheimer’s. Causes of Dementia

Dementia is caused by nerve cells in the brain not working as they should and dying off. Researchers aren’t sure why this happens in certain people and not others, though genetic variants have been found to cause certain types of dementia.

How Common is Dementia?

In 2014 it was estimated that around 7 million adults over the age of 65 had some form of dementia. By 2060, that number is expected to double. Around a third of people over 85 experience dementia. Although dementia mostly impacts older adults, it is important to realize that it is not simply a normal part of aging. Many people live to be 90 or older without ever developing dementia.

What Normal Aging Looks Like

Our bodies aren’t the only thing that shows our age. It is normal for older adults to have some memory changes as well. Normal changes in memory might look like:

• Occasionally misplacing car keys
• Having a hard time finding the word they want to use but remembering it later
• Forgetting the name of someone who is only an acquaintance
• Retaining old memories and language, even if they forget something more recent

Red Flags for Dementia

Changes that are not normal and should be cause for concern might include the following examples:

• Getting lost in a familiar neighborhood
• Using incorrect words for an object without realizing and correcting their word choice
• Forgetting the names of loved ones
• Not being able to complete tasks they could previously do independently, like paying bills and handling money responsibly
• Forgetting old memories
• Personality changes
• Hallucinations, delusions, or paranoia

These types of struggles could signal that the person is having an atypical amount of difficulty with one or more of the following:

• Memory
• Attention
• Communication
• Reasoning
• Judgment
• Problem-solving
• Visual perception

Risk Factors for Dementia

Age isn’t the only thing that can increase a person’s risk of developing dementia. Some of the other factors that can contribute include:

• Family history – having a sibling or parent with dementia increases risk.
• Race/ethnicity – African Americans are more likely than Hispanics, who are more likely than white individuals, to develop dementia.
• An unhealthy heart– High blood pressure, high cholesterol, and smoking all take a toll on the heart and have been linked to heightened dementia risk.
• History of traumatic brain injury – people who have experienced a brain injury in early or midlife are 2-4 times more likely to develop dementia later in life. This phenomenon is often seen in professional athletes who experience numerous concussions and then go on to develop chronic traumatic encephalopathy (CTE), a type of dementia associated with TBIs. Sports that often cause brain injuries include professional football, soccer, hockey, and boxing.

Ruling Out Other Causes

Just because someone is exhibiting signs that could be dementia does not mean that this is what is causing their symptoms. If you see an older adult who is struggling with issues that look like dementia, it is important that they see their doctor to rule out other causes of their issues. A variety of conditions can lead to symptoms similar to dementia but can be treated far more effectively. These conditions may require entirely different treatment from dementia, so ensuring an accurate diagnosis is crucial to maximizing recovery. 

Some of the conditions that can have symptoms that overlap with dementia are:

• An abnormal build-up of cerebrospinal fluid in the brain
• Alcohol use disorder
• Mental health diagnoses like anxiety or depression
• Tumors
• Vitamin deficiencies
• Side effects from medications
• Thyroid, liver, or kidney problems

How Dementia is Diagnosed

Because other issues can cause symptoms similar to dementia, the first step in ensuring an accurate diagnosis is for the individual to see their medical doctor. A physical exam, review of personal and family medical history, and blood tests may uncover other causes. Cognitive and neurological tests, brain scans, and psychiatric evaluations may also be used to confirm or deny various reasons for their struggles.

At The Pavilion, we want all of our patients to live the healthiest, fullest lives possible. We are here to offer support to seniors and their families as they manage their mental health journey.