Dementia: What does the brain look like?
A few MRI scoring systems contribute to grading the severity of dementia which will in turn guide management of the disease. Examples of scoring systems include the Global Cortical Atrophy (GCA) scale, Medial Temporal lobe Atrophy (MTA) scale, Koedam score for parietal lobe atrophy and Fazekas scale for white matter lesions/ vascular disease.
Dementia however, is not diagnosed based on imaging alone. It is diagnosed based on a combination of tests, ranging from a clinical history, assessment on mental ability such as memory and communication, lab tests and scans. Scans are utilised in this aspect mainly to i) exclude a structural/ surgical cause (for example, a brain tumour) and ii) grade brain changes in dementia.
Symptoms of dementia vary, depending on stage of the disease. Early symptoms of dementia are memory loss, being confused about time and place, mood changes and difficulty carrying out simple, usual daily tasks. At this stage, the disease is termed ‘mild cognitive impairment.’’ As the disease progresses, these symptoms worsen and the term dementia is used. Symptoms of dementia proper and advanced dementia are regular forgetfulness, difficulty finding the right words, difficulty with numbers and handling money, mobility issues, becoming more withdrawn or anxious, bladder or bowel incontinence, amongst others.
Dementia : Not so fun facts
Risk factors of dementia include advancing age, genetics/ family history, smoking and alcohol use, cardiovascular disease, high cholesterol and diabetes.
Most types of dementia cannot be cured but its progression can be slowed. Once a person is diagnosed with dementia, it is important to have a plan in place, such as Power of Attorney, support in terms of psychological treatment, physical and medical aid.