Several studies have been conducted to investigate the link between dementia and multiple sclerosis.
Dementia is not a specific disease but a group of conditions that are characterized by impairment of various brain functions like judgment and memory loss amongst others.
Multiple Sclerosis (MS) can be described as a neurological condition where the immune system attacks the human body. This leads to a process known as demyelination.
Note that nerve cells are covered in myelin which is a fatty protective coating.
This allows messages to travel faster between the brain and nerve endings. Myelin sheath found on the nerve cells is damaged when demyelination happens.
This can cause damage to the nerve cells leading to a wide range of mental and physical symptoms. Sclerosis stands for lesions or scars that appear in the white matter section of the brain.
Comparison of Dementia and Multiple Sclerosis
MS affects individuals in different ways. Some will experience loss of coordination, weakness, paralysis, and neuropathic pain.
Cognition is how well memory works and the ability to think things through. It is also about how people maintain attention, focus, remember new things, learn, solve problems, use and understand language, reason, and carry out activities, etc.
Based on various studies with statistics varying depending on the type of study, experts estimate that about 40-60% of persons with MS experience cognitive impairment.
Another difference between dementia and multiple sclerosis is the age of diagnosis.
With dementia, many people will get the disease when they are older. This is different from MS because it mostly affects younger people.
Differences between Dementia and Multiple Sclerosis
One of the major differences between the two illnesses is the fact that brain damage in dementia is different from that of multiple sclerosis.
While some people with MS may showcase cognitive problems like slowed thinking, poor focus, and fuzzy memory, the symptoms are normally mild and do not affect daily life.
With dementia, everyone with the illness will have problems with their day-to-day lives.
Also, as the disease progresses, they may have to be fully dependent on caregivers for activities of daily life.
In most cases, multiple sclerosis will not hurt long-term memory or a person’s intelligence.
Experts also agree that MS does not majorly affect the ability to read or carry conversations. These are things that dementia changes.
Similarities between Dementia and Multiple Sclerosis
In the beginning, they may have trouble understanding what people are saying.
They may also have a hard time using the right words to complete sentences; thus, making it hard to have conversations with others.
This also happens to people who have multiple sclerosis especially the ones who develop cognitive issues like blurred thinking.
This is where they will have challenges with finding the right words to say. They may also forget tasks they have already done or the things they need to do.
A high percentage also struggle to set priorities or plan ahead.
Many will likewise have challenges with concentrating especially when two things are happening at the same time.
Some people with MS may also experience emotional problems such as personality changes and mood swings which is common with persons with dementia.
Closing Thoughts
There is little known information about the coexistence of multiple sclerosis with other diseases of aging like dementia.
More research needs to be done in regards to the link between dementia and multiple sclerosis.
Anyone who has dementia and they suspect they have cognitive impairment should consult their doctor as soon as possible so that the professional can identify the best treatment options.
It can be described as a sleeping disorder that causes people to have trouble falling or staying asleep.
The condition can come and go and it can also be chronic or acute.
Acute or short-term insomnia lasts from a single night to a few weeks.
Long-term or chronic insomnia can go on for a minimum of three nights every week to three months or more.
Managing Dementia and Insomnia
Lack of proper sleep often leads to reduced functioning during the day and can also lead to increased health problems that may reduce the quality of life.
This not only causes strain on ill individuals but caregivers as well. It is not uncommon for persons with dementia to experience early institutionalization because of insomnia.
When caring for a person who has dementia and is experiencing insomnia as well, there are a few tips you can use to manage sleep problems, which we cover in detail below.
Treating Any Underlying Conditions
A person with dementia can experience sleep problems because of some untreated ailments or pain.
Some medical conditions like sleep apnea, depression, or restless leg syndrome can be the cause of sleep issues.
Visiting a doctor as soon as you spot the signs of insomnia can help treat such conditions or alleviate pain to help individuals with dementia enjoy a good night’s sleep.
If you want to know whether a person has sleep apnea, you can watch them as they sleep.
Most people with this condition will stop breathing momentarily because it causes them to pause while breathing.
An individual with restless leg syndrome will twitch or move their legs uncontrollably. Some individuals may experience burning, tingling, or fizzing sensations in the legs.
Avoid Over-Sleeping During the Day
One of the reasons why a person with dementia may not sleep well at night is because they sleep too much during the day making it hard to get some shut-eye at night.
For this reason, it is important to ensure that the individual with the neurodegenerative disease does not spend most of their days sleeping.
While it is okay for a person to take short naps during the day, they should not end up sleeping for hours.
These should only last 30 minutes to an hour.
This means that you have to come up with fun and engaging stuff for the suffering person.
Encouraging physical activity is also important as this promotes better sleep thanks to a better flow of blood in the body.
It will keep them occupied during the day so that they do not resort to sleeping even when they do not have to.
Keeping a person busy during the day also means that they will be tired by the time the sunsets.
This is something that can help them fall asleep faster because their bodies will be craving some relaxation.
Stay Away from Stimulants before Bedtime
Nicotine, caffeine, and alcohol are some of the things that can interfere with sleep.
To manage dementia and insomnia, limit or completely avoid these substances when a person is about to retire to bed.
Effects of caffeine can last many hours; thus, end up interfering with sleep. This substance can lead to frequent awakenings, or challenges initiating sleep.
Although alcohol can offer a sedative effect after a few hours of consumption, it is not advisable to take it at night because it often results in arousals as well as a non-restful night’s sleep.
It is also recommended that you keep away from stimulates during those wakefulness periods at night.
These include things such as engaging in conversations, reading books, or keeping the TV or radio on.
Using Light Therapy
Many people agree that exposure to light therapy especially during the daytime can help maintain the circadian rhythm.
The main source of this light is ideally the sun.
Take the person with dementia outside, and when the sun sets, the body will know that time for sleeping is around the corner.
If the sun is not an option, you can use some special lamps that are designed to emulate light from the sun.
Several studies reveal that light therapy is most beneficial for people with mild to moderate dementia.
Creating an Ideal Sleeping Environment
A person’s sleeping area can end up affecting the quality of sleep.
You want to make sure that the person with dementia and insomnia gets a comfortable place to sleep every night.
Some of the things that can help with the creation of a great sleeping place include:
Where possible, make sure that the individual with dementia only uses their bedroom to sleep or for intimacy. They should move from the room when they wake and not have any meals there. This way, they will associate the specific room with sleeping.
At night the bedroom should remain quiet and relatively dark. Blackout curtains are a great option for eliminating disturbances coming from outside. Persons who insist on sleeping with lights can use low levels ones. If there is noise from the surrounding areas, white noise can help with masking it out. Some experts state that using lights with violet colors helps to induce drowsiness.
The temperatures inside the bedroom also need to remain at comfortable levels.
Beds should be well made and comfortable. Remember to change sheets, pillows, and comforters. You can also invest in special pillows and mattress pads that work for the specific sleeper.
Keeping the room safe may also help. You can re-enforce safety by using the appropriate window and door locks. Motion detectors and door sensors can also be used to alert caregivers when a person starts wandering.
You can consider placing a clock next to the bed that shows a person whether it is day or night.
A person with dementia can try and take a hot shower or bath before bedtime. For some people taking warm milk or cuddling with their favorite soft toy can help with relaxing before sleeping.
Create and Maintain Schedules
Regular routines can help people with dementia sleep better.
Encourage the individual with dementia and insomnia to go to bed and wake up around the same time every day.
A consistent sleep schedule can enhance circadian rhythm to help persons with dementia not only sleep faster but also have better quality sleep.
It can also help to maintain regular meal schedules.
Take Steps towards Reducing Stress
People with dementia are likely to experience stress that can make them suffer from insomnia.
As a caregiver, you can try the following tips to help the person with the neurodegenerative illness reduce stress and probably sleep better.
Let the weak person enjoy some alone time as they engage in the things they love to have a bit of fun and forget about their troubles for a while.
It can be anything from doing hobbies like knitting, playing music, watching movies, and so forth.
They can also socialize with their loved ones as they catch up and make each other laugh one of the best ways to relieve stress.
Help the person talk about their expectations. If some are unrealistic, find a soothing way to tell them that they have to accept that some things cannot be changed.
Although the person may shy away from support, try and give them as much as you can without forcing it so that you can reduce and finally eliminate the harmful effects of stress on the body and mind.
When it comes to mealtimes, make sure that persons with the illness do not take heavy meals and processed foods just before bedtime.
If possible they should take their last meals at 6:00 PM. Anything a person eats after this should be low in carbs and sugar.
Experts state that eating some foods around bedtime can help induce sleep.
For instance, calcium is known to help in the production of a natural hormone called melatonin that is responsible for inducing sleepiness.
This means that a person can have a glass of milk before they go to bed.
Oatmeal is another option to consider.
Using Medicine
Most of the time, it is recommended that you try and use natural therapies when dealing with dementia and insomnia. Sadly, this may not work for everyone.
In such cases, it is important to consult a doctor who can prescribe drugs that can help with insomnia.
Sedatives, sleeping pills, and tranquilizers are examples of medications that a person can take to help with the situation.
Some doctors may even recommend the use of sleep aids that come with some kind of sedating antihistamine.
Keep in mind that there are some drugs a person may be taking that could be responsible for sleep problems.
The doctor should replace these as soon as possible with alternatives that will not negatively affect a person’s sleep.
It is essential to understand what dementia risk factors are the most common and what to do about them.
Everyone should carefully review them, as they can help with improving your overall life and health and possibly avoid or postpone the deadly disease.
Dementia Risk Factors and Prevention
WHO (World Health Organization) estimates worldwide, 50 million people have dementia and there are approximately 10 million new cases diagnosed each year.
With such a staggering statistic, understanding the risk factors and becoming educated may lower your chances of developing the condition.
What is Dementia Exactly?
Dementia is an umbrella term used to categorize certain symptoms associated with abnormal brain changes such as memory loss and poor judgment.
The condition itself is not reversible and there is not yet a cure.
It is important to clarify dementia is a serious condition, and not a disease of senility or considered to be a normal part of aging.
The causes are related to damaged brain cells that impair cognitive function impacting the ability to perform daily activities such as:
There isn’t a single test administered to diagnose dementia. Rather, a clinical assessment is made to determine the ability to perform cognitive skills needed for independent living.
Types of Dementia
Alzheimer’s Disease is the most common form of dementia and makes up about 60-80% of all cases. progressive brain disease that affects approximately 5.2 Americans and the most common cause of dementia.
Vascular Dementia is the second most common and is also referred to as multi-infarct dementia. It is defined as brain damage caused by multiple strokes (blocked blood vessels which deprive the brain of oxygen). This type of dementia falls into a subcategory of brain diseases called FTLD or Frontotemporal Lobar Degeneration.
Mixed Dementia is usually diagnosed at death. It occurs when there are multiple causes impairing brain function. At autopsy, the biomarkers typically reveal blocked blood vessels and a buildup of tau protein thereby confirming dementia as a diagnosis.
Dementia Risk Factors Explained
Alcohol
Medical experts state that excessive alcohol consumption over a long period of time can lead to a host of chronic health conditions including dementia.
Several studies have examined how alcohol impacts brain health.
A study in 2018 discovered alcohol holds potential to inhibits the body’s natural ability to clear amyloid plaque in the brain.
This explains excessive alcohol consumption as a potential risk factor for dementia.
Depression and Isolation
A major study conducted at Florida State University confirmed loneliness as one of the risk factors for dementia. They compiled data over a period of 10 years from approximately 12,000 participants.
The study results cited a 40% increase for risk for dementia as a direct effect of loneliness and depression.
Diabetes
Type 2 Diabetes poses serious vascular-related health risks, including dementia. Diabetes damages the blood vessels and causes nerve cell death which leads to further degenerative conditions.
Furthermore, research has concluded that Alzheimer’s patients don’t use glucose properly.
The receptors that communicate how to use insulin fail thus complicating blood sugar management. The lack of oxygen also creates a challenge for effective cell communication.
Obesity
Research has concluded that being “fat” is a big risk factor associated with dementia.
Adipose (fat) tissues have the potential to cause narrowing within the arteries leading to heart attack or stroke.
Additionally, it can affect the way oxygen is used and transported to important areas of the brain causing irreversible damage.
Smoking
Smoking directly affects vascular health. This translates to challenges in blood pressure, heart function, and breathing, increasing the risk for stroke or heart attack.
The relationship between stroke as a vascular dementia risk factor is very high due to the lack of oxygen to the brain.
The lack of oxygen to the brain creates unseen damage affecting logical thought, memory, judgment, and behavior.
Researchers conclude dementia is worsened by the loss of hearing. They also indicate in some cases; hearing loss is misdiagnosed as dementia.
Studies also cite the risk for developing dementia doubles in individuals with minor hearing loss, and triples in those with moderate loss.
Sleep Apnea
Research has shown that irregular breathing patterns seen in sleep apnea patients can cause a buildup of beta-amyloid plaques. These disease-related proteins are the major biomarkers represented in Alzheimer’s cases.
NIH has specified untreated Obstructive Sleep Apnea or OSA as a risk factor for dementia due to compromised oxygen intake and stress on the body.
Sitting for Long Periods of Time
Medical experts agree have always known the lack of physical activity can lead to many health complications.
Engaging in a consistent exercise regimen tops the list of things you can do to avoid the risk of dementia.
A clinical study conducted at UCLA concluded that sitting for long periods of time reduces the thickness in certain areas of the brain that forms new memories.
Enjoy time with friends and family. Socialize and keep your brain active with stimulating activities such as board games, cards, or reading. A study indicates the risk of board game players is 15% less than that of non-board players.
Manage your weight and stay within the recommended guidelines for blood pressure, BMI, cholesterol, and blood sugars.
Get treatment for any sleep disorders, if necessary. There are many modern treatment solutions available for sleep apnea.
If you are showing signs of depression, please reach out to a medical professional for treatment.
Conclusion
Healthcare management cites dementia as a leading cause of disability and care dependence.
Additionally, the projections for dementia cases worldwide are slated to be at 131 million affected persons by the year 2050.
With an ever-pressing need for answers, the research community is committed to finding improved treatment solutions for Alzheimer’s Disease and other dementia-related conditions.
Clinical study participation and improved technology assist scientists to better understand the complex actions of the brain.
They also serve to develop new drug therapies and to identify new possible risk factors associated with dementia.
There are a variety of ways doctors can test cognitive function in a person with dementia.
Often, a patient or a family member has picked up on clues that there is a problem with cognition.
However, are there ways to formally and objectively assess this?
The answer is, yes; there are a host of cognitive tests for dementia that range from simple bedside tests that take a few minutes to perform to in-depth neuropsychiatric testing that can take a few hours.
While imaging of the brain (MRI, CT, PET) can provide insights into brain structure and some types of brain imaging can even show metabolic and blood flow function, cognitive tests directly observe performance in certain domains and remain essential in the diagnosis of dementia.
In this article, we will describe what these tests are and how they affect the diagnosis and testing for dementia.
What Type of Doctor does Tests for Dementia?
These tests can be done by a primary care doctor or internist; often times they are also done by neurologists and psychologists.
Sometimes they are done to diagnose dementia; they can also be used to track dementia over time.
Types of Tests for Dementia
The first type of tests are called mental status scales.
These are short (<15 minutes) bedside tests administered by the doctor that assess memory and other cognitive domains.
They provide a score, which is used to distinguish people with normal vs. impaired cognition and even screen for mild cognitive impairment (MCI).
Examples of the most widely used include the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE).
These are screening tests, meaning they are not diagnostic of any particular dementia or diagnosis, but when abnormal definitely can hint that cognition is impaired.
Moreover, these tests can be repeated over time to track the progression of the disease as well.
These tests assess memory, language, executive function, visuospatial skills, and attention/concentration.
MMSE test
The MMSE is scored on a 30 point scale. Specific items include orientation (10 points), memory (6 points), attention/concentration (5 points), language (8 points), and visuospatial function (1 point). A score of <23 is abnormal and indicates cognitive impairment.
It assesses delayed word recall/memory (5 points), visuospatial function (7 points, includes clock-drawing), language (6 points), attention/concentration (6 points), and orientation (6 points). A score of <25 is abnormal and indicates significant cognitive impairment.
Another similar test is the Saint Louis University Mental Status Examination (SLUMS) which is scored similarly.
All three of these tests are widely available and free to use.
Alternative shorter tests
There are several shorter tests (<5 minutes) that are frequently used in busy primary care settings as a screener for cognitive impairment.
A famous one is the clock drawing test (CDT) where the patient is asked to draw a clock and set the hands to a specific time.
This quickly and efficiently tests visuospatial abilities, executive function, motor execution, attention, language comprehension and numerical knowledge.
The CDT is interpreted as normal or abnormal.
Another popular test is the Mini-Cog, which includes remembering three unrelated words told to the patient in addition to the clock drawing test.
There are more in-depth cognitive tests that take longer (>15 minutes) and these include the Consortium to Establish a Registry for Alzheimer’s Disease Neuropsychological Battery (CERAD-NP).
This takes about 30 minutes to administer, and can specifically identify cognitive deficits characteristic of mild Alzheimer’s dementia.
Another test, called the Addenbrooke’s Cognitive Examination (ACE), is also specifically designed for Alzheimer’s dementia and tracking progress.
Neuropsychological testing
Lastly, there is formal neuropsychological or neuropsychiatric testing which is very in-depth and is useful in patients who meet criteria for mild cognitive impairment (MCI) or patients who score normally on the basic screening tests above but still have subtle or persistent cognitive symptoms.
This is not useful in advanced dementia.
After all, the testing requires the patient to be able to participate in complex tasks and questioning.
Neuropsychological testing can take up to six hours to complete and is not always required as part of a dementia evaluation.
It can be useful when tracking mild cognitive impairment over time to see if a patient is worsening or improving, before actually reaching the cognitive impairment threshold for dementia.
For the most part, the short tests are easy to access and are available online both to the general public and to doctors.
Most primary doctors are familiar with the MMSE and MOCA and may even perform them in their daily practice.
The formal, longer tests such as formal neuropsychological testing require a referral from your doctor to a center that performs such tests.
After these examinations, the doctor performing the tests will be able to interpret the results and categorize them into either “normal” or “abnormal” results.
Within “abnormal” results the doctor can distinguish whether dementia is mild, moderate, or severe. With certain tests, the different subtypes of dementia can be discovered as well (Alzheimer’s vs other types).
Closing Thoughts
In conclusion, there are many facets towards a diagnosis of dementia; aside from history taking, physical examination, and brain imaging, there are a host of cognitive tests for dementia that are described above.
These range from short tests that only take a few minutes, to longer tests that can take up to several hours.
Each kind of test has a different purpose. It’s doctors (specifically neurologists) that may refer to different cognitive tests to evaluate for dementia.
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References
Geldmacher DS, Whitehouse PJ. Evaluation of dementia. N Engl J Med 1996; 335:330.
Tsoi KK, Chan JY, Hirai HW, et al. Cognitive Tests to Detect Dementia: A Systematic Review and Meta-analysis. JAMA Intern Med 2015; 175:1450.
Jacobs DM, Sano M, Dooneief G, et al. Neuropsychological detection and characterization of preclinical Alzheimer’s disease. Neurology 1995; 45:957.
Many persons with dementia develop communication challenges where some even stop speaking leading to the question of why do dementia patients stop talking.
Below, we are going to explore several reasons that may cause a person with dementia to stop speaking.
Why do dementia patients lose the ability to speak?
Brain Damage
One of the top answers to the query why do dementia patients stop talking is because of the damage the disease causes to their brains.
When a person is first diagnosed with the illness, they may be communicating well.
From here individuals may start experiencing some communication challenges mostly because they have difficulties remembering things.
After some time, they will completely lose the ability to talk.
At this point, therapies aimed at enhancing communication become futile. This mostly happens in the later stages of illness where dementia affects almost all aspects of a person’s life.
This renders the suffering individual dependent on all activities, and their willingness or ability to talk reduces among other severe changes.
Frustrations
Another reason persons with dementia may stop speaking is that they are frustrated with not being understood by the individual they are communicating with.
They can reach a stage where they keep repeating the same sounds, words, or phrases; thus other people will not understand the message they are trying to pass across.
Numerous studies done by linguists focusing on the language of individuals with dementia reveal that the affected individuals may be communicating about the reality from their past world but are not able to use “dictionary words” which results in misunderstandings.
Communication challenges can make a person feel discouraged and just not try and talk to other individuals.
Social Withdrawal
Social withdrawal may be another answer to why do dementia patients stop talking.
Many people with the neurodegenerative disease find their current world filled with loneliness, pain, noise, and confusion.
The affected individuals may also be dealing with an array of emotions from fear, anger, or sadness, etc.
They, therefore, find comfort in solitude as they retreat to a world that they once lived in. Here they can relive happier moments when the disease was not taking a toll on them.
Lack of Engagement
At times, a person with dementia may stop talking because of a lack of engagement.
They may opt to keep to themselves because they feel bored or isolated.
This is why you will find that some persons with the disease will spend a lot of time alone.
Even when they are in the company of others, they may remain mum because not much conversation may be going on.
Some people with dementia will find it difficult to start a conversation; thus opt to stop speaking especially when other people do not put in the effort to engage with them.
Hearing Loss
A high percentage of people who have dementia will end up suffering from hearing loss. This makes it one of the answers to why do dementia patients stop talking.
When individuals with dementia lose their ability to hear, it will most likely be associated with communication problems that can result in a person not talking because they cannot hear properly.
Closing Thoughts
Sadly, when a person with dementia stops talking especially because of excessive damage to the brain, it may be an indication that they are living their last days on earth.
Caregivers may want to consider hospice care at this point to ensure that the affected persons remain as comfortable as possible until they breathe their last breath.
Researchers continue to investigate the link between seizures and dementia.
This is after observing several people with dementia experience seizures as one of the symptoms of the neurodegenerative disease.
Seizures and Dementia in the Elderly
Seizures can be described as uncontrolled and sudden electrical disturbances that happen in the brain.
This can cause levels of unconsciousness, feeling, or movements as well as changes in behavior.
While seizures are usually an indication that a person has epilepsy, not everyone who experiences seizures has epilepsy.
Naturally, persons who have dementia are at risk of seizures.
People with dementia are at risk of seizures
Alzheimer described this way back in 1911. What is not clear yet is how common the seizures are.
This is because some seizures can be quite complex.
Many people are familiar with the generalized tonic-clonic seizures that make people fall to the ground, become stiff and unresponsive and their bodies shake with convulsions.
However, there is another type of seizure that mainly affects individuals with dementia.
These are known as focal onset seizures.
They generally involve short periods of increased unresponsiveness or amnesia.
The person going through this can showcase involuntary repeating movements of the arms, hands, face like swallowing, lip-smacking, or chewing.
Because it does not go on for long, it can easily be missed.
At What Stage of Dementia Do Seizures Occur
In the past, it was believed that only people who had been diagnosed with dementia for years developed seizures.
Recent studies on seizures and dementia, however, reveal that it is also possible for seizures to occur during the early stages of the disease.
Some people will even experience seizures before memory loss become obvious.
Reasons Persons with Dementia Develop Seizures
Individuals with dementia may experience seizures because of the structural changes that happen in the brain.
In some cases, they will occur after a brain infection like meningitis, head injury, or stroke.
As the cells in the brain begin to die, the size of the brain will shrink and this is something that can lead to seizures.
Some types of dementia like Alzheimer’s disease are a result of protein build-up in the brain that interferes with how cells in the brain communicate with each other.
This can result in nerve cells becoming “hyper-excitable” which implies that they will start to behave uncontrollably which can cause seizures.
The Role of Seizures in Dementia
While studying seizures and dementia, scientists were also triggered on the topic of the role seizures in the illness.
A study was conducted towards this end. Researchers observed 55 patients aged 50-69 years.
They were all admitted to an Israeli medical center with their first known seizure. A quarter of the participants developed dementia later on.
Another study that was done in the US looking at almost 300,000 veterans who were all over 55 years uncovered that seizures increased the risk of people developing dementia over a period of one to nine years.
Managing Seizures in People with Dementia
When talking about seizures and dementia, many people are usually concerned as to whether the seizures are manageable or not.
The good news is that there are drugs that a person can take to stop or reduce the seizures.
It is, therefore, important to consult a doctor when a person who has dementia suspects that they have seizure episodes.
In short, the medics will perform the necessary tests and prescribe medication that will treat the issue.
It is important to talk about hallucinations and dementia seeing that this is one of the most common symptoms that persons with this neurodegenerative disease experience.
Hallucinations are incorrect perceptions about experiences or things that involve the senses that can result in a negative or positive experience.
Hallucinations in People with Dementia
They normally seem real to the person who is experiencing them, but other people cannot see them the way the person hallucinating is.
In most cases, however, they will affect the visual or auditory senses where a person can see something that does not exist or hear voices or noises that are not there.
For example, a person can be convinced that they are seeing crawling bugs on their bed or seat but they are not actually there.
What Causes People with Dementia to Experience Hallucinations
People will dementia will experience hallucinations because of the changes that happen in their brains.
Some of the possible causes for hallucinations when a person has dementia include:
Physical problems like bladder or kidney infection or intense pain
Responding and Treating Hallucinations
Below we cover twelve steps that caregivers can try and take when they are dealing with a person who has hallucinations and dementia, like:
How do you deal with hallucinations in dementia
1. Ensuring that their environment is well-lit.
2. Making sure the person with dementia gets proper nutrition and stays hydrated because dehydration and malnutrition can lead to depriving the brain of the nutrients it needs to thrive and function normally.
3. Maintaining schedules and routines.
4. Where possible do not change the environment where the person stays and make sure it is as comfortable as possible, limiting distractions and people who visit or stay.
5. Look out for signs of physical injury like scrapes or bruises that may be causing hallucinations.
6. Come up with creative distressing techniques. For instance, if a person insists that a person has stolen their jewelry, do not outrightly tell them they are wrong.
Instead, offer to help search for the items or you can even look for another interesting activity that will distract them from their current thoughts.
7. Avoid arguments at all costs because at the end of the day the hallucinations are real to the person with dementia even though they may appear far-fetched to you.
Always responds to the person’s feelings rather than the issue as this shows that you acknowledge their concerns. Seek to constantly reassure the person at all times.
8. Figure out if the hallucinations have a negative impact. If they have a positive impact, it is best not to address the issue.
9. At times, it helps to investigate any suspicions that the person raises because it may end up being true.
10. Being flexible. Sometimes, you have to indulge in little fibs to make the person with hallucinations and dementia feel safe.
For instance, if they hear an imaginary sound you can tell them that you were the cause and that everything is okay.
Where possible have multiples of some of the things that a person loves. This way, if they keep misplacing them, you can always search for them and magically find them.
It is helpful because it helps frustration from boiling over to aggression or disappointments which can dampen someone’s mood.
12. Visiting a doctor to rule out any vision or hearing problems. The medic might also change medication if it is the source of hallucinations.
Medication for Dementia Hallucinations
If the hallucinations are severe, physicians can prescribe medications to treat hallucinations. Different drugs can do the job such as:
Nuplazid
This is one of the first drugs that has even been approved to treat hallucinations that relate to Parkinson’s disease dementia.
Antipsychotic medication
These can treat hallucinations by offering a calming effect which makes the hallucinations less distressing. The drugs can also reduce or eliminate the frequency with which they occur.
Cholinesterase Inhibitors
These are medicines that doctors will give people to treat both hallucinations and dementia. They increase levels of specific neurotransmitters in the brain which helps to boost cognition as well as alertness. They also have the potential to reduce hallucinations.
It is also recommended that caregivers seek out support because dealing with persons who have hallucinations and dementia is not an easy task.
This is because you may end up dealing with feelings of frustration, exhaustion, guilt, distress, and exasperation.
Seeking support helps you to effectively deal with such so that you can be in the best possible position to look after the individual with dementia.
Which Dementia’s Cause Hallucinations
Lewy Body Dementia is the number one culprit for causing dementia in person with this type of illness.
It is usually common in the early stages of the disease and might disappear as it progresses into the middle or end stages of the illness.
The hallucinations are usually persistent and last for a long-time. Studies also reveal that hallucinations can affect people who have Parkinson’s disease and Alzheimer’s disease.
With these diseases, the hallucinations occur during distinct periods for a short time. They can occur during the middle to late stages of the disease.
After numerous studies, it shows that horticulture therapy for dementia can bring very positive results.
The term “Horticultural Therapy” is often used to refer to the myriad of beneficial effects that people with dementia (or other diagnoses) reap simply by interacting with nature.
Horticultural Therapy in Patients With Dementia
Interaction with plants and nature creates an astounding array of therapeutic benefits to human health and wellness.
Horticultural therapy is firmly rooted in the past
Although the idea of horticultural therapy may be new to some, the practice is not.
Using exposure to nature to promote healing dates back thousands of years to the earliest known civilizations, including the Mesopotamians and the Persians.
In the 1800’s doctors in the United States and Europe began prescribing time in the garden for certain patients. Florence Nightingale, the founder of modern nursing, was a big proponent of the healing effect of gardens.
By the mid-1900s horticultural therapy was being more widely used to aid the rehabilitation of military veterans. In 1972 the first formal degree programs were established and in 1976 the first PhD in horticultural therapy was awarded.
The benefits of horticulture therapy have been scientifically proven time and again
Scientists have studied horticultural therapy rigorously over the past several decades. This has led to an overwhelming abundance of evidence that interaction with nature leads to a marked improvement in physical, emotional and social health.
These improvements in health have been researched and confirmed for seniors and people of all ages. They have been proven for people with dementia and countless other conditions.
Studies specific to the benefits of horticulture therapy for dementia abound
Many research studies focus specifically on how horticultural therapy affects dementia and its symptoms.
Additionally, abundant research demonstrates profound positive benefits to elders in areas such as relief of pain, stress, anxiety and depression.
Conditions such as pain and anxiety are very common in people with dementia. These conditions tend to exacerbate, or worsen, dementia symptoms such as behavioral changes, restlessness, agitation and confusion.
When these conditions have been relieved or prevented, people with dementia not only feel better, they can also function better. They can enjoy a higher degree of independence, think more clearly and behave more calmly.
Each individual research study tends to focus on one particular area of nature exposure, such as gardening, grounding or forest bathing.
Gardening
Spending time or working in a garden setting is known to be extremely helpful for mental and physical health. It’s even been proven to reduce the risk of developing dementia later in life.
Increase feelings of satisfaction, well-being and quality of life
Improve mood
Enhance a person’s connection with community
Improve cognitive function
Reduce stress
Diminish anger
Lower levels of agitation
Relieve depression and anxiety
Increase energy and reduce fatigue
Decrease inappropriate behaviors
Reduce usage of medications for agitation
Reduce number of falls and fall severity
These beneficial effects tend to be noticeable immediately after spending time in the garden setting, and then persist for weeks or months afterward.
Wander gardens
Wander gardens have become increasingly popular in recent years for people with dementia. They can often be found near memory care communities and healthcare facilities.
These gardens are thoughtfully and purposefully designed to provide a safe and calming environment for people with dementia to experience nature actively or passively.
Wander gardens typically feature winding wheelchair-friendly pathways with occasional benches. There are often shaded areas to sit and enjoy the birdsong or soft rustle of leaves in the pleasant afternoon breeze.
There is usually an array of colorful non-toxic plants, which are often aromatic and sometimes edible.
Sometimes there are raised garden beds so elders can dig, plant and actively tend to the garden from a wheelchair or a comfortable height.
Each wander garden is unique, but each provides plenty of sights, sounds and aromas to gently stimulate the senses.
Grounding
Grounding, also known as “Earthing” is the practice of connecting with the earth’s electrical field.
Moreover, grounding exposes the body to electrons which neutralize many of the harmful effects of oxidation on a molecular level. This has a significant effect on how the immune system functions.
Reduces inflammation associated with a wide range of chronic diseases, including heart disease, cancer, stroke, chronic obstructive pulmonary disease, osteoporosis, diabetes, asthma, Alzheimer’s disease, arthritis and others
Drastically improves wound healing
Significantly improves immune system function
Markedly reduces pain and swelling
Improves energy and fatigue
Grounding can be accomplished simply by placing one’s bare feet or hands in soil, sand, stone, wood or other natural substance that is in contact with the earth.
There are also products available that can ground a person who would have difficulty getting outdoors.
Forty minutes per day of grounding is sufficient to achieve ideal results.
Forest Bathing
First popularized in Japan in the 1980s, “Forest Bathing” (essentially spending quiet time in forest-like settings) has amassed an amazing amount of evidence for some remarkable results.
Reduce blood pressure and improve cardiovascular health
Minimize symptoms of depression
Reduce feelings of anxiety
Lower feelings of stress and reduce cortisol and other stress biomarkers
Increase mental relaxation
Decrease physical pain
Reduce feelings of psychological distress
There are many reasons why forest bathing is effective, according to scientists.
Viewing nature, physically handling or touching natural objects, gentle multi-sensory stimulation and immersion in nature have all been proven to have a restorative effect on multiple aspects of mental and physical health.
Additionally, certain evergreen trees release a phytochemical compound that, on its own in studies, has been shown to decrease adrenaline and heart rate.
How much horticulture therapy time does a senior need?
How much exposure is necessary to start seeing these effects? Surprisingly little.
In fact, even just viewing images of nature – or the addition of a single cut flower or houseplant into a room – can have measurable outcomes.
However, the strongest and most profound results will often be achieved in conjunction with a horticultural therapist.
Horticultural therapists are specially trained and uniquely creative
Horticultural therapists are generally some sort of healthcare or social worker who has received additional training and certification specific to this modality.
This often includes occupational therapists, physical therapists, counselors, hospice workers, nurses, spiritual care professionals, activity providers and others.
All of whom have their unique approaches to integrating plant based interactions into their practices in different ways.
What they have in common, besides the plant based nature of their approaches, is that they are helping the participant(s) reach specific, measurable goals.
Horticultural therapy focuses on achieving defined goals
A “specific, measurable goal” could be, for example, to reduce one’s blood pressure by 20 points. Another goal might be to decrease the frequency or dosage of pain medication one is taking.
In dementia care, goals of horticulture therapy often include activity engagement or aggression, yelling, restlessness and other such behavioral symptoms. These types of symptoms can be concretely measured using tools such as the Cohen-Mansfield Agitation Inventory (CMAI).
The CMAI measures 29 specific negative behavioral symptoms in people with dementia.
1. Pacing and aimless wandering
2. Inappropriate dressing or disrobing
3. Spitting
4. Cursing or verbal aggression
5. Constant unwarranted request for attention or help
6. Repetitive sentences or questions
7. Hitting (including self)
8. Kicking
9. Grabbing onto people or things inappropriately
10. Pushing
11. Throwing things
12. Making strange noises
13. Screaming
14. Biting
15. Scratching
16. Trying to get to a different place inappropriately
17. Intentional falling
18. Complaining
19. Negativism
20. Eating or drinking inappropriate substances
21. Hurting self or other
22. Handling things inappropriately
23. Hiding things
24. Hoarding things
25. Tearing things or destroying property
26. Performing repetitive mannerisms
27. Making verbal sexual advances
28. Making physical sexual advances or exposing genitals
29. General restlessness
By performing a behavioral assessment at baseline, and then performing the same assessment at key points during or after the study, these types of behaviors can be measured.
Horticulture therapy is extremely effective for dementia
The results are profound and dramatic. Study after study has shown overwhelming evidence that people with dementia who receive horticultural therapy interventions…
Have significantly less agitation
Have much fewer behavior disturbances
Experience much more emotional stability
Spend significantly more time engaged in activity, and
Spend markedly less time doing nothing
… than their counterparts who receive non-horticultural interventions.
Researchers theorize that enabling people with dementia to have responsibility for and connection with living things is therapeutic for them.
They are receiving gentle multi-sensory stimulation, which is likewise known to be therapeutic. Also, they are engaging in physical activity, social activity and relieving emotional tension.
Horticulture therapy is especially exciting because of what it’s not
Experts are excited about using horticultural therapy to reduce the distressful symptoms of dementia for a number of reasons.
It’s not full of side effects
Medications for dementia symptoms are frequently ineffective and often come with dangerous side effects. These may include, sedation, increased confusion and decreased ability to function independently.
Dementia care experts whole-heartedly agree that non-drug interventions are highly preferred over medications whenever possible.
It’s not expensive
Because horticulture therapy approaches are generally inexpensive, there is no real cost barrier.
It’s not inaccessible
Some of the non-drug interventions out there, such as music or reminiscence therapy, are most effective when based on an individual’s particular memories and experiences.
Horticulture therapy, by contrast, is easy to apply to a wide array of people without a lot of customization.
It’s also easy to incorporate into a variety of different activities and schedules, so it’s well suited to senior living communities and health care facilities.
What’s more, is that it can be done literally anywhere!
Even if a person doesn’t have access to a garden plot or can’t get outdoors at all, horticulture therapy can occur inside.
Horticultural therapy should be utilized to the fullest extent possible to enhance the health and well being of people living with dementia
Researchers acknowledge that it can be hard to separate the exact amount that each individual facet of horticultural therapy contributes to its overall beneficial effect.
Multi-sensory stimulation is known to be therapeutic. The natural world is full of visual, auditory, tactile and olfactory stimuli that promote healing.
Additionally, there are many known (and likely many as yet unknown) phytochemicals that affect how the human body functions on a microscopic level.
What is clear beyond any shadow of a doubt is that horticultural therapy is an easy, inexpensive, accessible and enjoyable way to support and promote good mental, physical, emotional and social health for people living with, or without, dementia.
After years of research, experts uncovered that there is a link between Down syndrome and Alzheimer’s disease.
Down Syndrome and Alzheimer’s
Down syndrome is a medical condition where an individual is born with an extra copy of chromosome 21 rather than the normal two copies.
The genetic abnormality usually results in health issues and developmental challenges that can affect memory, learning, and language.
Alzheimer’s disease (AD) can be defined as a brain disease that is one of the major causes of dementia. It makes affected persons experience impaired memory, behavior, and thinking.
It can also affect mood and emotions.
The illness is caused by an abnormal build-up of beta-amyloid which is a type of protein that forms plaques in brain cells.
This accumulation damages the connections between brain cells which, in turn, disrupts how messages are passed from one part of the brain to another.
The brain cells die eventually and this will reduce the size of the brain.
Brain degeneration that happens because of AD can impair an individual’s ability to carry out day to day activities. Because Alzheimer’s disease is a progressive illness, the symptoms become worse as time goes by.
Correlation between Down syndrome and Alzheimer’s disease
Studies reveal that most people (not all) who have Down syndrome will also develop AD.
Chromosome 21 carries the APP gene (amyloid precursor protein). Beta-amyloid forms when APP breaks down.
This clumps together into brain plaques that are common with AD.
As stated earlier, persons with Down syndrome have an extra copy of chromosome 21 which implies that they can make 11/2 times more APP than persons who only have two copies.
Individuals who have Down syndrome have a higher chance of developing Alzheimer’s.
Many studies state that about 50% of individuals with Down syndrome will end up with AD by the time they are celebrating their 60th birthday. The average onset age, however, is usually 50-55 years.
The National Down Syndrome Society reports that about 30% of individuals who have Down syndrome and are in their 50s already have AD.
Early Alzheimer’s disease Signs for Persons with Down syndrome
A person who has Down syndrome can showcase several symptoms that may indicate they have AD such as:
To determine whether a person has both Down syndrome and Alzheimer’s disease, a doctor may subject the individual to various tests that may include:
Memory and thinking tests
Physical examinations that may include brain scans and blood tests
Assessing medical history
Careful observation of symptoms as well as how a person’s behavior and abilities change is crucial.
This is because persons with Down syndrome already have pre-existing difficulties with memory, thinking, and daily living skills.
Naturally, a person with Down syndrome may not be in a position to report concerns about memory or other changes happening in their lives.
For this reason, their loved ones or professional caregivers must help with observing cognitive changes.
Indidivual diagnosis for Down syndrome
Experts recommend certain principles that can help with a person-centered diagnosis for individuals with Down syndrome, such as:
1. Documenting baseline adult function by the time they are 35 years. The medical records of a person with Down syndrome should include details about their adult abilities.
2. Checking for Changes in Daily Function. Family members or other reliable individuals should also be on the lookout for changes in day to day function.
A person may note that an individual with Down syndrome showcases less interest in social interactions or things they loved doing previously. Changes in behavior and personality may also indicate a decline in thinking skills.
Doctors also perform other examinations to rule out other medical conditions that may look like Alzheimer’s disease.
This is because of something that is known as “differential diagnosis.”
When a person with Down syndrome showcases a decline in abilities or loss of skills, medics can consider:
Changes in sensory impairments like vision or hearing difficulties that can inhibit social engagement or lead to a loss in skills
Life changes, for instance, adjustments in a person’s day service, retirement, menopause, or reaction to something like bereavement.
Thyroid disorders which can be treated
Depression which is treatable with the proper interventions
Drug interactions
Poor sleep patterns
Urinary or other types of infections
Vitamin deficiencies
Because the above conditions are treatable, a person with Down syndrome needs to undergo a comprehensive medical assessment, especially during the early stages to rule them out.
Research on Down syndrome and Alzheimer’s disease
Scientists are working round the clock to figure out why some people with Down syndrome end up with AD while others do not.
The experts want to get a clear picture so that they can come up with medication or other treatments that can help delay, stop, or prevent the development of AD.
Some studies are already in the clinical trial phase and people can only hope that these will yield great results in the future to help effectively deal with the two medical conditions.
Living with a Positive Alzheimer’s Disease Diagnosis
Sadly if a person has Down syndrome and they get diagnosed with Alzheimer’s disease, they have to live with both medical conditions.
Currently, there is no approved cure for AD. However, there are some medications and alternative treatments like therapies and natural remedies that a person can try to treat some symptoms as well as slow or stabilize the decline in thinking abilities and memory for a while.
It is important to consult a physician before starting any treatment regimen to ensure it is best suited for the weak person.
Support services for people with Down syndrome and Alzheimer’s disease also exist. They help affected individuals and their families or carers live well with the conditions.
Research is, however, ongoing to try and find a cure for AD as well as discover new treatments to help delay or avoid the onset of Alzheimer’s symptoms for persons who already have Down syndrome.
Researches show that dementia and sleep are actually quite closely connected to each other.
Also, those with dementia usually develop bad sleeping habits which we need to take into consideration as soon as possible.
Sleep deprivation is known to have profound consequences on a person’s health.
This can include tiredness and grumpiness as well as the risk of serious medical conditions like heart disease, diabetes, obesity, and shorter life span among many others.
Over the years, there also seems to be a connection between dementia and sleep.
This is even though scientists and researchers cannot conclusively explain how dementia affects a person’s sleep.
Studies indicate that about 40% of people who have dementia experience sleep disturbances. For some individuals, their internal “biological clock” may be damaged, affecting their sleep.
Another logical explanation is that the parts of the brain that control whether a person stays awake or not may be damaged by the disease, which results in disturbing sleep patterns.
Before experts can give conclusive explanations, let us look at different aspects of sleep risk and dementia.
Sleep Problems That Dementia People May Face
There is a wide array of sleep issues that people with dementia may experience over the course of the illness, such as:
Oversleeping
In as much as we are encouraged to enjoy quality sleep all night, people with dementia may end up oversleeping.
This is where a person spends most of their time in bed during the day and at night. Sleeping a lot is usually common in the later stages of the illness.
As the disease progresses, brain damage also becomes more extensive, making a person become frailer and weaker over time.
Some medication that an individual may be taking like antihistamines, antidepressants, and antipsychotics can contribute to excessive sleepiness.
Light Sleep Disorders
These are disorders that are also known as (RDB) rapid eye movement sleep behavior disorder. They make individuals act out their dreams by talking or moving in their sleep.
Sleep Disordered Breathing
This is where a person has difficulties breathing while sleeping.
It may be as a result of obstructions in the airway, which makes an individual work harder to breathe normally. At times, this is also referred to as sleep apnoea.
It is considered to be one of the risk factors when it comes to dementia and sleep.
This is because disordered breathing can damage the brain because the levels of carbon dioxide and oxygen change when a person has challenges while breathing.
Most of the time, this can also change how blood flows to the brain.
Difficulties Falling Asleep
Many people with dementia often have trouble falling asleep. A person may be in bed wanting to sleep, but it will not happen.
Counting sheep and drinking chamomile tea may not offer the solution that the person needs.
This makes the affected person want to wander off into the darkness or start yelling or calling the names of their caregivers.
Hypnagogic Hallucinations
These are imagined sensations that a person ends up thinking are real. They are also known as sleep hallucinations that happen when a person is falling asleep.
The hallucinations can appear in different forms, whether vision, taste, smell, or sound. Research about this is still ongoing as the hallucinations continue to fascinate scientists, philosophers, and writers.
Circadian Rhythm Sleep Disorders
These are characterized by normal sleep patterns that usually happen at random times during the day. These are very common when a person is growing older.
It usually happens because of reduced exposure to natural light, a decrease in physical activity, as well as changes in circadian rhythms that come with aging.
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Factors that May Cause Sleep Problems in People with Dementia
Several factors besides brain damage may be the cause of sleep issues worth mentioning when talking about dementia and sleep. Some of these include but are not limited to:
1. Restless leg syndrome
This is a disorder that brings about unpleasant “tingling” or “crawling” feeling on the legs which makes a person want to move them all the time
2. Depression
Depression is very common with people who have dementia, and it may end up affecting how they sleep. In most cases, only a professional can give a positive diagnosis of depression in adults because this is often confused with Alzheimer’s disease.
The two conditions share symptoms like apathy, isolation, impaired thinking, social withdrawal, loss of interest in hobbies, and activities amongst others.
Once depression has been positively diagnosed, treatment can improve quality of life significantly.
Treating Sleep Problems
There are two main approaches when it comes to treating sleep issues in people who have dementia.
One of these has a lot to do with lifestyle changes that can improve sleep quality.
Some of the solutions to these may include:
1. Regular sleep regimes
Encouraging a person who has dementia to stick to regular meal times as well and going to bed and waking up times can help them enjoy their sleep more.
This way, they will not have to deal with too many dire consequences of dementia and sleep.
2. Exercise
Exercise is a recommended treatment method because it gets the body moving; thus, helps the organs in the body to function as they should.
Because people who have dementia may not be able to work out vigorously, caregivers must identify light exercises that the individuals under their care can handle with ease.
Moderate amounts of walking can do the trick. Night-time stretching may also be helpful.
3. Diet
It is vital for people who have dementia to eat well-balanced food to get the nutrients the body needs to boost immunity. Avoid processed foods and stick to organic vegetables, fruits, nuts, complex carbs, and proteins.
Sleep interruptions, whether caused by a noisy neighborhood or a snoring partner, can end up harming brain health.
Persons who experience poor restless sleep have a higher risk of cognitive decline compared to the ones who sleep well throughout the night.
Individuals who experience fragmented sleep can use blackout curtains or a white noise machine to help them sleep well throughout the night.
5. Plan more active days
Boredom during the day is one of the reasons why an individual may want to nap more.
It is advisable to plan more active days filled with activities that the seniors love. This way, they get more tired at night, making it easier to fall and stay asleep.
6. Creating a safe and comfortable sleeping space
Modifying a person’s sleeping environment to make it more welcoming, safe and comfortable can help an individual enjoy quality shut-eye at night.
This is where you can do things like check on temperatures, use nightlights, clean and soft bedding.
7. Ensuring exposure to bright light in the morning
Furthermore, persons with dementia can also try light therapy.
Exposing seniors to natural light often can help to realign their circadian rhythm to reduce the effects of some sleep disorders.
Studies also show that light therapy helps to enhance sleep patterns for people with dementia.
8. Music intervention
The right type of music can also help a person fall asleep when they are having difficulties with this.
Ideally, it should be something with soft beats like Mozart and other classical tunes. Loud music with fast beats may not offer the desired results.
An individual can also try playing a musical instrument to drive them to sleep.
The other option available when a person wants to deal with sleep issues is the use of medications and other apparatus.
Note that a person should only consider this when they have tried the non-medical route without any success.
Examples of such include:
1. Using CPAP (continuous positive airway pressure) – This is a machine that helps to reduce the effects of sleep apnea.
2. Some medications like benzodiazepines and tricyclic antidepressants can also improve sleep.
It is always best for the person with dementia to consult a doctor before taking any type of medication to be on the safe side. Some drugs may have a negative effect when it comes to dementia and sleep.
3. Doctors may also prescribe melatonin hormone that can maintain regular sleep-wake cycles.
4. Treating any pains that a person may be having can also work well for a person who wants to sleep better.
5. A person who wakes up at night should not be encouraged to watch TV, listen to loud music, or be over-active during the wakefulness periods.
This will only encourage them to stay awake instead of going back to bed
This may end up worsening cognitive symptoms, ultimately reducing the quality of life of the person with the disease as well as the people around them.
When a person is having problems with dementia and sleep, it is important to try and get to the bottom of the issue.
This is by finding out what is causing these issues to administer the proper treatment that will help a person lead a more fulfilling and satisfying life even when they are ill.
