dementia - ReaDementia

Dementia and High Blood Pressure

Petra Boh Blog, Causes February 19, 2021October 16, 2021dementia, high blood pressure

Numerous research studies confirm that there is a link between dementia and high blood pressure.

High blood pressure also known as hypertension is a chronic condition where the force of blood against the artery walls becomes too high causing various health problems including strokes and heart attacks.

Hypertension is known to cause progressive brain damage.

Blood pressure usually measures the force that is applied to the arteries as blood is circulated by the heart around the body.

Normal blood pressure should read about 120/80 mmHg. Hypertension is constantly above 140/90 mmHg.

Common risk factors for high blood pressure include an unhealthy diet comprising mostly salty foods, lack of exercise, excessive alcohol consumption, being obese or overweight, taking steroid medication, drinking lots of caffeine and kidney disease.

Also, everyone in the family with a history of hypertension is at risk, as well as those of Caribbean or African descent.

Dementia is a general term that is used to describe problems with memory, problem-solving, language, and other thinking abilities that end up interfering with a person’s day-to-day life.

The disease is progressive implying that the symptoms will become worse over time.

Research on Dementia and High Blood Pressure

The World Alzheimer Report 2014 states that several studies observing large groups of individuals demonstrated that people with hypertension especially in mid-life were at high risk of developing vascular dementia one of the most common kinds of dementia later on in life.

The subjects were between the ages of 15-40 while mid-life was characterized by people between the ages of 40-64.

Vascular dementia occurs when there is an inadequate flow of blood to the brain which denies the organ essential nutrients and oxygen it needs to function properly.

People with hypertension are at higher risk

A study published by Oxford University Press in Cardiovascular Research also reports that persons who have hypertension are at a higher risk of getting dementia.

For the first time, the research also reveals that doctors can conduct an MRI to detect neurological damage for persons with high blood pressure before dementia symptoms occur.

Researchers came to this conclusion after subjecting individuals between the ages of 40-65 to undergo a 3 Tesla MRI scan at the Regional Excellent Hypertension Centre of the Italian Society of Hypertension of the I.R.C.C.S.

The participants of the study did not have a dementia diagnosis or any structural damage.

The subjects also underwent clinical examinations to know their hypertensive status as well as damage to the target organ.

They were also subjected to an MRI scan to identify any microstructural damage.

The results indicated that hypersensitive participants had major alternations in 3 specific white matter fiber tracts.

The group also scored worse in cognitive tests and decreased performances in memory, speed, and learning-related tasks.

This goes to show that it is possible to detect changes before a person starts showcasing symptoms. Medics can then offer medication that will prevent further deterioration in regard to brain function.

Hypertension medication and dementia

Another study worth mentioning about dementia and high blood pressure was conducted at the John Hopkins University.

Experts analyzed previously gathered data to report that persons taking hypertension medication were half as likely to end up with Alzheimer’s (the most common cause of dementia) when compared to the people who do not take the drugs.

Constantine Lyketsos, director of Memory and Alzheimer’s treatment at John Hopkins explained that people who do not have Alzheimer’s but are taking blood pressure drugs were less likely to develop dementia.

He went ahead to say that individuals who got dementia from Alzheimer’s and were taking specific antihypertensives were likely to experience slow or halt progress.

He concluded that it was still not clear where this connection arises.

It can either be from better management of blood pressure or some medications that may have some properties that interfere with some of the processes that relate to Alzheimer’s.

Women with high blood pressure are more like to get dementia

A sex-specific study reveals that women who experience hypertension in their 40’s are 73% more likely to get dementia later in life when compared to the ladies who did not have high blood pressure.

This was in a bid to determine how dementia strikes women and men differently.

Experts who conducted the study said they adjusted the results for other risk factors that can also lead to dementia including diabetes, smoking, and obesity which held true for all races.

This, however, was not the same case for men even though hypertension was more common among the male fraternity. The study that was published in the American Academy of Neurology journal observed more than 7,000 individuals.

The participants went through blood pressure checks at the age of 33 and again at 44 in the 60s and 70s. Researchers began to follow up to see the persons who developed dementia in 1996.

The results indicated that ladies who had hypertension in their 30’s did not have a higher dementia risk as compared to those with high blood pressure in their 40’s.

How Hypertension Affects the Brain

There are several ways high blood pressure affects the function of the brain. One of them is that over time, hypertension causes strain on the arteries.

This makes the artery walls become stiffer, thicker, and narrower a condition known as arteriosclerosis.

When this happens, the brain is deprived of important oxygen and nutrients which results in damaged brain cells that negatively affect the functioning of the brain.

Hypertension is also one of the major stroke risk factors.

One of the major reasons that cause strokes is the blockage of arteries in the brain which is usually a result of hardening arteries.

A stroke can also occur when an artery in the brain burst causing bleeding in the organ. Strokes can result in post-stroke or stroke-related vascular dementia.

When talking about dementia and high blood pressure, it is also important to mention that hypertension can damage small blood vessels in the brain.

This can affect the parts of the brain responsible for memory and thinking.

Closing Remarks

Even though the link between vascular dementia and high blood pressure is quite apparent, there is still no proof that lowering blood pressure can help to prevent the development of dementia.

More research needs to be done to identify the link between hypertension and dementia to see if anything can be done to prevent or treat dementia.

Migraine and Dementia: Is There a Link?

Petra Boh Blog, Signs February 19, 2021October 16, 2021alzheimer's disease, dementia, migraine

Research looking into the link between migraine and dementia reveals that migraines are among the top dementia risk-factors.

Migraines are a neurological disease that involves repetitive and severe headaches as well as other symptoms.

In some cases, there may be an aura which is a sensory change before the headache occurs. Migraines are not your typical headaches.

They can last for days and can affect an individual’s daily life including their ability to study or work.

The Migraine Research Foundation reports that the disease affects one billion people across the globe.

That makes it the 3rd most widespread disease in the world.

Are Migraines and Dementia Closely Related?

Dementia on the other hand is not a specific disease but a group of conditions that are characterized by impairment of brain functions like judgment and memory loss.

One of the reasons why researchers were interested in studying dementia and migraines is because both are common neurological diseases.

While dementia mostly affects seniors, migraines usually affect people of all ages.

One of the studies that support the idea that there is an association between migraine and dementia was published in the International Journal of Geriatric Psychiatry.

It explains that researchers talked to 679 seniors asking them about their migraine history. More than half of this group were women and none had a history of cognitive problems.

Are migraine sufferers more likely to develop one form of dementia?

The average age of the subjects was 76. The experts pursued elderly individuals for 5 years and discovered that 51 of them had a positive dementia diagnosis.

Considering factors such as age and education, the researchers found that individuals with Alzheimer’s disease (AD) were over four times more likely to have had migraine attacks.

AD is one of the most common forms of dementia.

Suzanne L. Tyas a senior author of the study said that persons with migraines history were three times more likely to develop a kind of dementia and four times more as likely to develop Alzheimer’s.

The study, however, did not find a link between migraines and vascular dementia.

What affects migraines?

According to Rebecca Edelmaye, director of scientific engagement at the Alzheimer’s Association, the link between migraine and dementia is advanced by the fact that migraines affect the lifestyle decisions of a person.

This includes not eating a healthy diet, poor sleep, reduced social/cognitive stimulation, and not being active.

These factors have very much in common with those known to increase the risk of dementia.

Previous research had found connections between dementia risk and migraines. Scientists have, however, not yet pinpointed the exact link between the two diseases.

Many suspect that it has a lot to do with vascular risk factors like diabetes and hypertension. On record, these are potential dementia risk factors.

Research also reveals that long-term migraines can alter the structure of the brain resulting in some destructive effects.

A study published in Neurology in 2013 examined the contribution of migraines to structural changes in the brain including volumetric changes in white and gray matter, white matter abnormalities, and infract-like lesions.

Experts in this study were looking for solid evidence and a better understanding of the relationship between migraine and dementia.

Implications of the Studies

There are a couple of things that come up after the discovery that there is a link between migraine and dementia.

One of them is the fact that the research can help medics predict better the people who are at risk of this neurodegenerative disease.

This might also lead to early detection of the disease. This is an essential part of treatment according to the professionals.

Early detection is helpful because it means that affected individuals can start treatment as soon as possible. It can, in turn, enhance the effectiveness of the treatment therapies.

This can also empower persons with the illness and their loved ones to make the proper decisions at the right time.

There is also a chance that future research will better explain how migraines affect Alzheimer’s and other forms of dementia as well as how to ease the risk.

Stroke and Dementia: Is There A Link?

Petra Boh Blog, Signs February 19, 2021October 16, 2021dementia, stroke

Several studies confirm that there is a link between stroke and dementia.

A stroke occurs when brain cells are damaged or die-off because the flow of blood to the organ is interrupted.

This kind of damage can lead to the development of dementia because it results in problems with thinking and memory.

Dementia is a group of symptoms that result in cognitive decline.

This includes problems with communication, memory, and concentration.

Statistics indicate that having a stroke doubles the risk of developing dementia.

Understanding Stroke and Dementia

The conclusion was made after a large-scale study led by The University of Exeter Medical School. Researchers analyzed data on stroke and dementia risk from over three million people from across the globe.

The experts were building on research that has been previously done but had not quantified the extent that stroke increases the risk of dementia.

The research analyzed 36 studies where 1.9 million subjects had a history of stroke.

They went ahead and also examined twelve more studies where the participants had a recent stroke during the period of the research adding 1.3 million people.

Stroke increases the risk of dementia by 70%

Dr. ILianna Lourida who was part of the study from the university said that they discovered that a history of stroke increases the risk of dementia by about 70%.

Moreover, recent strokes increase the risk by more than double.

The link between dementia and stroke was prevalent even after the experts took into account other dementia risk factors like diabetes, cardiovascular disease, and blood pressure.

Findings from this study released strong evidence that having a stroke increases dementia risk significantly.

This was important given how common dementia and stroke are.

World Health Organization reports that 50 million people around the world have dementia and the number will continue to rise significantly.

Meanwhile, 15 million individuals experience strokes yearly.

The study on stroke and dementia is also useful because it can help with the prevention or treatment of dementia.

Dr. David Llewellyn who hails from the University of Exeter Medical School believes that about 1/3rd of the cases of dementia are preventable.

He reckons that protecting the supply of blood to the brain might help to reduce dementia cases.

The research was published in Alzheimer’s & Dementia: The Journal of The Alzheimer’s Association one of the top dementia journals.

What Type of Dementia are People with Stroke Likely to Get?

When talking about stroke and dementia, it is important to note that a majority of people who suffer from stroke will end up developing vascular dementia.

This is one of the most common dementia types.

It is not to say that every person who has a stroke will end up with vascular dementia.

The risk may also depend on sex, age, family history, and severity and location of the stroke.

In addition to damaged brain cells, vascular dementia can also develop after an individual experiences a series of silent strokes.

These usually cause small areas of damage in the brain.

They are known as silent strokes because in most cases, the strokes are usually so small that a person may not even know when they are happening.

Worth mentioning is that it is possible to confuse vascular dementia with the effects of stroke.

Both medical conditions can cause issues with memory, mood, and thinking.

If a person with stroke experiences these problems and they do not improve but seem to get worse, it could be an indication that they have vascular dementia.

If caused by a single stroke, the symptoms of vascular dementia can appear suddenly.

They tend to appear gradually if the symptoms are caused by silent strokes. In the absence of dementia, these symptoms will improve after some time.

Experts also believe that stroke can cause dementia at any age. As people grow older, their risk of stroke and dementia increases.

Nowadays, however, stroke risk factors are increasing even for younger adults.

The same case applies to dementia where individuals can start developing the neurodegenerative disease in their 40’s or younger.

How to Grow a Therapeutic Indoor Garden for Dementia

Laura Herman Blog, Prevention February 18, 2021October 16, 2021dementia, garden, gardening, therapeutic garden

The healing power of plants and nature has been realized for centuries. The last several decades of scientific research has yielded overwhelming evidence of its efficacy. In this article we look at the benefits of a therapeutic indoor garden for dementia.

Gardening, and interaction with live plants, is very beneficial to the physical, mental and social health of human beings.

It is one of the more effective natural remedies for dementia.

This is happy news for all humans, but it’s especially exciting for people with certain hard-to-treat health conditions, such as dementia.

Therapeutic Gardening for People With Dementia

While there is still no cure for most types of dementia, gardening has been proven to offer a very effective method of relieving some of dementia’s distressing symptoms including:

Furthermore, gardening and interaction with plants has been shown to improve the quality of life for people with dementia by:

Enhancing their general well-being
Improving their level of functioning
Reducing their use of psychotropic medication
Decreasing their incidence of serious falls

Interaction with plants benefits people with dementia

Sensory stimulating interaction with plants has been determined to be therapeutic to people living with dementia.

Tactile stimulation, or touching live plants, has been shown to promote psychological feelings of relaxation along with a physiological calming response in the body.

Meanwhile, olfactory stimulation, or smelling certain natural aromas, has been proven to:

Enhance feelings of calm
Increase alertness
Improve mood
Stimulate memories

Visual stimulation, or viewing images of nature, has been shown in numerous studies to have these health-promoting effects:

Significantly increase feelings of comfort
Significantly increase feelings of relaxation
Reduce biochemicals related to stress

Listening to the gentle sounds of nature is well known to promote feelings of calm and offer these benefits:

Aid in stress recovery
Increase attention
Promote relaxation
Decrease feelings of anxiety
Reduce agitation

Many studies confirm that spending time outside in nature will create a wealth of positive effects on the health, happiness and well-being of people with dementia.

The science confirms these effects occur indoors as well.

Indoor gardening can bring about many desirable health outcomes

Indoor gardening can be especially effective when working with a certified horticulture therapist – but even without one, the benefits of simply interacting with plants can be profound.

A therapeutic indoor garden can be any size. Each garden is as unique as the individual for which it was created.

How to create a therapeutic indoor garden for someone with dementia

Ideally, you can start by selecting an assortment of sensory-stimulating plants. Look for colorful flowers, interesting foliage and pleasant aromas.

However, don’t worry if this isn’t possible or practical – even a single plant can be therapeutic. For some individuals, or in some circumstances, a single plant might be a better choice than a whole garden.

There aren’t too many rules or restrictions when it comes to indoor dementia gardens, but there are a few.

1. Plants and any additives should be non-toxic

Double check every plant for toxicity before including it.

Many people don’t realize, for example, that poinsettias are poisonous. Lilies, ivy, philodendron, jade and oleander are other common poisonous houseplants, and there are many more.

There shouldn’t be much need for insecticides or other additives in an indoor garden.

If you apply fertilizer or any other substance, avoid a potential crisis by taking proper precautions.

Keep all chemicals or substances securely put away when not in use.
Read labels thoroughly to understand any potential dangers associated with anything you use.

Err on the safe side; assume that any part of every plant could be ingested and plan accordingly.

2. Avoid thorns, stickers and other sharp points or edges

Avoid thorny roses, prickly cacti and other sharp plants that may cause injury or discomfort.

Also, be aware of sharp points or edges on the garden tools. It may be okay for an experienced gardener with dementia to use a familiar tool, even if it is sharp.

There is something extremely therapeutic about using familiar items!

However, depending on the person’s situation, it may not be safe or appropriate for them to use particular tools or items.

Use good judgment to determine the risks and benefits of the person using a potentially dangerous item.

Since people who have dementia often experience ups and downs from day to day, it’s possible that using an item could be unsafe one day but not the next.

Re-evaluate the safety of the situation daily or as needed.

In most cases, any sharp tools should be kept secured when unsupervised.

3. Expect interaction and recognize success

Be sure to set up the garden so that the person can interact with it to the extent desired.

This may mean frequent handling, overwatering or other behavior that might actually not be in the best interest of the plants themselves.

If possible, select hardy plants that will tolerate the amount of care – or neglect – they are likely to receive.

Get creative to create success

If the person will be watering the plant or garden, find a small watering can that won’t get too heavy when full.

This can also keep flooding to a minimum if the person enjoys watering the plants frequently.

Another solution to potential over-watering could be to ensure plants have plenty of drainage. Elevate them with pebbles above extra-large drip-trays so they aren’t soaking in overflow.

Alternatively, it could be as simple as putting up a sign that says “Already Watered” – or finding plants that love lots of water!

Opting for a hydroponic system could be another solution.

Knowing the person and their needs, and then tailoring solutions accordingly will lead to the best successes.

It’s important to keep perspective on the goal of this garden: for the person to engage with it.

Don’t worry about imperfection if it would discourage the person with dementia from interacting with the garden.

If the person is engaging with the garden, it is a success!

There are many ways that a person with dementia can interact or engage with the garden.

Depending on their interests and abilities, any of the following activities may be very therapeutic engagement:

Choosing which plants, or types of plants, to grow
Sharing their opinions, experience or thoughts about the garden
Reminiscing about past gardening or plant experience
Using hands or a gardening spade to fill pots with soil
Planting seeds or starts
Watching the plants develop
Simply sitting near the indoor garden
Smelling, touching or looking at the fruit, flowers or foliage
Watering the plants
Deadheading flowers, harvesting, pruning or providing other care
Cutting flowers or arranging bouquets
Cooking or crafting with what they have grown
Picking the plants (even at “non-traditional” or “non-ideal” times)

Any other activity not listed above that allows the person to enjoy, experience or interact with the garden area or individual plants is also considered a success.

4. Find the right light

Find a suitable location to start a garden

A sunny south-facing window is perfect. If that’s not available, adding a grow light can help. Grow lights are designed to simulate sunlight. They can even enable plants to grow year-round.

Consider a countertop hydroponic system for simplicity and ease

Another alternative to consider may be a self-contained countertop hydroponic system. These systems are designed to make gardening extremely easy and successful.

“Hydroponic” means that the plants grow without soil – just water, light and nutrients. Basically, all that is required in many of these systems is to drop a seed into a designated area and then ensure that the device’s water reservoir is kept full.

They usually provide nutrient tablets to drop into the water every couple of weeks or so.

All in all, these systems tend to require very little work for a countertop full of fresh herbs, greens, strawberries, or other lush plant life.

Keep safety foremost in mind

If using a grow light or other electrical devices in a dementia garden, take extra care to be sure that any light bulbs or cords are handled safely.

Look for LED grow lights when possible, which emit less heat than their counterparts.

Be sure cords are kept well out of walkways. Taping them into place may be a good idea, depending on the particular set up.

5. Choose good plant candidates

Select plants that are non-toxic and not sharp. If possible, find plants that stimulate the senses, memories or both.

Most of all, don’t worry too much about getting everything “right.” Just enjoy the experience, and ensure that the person with dementia does too.

That being said, the following is a list of some generally good candidates for an indoor dementia garden.

Lavender

This lovely flowering plant has a pleasant aroma and phytochemicals known to promote relaxation. It needs a lot of heat and light to thrive.

Herbs

Edible, aromatic and purposeful! Using herbs in cooking may even help to stimulate an appetite.
Basil likes its soil to be kept moist while oregano, thyme and rosemary prefer less frequent watering. All of these herbs enjoy warm sunny conditions.
Mint, parsley and chives fare well with lower levels of heat and sunlight.

Jasmine

This pretty vine boasts small white flowers with a strong sweet aroma that can easily fill a room. It can be grown indoors in a partly sunny location where temperatures remain on the cooler side. They prefer growing in moist soil on a trellis or support.

Lemon balm

Lemon balm has a strong sweet lemony aroma. It prefers lots of light and well-drained soil. It can be enjoyed as cuttings in a vase or bouquet. Moreover, lemon balm has long been prized for its medicinal properties. Among other things lemon balm is known for calming the mind, improving mood and enhancing cognitive function.

Spider plant

Appreciated by many for their ability to survive without much sun or attention, spider plants are among the easiest houseplants to grow.

African violet

African violets are popular houseplants due to their velvety leaves and pretty purple flowers. They can blossom year-round under the right conditions. They prefer indirect light and are sensitive to overwatering.

Hoya

Also known as a wax plant, honey plant or wax vine, hoyas are popular hanging or climbing houseplants. They are pretty, hardy and low maintenance. They tolerate various lighting conditions but grow best and produce flowers in bright light. Avoid overwatering.

Baby rubber plant

Another easy to grow houseplant, the baby rubber plant prefers moderate light and somewhat cooler temperatures. It doesn’t like to be overwatered, but it does appreciate humidity. Misting it regularly would make a good activity.

Lettuce, kale or salad greens

These grow quickly and easily in a sunny location.

Scallions

Also known as green onions, these aromatic plants grow quickly in bright sunlight. They take longer from seed, but can be regrown from kitchen scraps within days or weeks simply by placing the roots in water or soil. Cut off the green tops for cooking or eating and the plant will continue to grow.

There are countless more good choices of what to grow in your unique indoor dementia garden.

How will an indoor garden affect your loved one’s life?

There are so many reasons to grow an indoor garden with, or for, someone with dementia.

Science has proven it with countless studies, but what really matters are the effects each individual sees in his or her own life.

Even if you have access to an outdoor garden, having plants indoors as well will only increase the therapeutic benefits.

So, let’s get growing!

Smoking and Dementia Risk

Petra Boh Blog, Causes February 18, 2021October 16, 2021dementia, smoking

Recently, there has been a lot of controversial information about smoking and dementia. Does it damage brain health?

Some studies strongly state that smoking increases dementia risk.

Other research reveals that there is no link between dementia and smoking. Some reports even suggest that active smoking has beneficial effects on the brain.

Conversely, there is evidence suggesting that active smoking has neurotoxic effects that double the risk of dementia for older adults.

Is There a Link Between Smoking and Dementia?

Tobacco is already recognized as one of the risk factors for several non-communicable diseases. These include diabetes, cancers, chronic lung disease, and cardiovascular diseases.

According to Dr. Douglas Bettcher, tobacco is one of the largest threats to public health killing almost six million people every year.

Below, we will look at both sides of the debate.

This will give a better understanding of whether smoking increasing a person’s risk of getting dementia or not.

Studies Supporting the Fact that Smoking Increases Risk of Dementia

WHO (World Health Organization) published information stating that smokers have a 45% higher risk of developing dementia when compared to non-smokers.

This was done in collaboration with ADI (Alzheimer’s Disease International).

WHO reviewed the evidence that showcases a strong relationship between smoking and dementia risk. The organization also concluded that the risk becomes higher the more an individual smokes.

This is one of the reasons the organization is at the forefront of encouraging people to quit smoking because of all the negative effects it has.

It is estimated that about 14% of Alzheimer’s cases in the globe are attributed to smoking.

Alzheimer’s Society UK supports this statement explaining that there is strong evidence that smoking can increase a person’s risk of developing dementia.

Although not every smoker will end up with dementia, quitting smoking is thought to reduce the risk of equating it to that of non-smokers.

One of the primary reasons behind this is that vascular dementia and Alzheimer’s disease the two most common dementia forms are linked to issues with the vascular system i.e. blood vessels and heart.

Smoking is known to increase the risk of suffering vascular problems through smaller bleeds inside the brain or strokes.

These are among the top dementia risk factors.

Additionally, the toxins present in cigarette smoke are known to increase inflammation and oxidative stress

Does Second-Hand Smoking Increase the Risk of Dementia?

WHO also warns that passive smoking or exposure to 2nd hand smoke can also increase the risk of developing dementia.

A Cardiovascular Health Cognition Study published in the American Journal of Epidemiology in 2010 supports the statement that second-hand smoke (SHS) can increase the risk of developing dementia.

The researchers observed 5,201 participants from different parts of the US all of who were 65 years or older for one year.

They also followed another group comprising African American participants for 12 months as well.

Out of these groups, the experts recorded 3,608 participants who had developed dementia after follow-ups.

The researchers asked the subjects if they had lived with a regular smoker and the number of years this happened.

They found out that over 60% of the individuals have lived with a smoker for over 15 years.

The experts concluded that exposure to high levels of second-hand smoking, as well as carotid artery stenosis, was associated with a higher risk of developing dementia, especially over six years.

This study also revealed that the risk of dementia increased three times for people who had more than 25 years of exposure to second-hand smoke.

SHS affects your body in the negative, too

The study goes ahead to explain that tobacco smoke contains numerous carcinogenic or toxic chemicals. These include heavy metals, vinyl chloride, arsenic, formaldehyde, hydrogen cyanide, and carbon monoxide amongst thousands of others.

The chemicals are highly concentrated in SHS when compared to the smoke that smokers inhale.

Studies reveal that exposure to second-hand smoke in adults is associated with a greater risk of cognitive impairment.

While looking into smoking and dementia, second-hand smoke may increase the risk of dementia indirectly because of the aggravating risks that relate to the disease.

SHS causes several vascular changes including the formation of lesions, carotid artery thickening, compromised endothelial function, platelet aggregation, and it may also lead to stroke.

These vascular changes have been known to increase the risk of dementia.

More studies, however, need to be conducted to establish the link between dementia and SHS.

Research that Finds No Link between Smoking and Dementia

While many studies ascertain that smoking increases the risk of dementia, some strongly state that smoking is not related to dementia risk.

One of the studies that support this observed 531 seniors for more than a decade.

The researchers did not find any link between elevated dementia risk and tobacco smoking.

The study was conducted at the University of Kentucky and the researchers said that they used a different method known as “competing for risk analysis” to analyze data.

At baseline, the experts recorded that no participant was cognitively impaired.

During that time, 231 participants were former smokers while 49 were current smokers. After follow-up 111 subjects got a positive dementia diagnosis. 242 persons also passed on without dementia.

Their analysis revealed that smoking led to early death and that smoking was not associated with dementia.

The experts, however, acknowledged that because the study only looked at individuals from a single research center, the results may not necessarily represent other populations.

Why Research on Smoking and Dementia is Complex

Despite researchers carrying out a multitude of studies trying to connect smoking and the risk of dementia, it remains complex for various reasons like:

1. Many studies will not have accurate data because the researchers will focus on comparing individuals and their smoking habits at certain points in their lives.

A person may not be able to tell how much they smoked at that point especially if they have already started to develop some dementia symptoms.

It may help if researchers commit to following a large group of people over a long time recording their smoking habits to collect accurate data.

2. Cigarette smoke contains different toxins and chemicals making it hard to identify the one that is causing the damage. Some experts strongly believe that one of them (nicotine) helps to reduce dementia risk.

3. Some lifestyle risk factors for dementia may be challenging to separate.

For instance, many individuals who smoke also consume alcohol which is another dementia risk factor.

4. Smoking has been documented as one of the leading causes of premature death. A majority of smokers will most likely breathe their last breath before dementia starts to develop.

This implies that smokers who live to be older may have certain traits such as genetics that may not be a true representation of the entire population.

5. Some studies that have reported protective tobacco effects were influenced by players in the tobacco industry.

Closing Thoughts

Because there is still no cure for dementia, it is important to focus more on prevention by changing some of the modifiable risk factors like smoking.

Research on smoking and dementia shows that there may be a decrease in the dementia burden in future years if there will be a decrease in smoking.

More research needs to be done to give out a final stand on whether smoking increases the risk of dementia or not.

Dementia and Head Injury Risk

Rok Krivec Blog, Causes February 18, 2021October 16, 2021dementia, head injury

Numerous studies have been done to find out the connection between dementia and head injury.

This is after suspicion that TBI (traumatic brain injury) which is usually caused by head injury normally disrupts the normal functions of the brain which can affect someone’s cognitive abilities such as thinking and learning skills.

Can a head injury make dementia worse?

Keep in mind that it is not everyone who gets a head injury will end up developing dementia.

The immediate effect of a head injury can induce symptoms that people with dementia also exhibit.

These can include things memory loss, confusion, changes in speech, personality and vision.

They can go away quickly, last for years, or never clear up depending on the severity of the injury.

Causes of Head Injury

Some of the most common causes of head injuries that can lead to traumatic brain injury include:

Car accidents
Being struck on the head by objects
Bullet wounds
Falls
Assault
Injuries that penetrate the brain and skull
Blast injuries, etc.

The above causes the brain to jolt violently in the brain.

Each of them normally has different outcomes for the people they impact.

Some types of TBI can increase the risk of developing various types of dementia including Alzheimer’s years after the injury took place.

Reasons Head Injury may Result in Increased Dementia Risk

There are a couple of mechanisms that explain the link between dementia and head injury.

One of them is that brain injury is known to accelerate or induce the accumulation of abnormal proteins.

This then leads to the death of neurons that are associated with some dementia types like Alzheimer’s disease.

There is also a possibility that trauma leaves the brain more vulnerable to other types of injuries.

Research that has been done on Dementia and Head Injury

As mentioned earlier, researchers have been trying to uncover the link between head injury and increased dementia risk.

Below are examples of research that has been done on this course.

Umea University Study

A study done at the Umea University in Sweden confirms that traumatic brain injury is one of the dementia risk factors.

It was after observing over three million people aged 50 years and above. This was published on 30th January 2018 in the PLOS medical journal.

It indicated that the risk of dementia diagnosis was highest during the first 12 months after the injury.

During this period, individuals with traumatic injuries are 4-6 times likely to get a positive dementia diagnosis when compared to the ones who do not have a traumatic brain injury.

The study also concluded that a traumatic brain injury or a concussion can increase the risk of dementia even 3 decades later.

Another study published in the Journal of Neurology discovered that a history of traumatic brain injury may increase by two or more years the age of onset for cognitive impairment.

Other studies also had similar results indicating that traumatic brain injury causes a significant risk when it comes to cognitive decline in the elderly.

It is also associated with earlier onset of in people with Alzheimer’s disease and mild cognitive impairment.

Increased Risk in Boxers

Some research on dementia and head injury also reveals that boxers have an increased risk of chronic traumatic encephalopathy (CTE) which is a type of dementia.

CTE symptoms include confusion, memory loss, impulse control problems, impaired judgment, anxiety, aggression, suicidality, and progressive dementia.

The symptoms may show up after years or decades of traumatic brain injury.

This is mostly due to the number of rounds that the professional boxers rather than the times he or she was knocked out.

This implies that when someone suffers mild traumatic repeatedly, they are also at increased risk of getting dementia even when the injuries did not cause unconsciousness.

Researchers are yet to uncover whether CTE is likely to occur after several traumatic brain injuries, a large number of mild traumatic brain injuries, or some other forms of heard trauma patterns.

Brain Issues in other Professional Athletes

Several studies have also been done focusing on professional athletes including boxers, football players, and mixed martial arts fighters.

Most have found a connection to serious brain troubles later in life. These include dementia or CTE.

A UCSF study also reported that the risk of dementia doubles after a person suffers a concussion.

The researchers tracked over 330,000 veterans while trying to find the link between dementia and head injury.

After adjusting sex, age, education, race, and other health conditions, they stated that without loss of consciousness, people who had a concussion were 2.36 times likely to get dementia.

The number was higher for people who lost consciousness at 3.77 times higher.

The research focused on veterans and members of the general public and the findings were similar for both groups.

There is still no evidence that one mild traumatic brain injury can increase the risk of developing dementia.

Nonetheless, there is emerging evidence that states that repeated mild traumatic brain injuries lead to a greater risk of CTE.

Closing Thoughts

More research still needs to be done concerning dementia and head injury.

Scientists are working to establish the link between traumatic brain injury and the increased risk of dementia.

Based on the existing evidence, it is highly recommended that people protect their heads when participating in activities that can lead to head injury.

Dementia and Multiple Sclerosis – Is There A Link?

Petra Boh Blog, Signs February 17, 2021October 16, 2021dementia, multiple sclerosis

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.

Many people with MS will end up developing cognitive symptoms.

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

It is common for people with dementia to have communication problems.

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.

How to Deal with Dementia and Insomnia

Petra Boh Blog, Causes, Signs February 17, 2021October 16, 2021dementia, insomnia

Many seniors end up suffering from both dementia and insomnia at some point in their lives.

Insomnia affects about 20%-35% of persons who have dementia.

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.

Not getting enough sleep can also make dementia worse.

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.

Eating a Healthy Diet

A well-balanced and nutritious diet is important for everyone, more so, individuals with dementia.

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.

Dementia Risk Factors: Will You Get It?

Candace Kastanis Blog, Causes February 17, 2021October 16, 2021dementia, risk factors

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:

Paying bills
Driving
Using the bathroom
Cooking
Taking medications
Communicating
Self-Care Practices

How is Dementia Diagnosed?

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.
Dementia with Lewy Bodies is a type of dementia that has distinct physical symptoms such as body stiffness, tremors, insomnia, and visual hallucinations.
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.

The reason is that being overweight negatively impacts our vascular health.

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.

Hearing Loss

The exact relationship between hearing loss and dementia is still being explored.

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.

How To Lessen Your Risk Factors for Dementia?

By educating yourself and partnering with your medical doctor, you can help to lessen your risk for dementia and other chronic diseases.

Top medical experts recommend the following self-care practices to stay healthy and reduce your personal risk for developing dementia.

Find a way to incorporate exercise into your daily life.
Consume nutrient-dense foods whenever possible. Experts advise adopting a Mediterranean style diet to ward off dementia and other chronic health conditions.
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.

5+ Cognitive Tests For Dementia & Alzheimer’s

Dr. Yasmin Aghajan Blog, Prevention February 16, 2021March 23, 2022cognitive tests, 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.

Note: you can find only MMSE test here.

MOCA test

The MOCA is also scored on a 30 point scale.

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.

Note: you can also access MOCA test online.

SLUMS test

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.

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.