Former NFL and Hall of Fame star, John Mackey died Wednesday at age 69, after years of struggling with dementia. He was instrumental in establishing the "88 Plan" which supplements the health care costs of former players suffering from dementia. Here are the current facts about dementia and its various categories.
Definition
Doctors Shadlen and Larsen, in an UpToDate article, describe dementia as memory impairment with at least one other cognitive domain being affected. This could be speech, mental acumen, or motor dysfunction. In addition, these symptoms must represent a decline from previous function and interfere with daily activities and the ability to function independently.
Dementia is not a disease but instead a "group of symptoms" that affect cognitive and social functioning and interfere with daily living. The Mayo Clinic discusses a number of causes of dementia symptoms. Alzheimer's is the most common type of dementia, but there are other dementias that are grouped by what they have in common, such as their location in the brain, or if they are progressive over time. Some types can be caused by alcohol effects, depression and medications, and they may be reversible if the cause is not neurodegenerative.
Progressive dementias
These worsen over time and include:
- Alzheimer's -- This occurs the most often and most elderly patients who have dementia meet the criteria for Alzheimer's disease, accounting for 60-80% of the dementia diagnoses.
- Lewy body dementia -- The second most commonly occurring dementia after Alzheimer's. "Abnormal round structures," called Lewy bodies, occur in the areas of the brain which affect thought processes and movements. This causes a progressive decline in mental functioning and may exhibit visual hallucinations, alterations in alertness and attention, daytime drowsiness, muscle rigidity, slow movements and tremors.
- Vascular dementia -- This type commonly occurs after a stroke, and the symptoms occur due to impaired blood flow to those areas in the brain. Typical symptoms include: impairments in judgment, reasoning, decision-making, planning and memory. All strokes do not cause dementia, but it can be the result of a severe enough stroke. Marie-Florence Shadlen, MD and Eric B Larson, MD, MPH indicate that vascular dementias account for 10-20% of all dementias.
- Frontotemporal dementia --This causes degeneration of the nerve cells in the frontal and temporal brain areas. Occurring less often, this type affects younger individuals, usually between 50 and 60, like Mackey, but can occur between 40 and 70. Symptoms include personality changes, concentration and cognitive difficulties, language problems, difficulty with mental flexibility and social inappropriateness.
Reversible dementias
There are some types of dementia or dementia-like symptoms that are may be reversible and these fall into the following categories:
- Infections and Immune disorders
- Endocrine abnormalities
- Nutritional deficiencies
- Medication side effects
- Poisoning
- Subdural hematomas
- Lack of oxygen to the brain (anoxia)
In all of the above instances, the outcome is dependent upon the severity of the cause.
Margie Miklas is a critical-care nurse with more than 30 years experience. She currently works in south Florida in a cardiovascular ICU with a specialty certification in cardiac surgery.
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