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The Lonely World Of Dementia.
Lisa Nesbitt
DEMENTIA
WHAT IS DEMENTIA?
Dementia is a term used to describe when the brain starts to
deteriorate, causing damage to the cerebral cortex. This may be
due to a disease attacking the brain, a build-up of proteins, strokes,
or alcohol misuse. It is a neurological disorder that affects cognitive
abilities like memory, language, and reasoning. It is progressive and
degenerative and can lead to a person being unable to carry out
daily tasks. Dementia is incurable but treatments can alleviate and
slow the process down.
HOW IS THE BRAIN AFFECTED?
As the dementia takes hold within the brain, it starts to disrupt the
neuron links inside the cerebral cortex, causing the nerve cells to
die. The frontal and temporal lobes are greatly affected as they
control functions like decision making, conscious thought, facial
recognition, language and short- and long-term memory processing
and retrieval. However, the occipital and parietal lobes are also
affected.
(Wakefield Hospice, no date)
As shown in the image above, the frontal lobe of a dementia
sufferer may cause the person to behave differently, possibly more
aggressive or with a lack of empathy, or struggle to multitask and
problem solve. The parietal lobe may cause the person to seem
uncoordinated and struggle with surroundings. The temporal lobe
may cause the person to easily forget something that happened a
few days earlier while being able to remember their childhood. The
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occipital lobe may cause the person to be unable to focus on an
item in front of them, not seeing it correctly.
WHY IS IT DIFFICULT TO DIAGNOSE DEMENTIA?
An early diagnosis helps with effective treatment and allows for a
care plan to be put in place. It also helps the person answer
questions they may have been wondering about, in relation to any
changes they had noticed. The initial diagnosis may be hard to
make as a lot of the symptoms may occur with aging, such as
forgetfulness, or are seen due to a separate underlying condition
and once the condition is treated then the dementia symptoms
disappear (this is called temporary dementia).
Temporary dementia may arise due to sleep apnoea, depression,
dehydration, or infection to name a few. While the diagnosis is
needed, sometimes the stigma can be seen negatively and could
cause initial shock and unwillingness for treatment, with the person
trying to pretend that it is not happening. There is also a fear that
dementia is a ‘death warrant’ so a person may not seek out
support.
Before a diagnosis is made, a baseline should be formed to show
deterioration. This is done by either the person or someone close
to them creating a diary which shows each time a symptom
presents itself and how. Collecting this data will help to show when
the symptoms become more frequent and is used by the GP to
establish a coloration to dementia. The GP would then start making
formal assessments, using a mini-mental state examination and a
physical self-maintenance scale which are repeated regularly to
track differences within the persons cognitive and functional
abilities.
DEMENTIA SHOWS ITSELF IN DIFFERENT WAYS
WHAT FACTORS AFFECT THE RISK OF DEMENTIA?
The risk factors that increase a person's chance of developing any
form of dementia is age, gender, genetics, health issues
(depression, vitamin deficiencies, diabetes, cardiovascular
problems), and lifestyle choices (diet, exercise, smoking, alcohol
and drug intake) however each form of dementia develops due to
different causes.
Some of the main factors causing Alzheimer’s disease is a family
history of it, aging, injuries to the head, or cardiovascular problems.
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The Lonely World Of Dementia

Scientists have discovered that a person with certain genes within
their DNA will have an increased risk of developing Alzheimer’s and
these genes are coding the APP, PS-1 and PS-2 proteins.
Vascular dementia can be caused by a blockage within the blood
vessels of the brain which leads to a reduction of oxygen flowing
through them. Due to this blockage being visible on MRI and CT
scans, it allows the diagnosis to be quite easy.
Lewy bodies are small protein particles (alpha-synuclein proteins)
that disrupt the brain cell connections and is often linked with other
forms of dementia depending on the area of the brain they are
found in.
Frontotemporal dementia can be caused by head trauma of the
frontal lobe or the overproduction of tau or TDP-43 proteins which
cause the brain tissue to shrink.
Alzheimer’s and Vascular Dementia). Behind them are the more
rarer forms of dementia such as Lewy bodies dementia,
frontotemporal dementia, and other dementias like Huntington’s,
Parkinson’s, Creutzfeldt-Jakob Disease, Wernicke-Korsakoff
Syndrome (caused by a B-1 deficiency usually seen in alcoholism),
and Normal Pressure Hydrocephalus (this is a form of dementia
caused by excess fluid within the brain, however it can be fully
treated and affects reversed if diagnosed early enough). This can be
shown in a pie diagram.

WHAT ARE THE POSSIBLE SIGNS AND SYMPTOMS?

Each type of dementia may show different symptoms, due to the
different areas of the cerebral cortex affected.
Alzheimer’s disease has the initial symptoms of forgetfulness and
change of personality (which may account for a misdiagnosis) and
leads to spatial awareness difficulties, communication challenges,
hallucinations, and the inability to preform daily tasks as the
dementia progresses. These symptoms are due to the impact on
the hippocampus, frontal lobe, temporal lobe, and parietal lobe
within the brain.
Vascular dementia has similar symptoms to Alzheimer's (which
could lead to a misdiagnosis) however what may be different is a (Foggin, 2018)
impact to the speed it would take a person to problem-solve or
respond as the ‘thinking’ times can increase. As vascular dementia
is caused by blockages within the blood vessels, its impact is seen DEMENTIA WITHIN SOCIETY
within all parts of the brain including the cerebrum.
Lewy bodies has the initial symptoms of urinary issues, delusions, WHAT IS THE MEDICAL MODEL OF DEMENTIA?
and sleep disorders progressing to confusion, paranoia, and motor
The medical model of dementia sees dementia and its sufferers as
difficulties then to increasing susceptibility to infections, rigidity
the issue. It takes a medical standing, with the aim being to
within muscles, and heightened sensitivity to touch. The cerebrum
research and develop medications that may be able to cure the
is affected within Lewy bodies dementia due to the alpha-synuclein
dementia. This could cause the patient to feel like their needs are
proteins clump together within the grey matter of the brain.
not being met and opinions are not listened to as, within this
Frontotemporal dementia has similar symptoms as Alzheimer’s due model, the patient is seen as the problem that needs to be ‘fixed’
to the impact on the frontal lobe and temporal lobe, which affects and that they are unable to make decisions. It looks at what is
the cognitive functions of the brain. happening within the brain, both chemically and neurologically,
In general, dementia follows the same progress with symptoms rather than at the impact from the environment. As a whole, the
starting off mild and progressively getting worse as time goes on medical model can sometimes be seen as flawed due to the lack of
due to the constant damage affecting the brain. As the dementia importance put into what the patient needs.
progresses into the later stages, the amount of care needed also Medical Model of Dementia
increases as daily tasks become more difficult, to a point where Can not
make
decisions
even the act of swallowing is impacted. Needs
policies and
services to Needs to be
do things for cured
them
HOW DO THE PREVALENCE RATES DIFFER BETWEEN THE TYPES?
A patient
The different types of dementia have varying levels of prevalence. with
dementia...
Alzheimer’s disease is the most common form of dementia,
followed by Vascular Dementia then Mixed Dementia (when a Is dependant
Expects and
deserves
on others
patient is suffering from a multiple of dementias, most commonly is sympathy

Is a victim

2 | L. Nesbitt ., 2023, 1-3

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The Lonely World Of Dementia

WHAT IS THE SOCIAL MODEL OF DEMENTIA? groups, and The Alzheimer’s Society can be invaluable as there will
The social model of dementia sees the environment and social be a lot of questions that need answered.
situations as causes of difficulties a patient may encounter. It takes The impact to the care system needs to have an aspect to training
a social standing and aims to focus how the dementia affects a of care staff should be made to allow effective care and treatment
person within different settings. This allows the patient to feel like for dementia sufferers as the support can vary, depending on the
they are being listened to as their environments are being adapted type. Medication and restraints may be used but should be only if
to allow for any changing needs. It is a holistic approach used to fully required and without causing harm. Without the effective
help the patient stay as independent as they are capable of and training, the care staff open themselves to litigation. Media are
gives them control over their treatment and care plans. quick to put blame when care is abused and this may cause more
struggles for the patient and family when considering long term
Social Model of Dementia Should be plans.
included
within any
decisions
being made Wants
The financial impact to society for dementia care in the UK is
Needs
policies and
services to do
attitudes of
others to around £26.3 billion, with only around 1/3 of that being
change and
things with
them settings to government funded, meaning that the rest is paid for by the
adapt
patients and their families. According to Public Health England,
A patient with
dementia...
“This corresponds to an average cost per person of £32,250
annually.” (Public Health England, 2021). This alone can create
Can be
independent
Should be
able to live as
additional stress for those involved as it would normally come at a
and soically
active within
normally as
possible time when the independence has started to diminish due to loss of
communities
Has rights earnings from either the patient (having to stop work), or the family
and
derserves
respect
(having to take on a more full-time carer role). Depression and
other illnesses (both physical and mental) may start to be seen
within the people around the patient as well as the patient
themselves, this is something that could progress further in a
negative way by neglecting themselves.
Obviously, working alongside only one of these models could cause
the patient to not receive the fullest treatment. This is because,
even though the social model is seen as a holistic model, medical
advances in treatment and medication may also help the patient by
slowing the deterioration process down.

HOW DOES DEMENTIA IMPACT THE INDIVIDUAL AND SOCIETY?

From the onset of symptoms of dementia (even before diagnosis)
the individual and their loved ones may notice the impact of
dementia as it starts to change the behaviour of the individual.
Frustrations of the forgetfulness and loss of interest in hobbies may
be accounted for as just getting old or even the unwillingness (due
to the stigma attached) to get those answers, may leave some
people to suffer undiagnosed. If left, this can create isolation from
the community as personality changes, memory starts to worsen,
and mobility becomes uncoordinated, the sufferer may choose to
not leave their home. This can be an unnerving time for the
community as they start to worry about the individual.
After diagnosis, the individual may still not want to accept the cause
and go into denial. Again, this could be due to the stigma of
dementia with the impending loss of independence and memory of
loved ones. However, once the individual has accepted the
diagnosis, the support factors can arise. This includes the
introduction of a care plan and possible support care team which is
agreed upon by the individual. Plans can be made regarding the
impending changes which include when to start giving up
independence, what can be brought in to replace that loss, who
would take on the role of advocate, and whether relocation into the
care system is required. The amount of support available to the
individual and their families from medical professionals, support

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