For some, dementia conjures up images of difficult behavior and loss of control. Dementia is not a specific physiological or psychological disease. Rather, it is the progressive deterioration in cognitive functions due to



brain damage, leading to symptoms of dementia. In many instances, progressive deterioration in cognitive function is part of normal aging. According to a study published in The Lancet, the number of people with dementia is expected to double every two decades, reaching 8.1 million in 2040.

Symptoms of dementia can be classified as reversible or irreversible. Not all symptoms of dementia are permanent. About 10 percent of all dementia are reversible. Reversible dementia can be triggered by reactions to medication or endocrine abnormalities.

In general, irreversible dementias are degenerative and incurable. Alzheimer's or strokes can cause them. Symptoms include memory loss, cognitive confusion, and the inability to problem-solve and complete multi-step activities, such as preparing a meal or balancing a checkbook. The three most common dementia causes are Alzheimer's, vascular dementia (induced by strokes), and dementia cause by Lewey bodies. They often bring

on memory loss (normally the initial symptom of dementia). When this occurs, the individual should seek a medical evaluation to determine the cause. Proper differential diagnosis between the types of dementias requires

thorough and comprehensive mental and physical exams by a qualified specialist such as a geriatric internist, neurologist, neuropsychiatrist, or geropsychologist.

The earlier the symptoms of dementia are diagnosed, the sooner the implementation of several agents and lifestyle changes (i.e. eating a balanced diet, increased physical, social, and mental activities) can be put in place to slow down the progression of cognitive decline. The benefit is

that this will allow people with dementia a better chance at maintaining their independence and quality of life for a longer period of time. In understanding the symptoms of dementia, family members will be able to cope more effectively with their loved ones' changes in personality and functioning. For instance, it's very helpful for a family member to understand that in the middle stage of dementia, their loved ones' ability to formulate sentences and comprehend complex directions have deteriorated.

At this stage, the family member will communicate baby-step instructions that involve one action at a time. For example, teeth brushing require multiple steps, from picking up the toothbrush and putting toothpaste on the

brush to brushing one's teeth, rinsing.

Since agitation and irritability increases as dementia progresses, family members will know to speak only in a positive manner. Positive instructions and statements are made while avoiding using the word "don't" or "can't".

Negative commands are avoided, so instead of saying, "Don't go in that room", say instead, "Let's go over to the other room."