WHAT IS DEMENTIA?

Dementia is something that everyone has heard of, and that a lot of people are scared of (not without reason). But dementia is not always a terrible thing. It is a normal part of life, and we are seeing more of it than we used to because people are living to be older and older.

Not all dementia is Alzheimer’s, though that is the most common type. Dementia is any kind of cognitive impairment that comes on later in life (so, not mental retardation or developmental delay), is permanent, and interferes with someone’s ability to function.

When someone who is older starts forgetting things—what the doctor said, when they’re supposed to call their daughter—that is not necessarily dementia. For one thing, it may just be that the person has a lot on her mind, or is anxious, or is sleeping poorly, or is depressed. But if this is ongoing and persistent, then it is likely a real beginning of memory impairment. But is it dementia? If the person is still able to function, maybe by writing things in a calendar, then what she has is not yet dementia, but what we call “mild cognitive impairment,” or MCI.  Many times, MCI does progress to dementia, but sometimes the MCI just persists and there is no progression.

If the impairment does progress, and the person becomes unable to manage without help (maybe she can’t manage her medications, or she forgets how to use a telephone), then she has dementia and needs to have some care. This is when she may need to move to an assisted living, or to a daughter’s house, or may need to have someone come into the house to help.

Since there are many kinds of dementia, and no two progressions of dementia are exactly alike, you may find that one person with dementia can still hold a perfectly good conversation on difficult topics, and another can still play the piano well. Having dementia doesn’t mean that everything in the mind goes at once: just that there is enough impairment that the person needs help.