Mental health is arguably one of the most preannounced topics within general health discourse. Primarily this is because the number of people suffering from mental health issues continues to soar, and the types of mental health conditions are increasing. Degenerative dementia is one such mental health condition and is currently affecting many people some of whom remain undocumented due to ignorance or fear of stigma, and difficulty in accessing mental health service. Yet, less is known about degenerative dementia, especially the types of the condition so far identified. The goal of this paper is to provide an overview of the different types of degenerative dementia and discuss the major factors impacting mental health services.
Types of Degenerative Dementia
It is prudent to mention that the exact types of degenerative dementia remain debatable to date. This is because the types of this condition continue to emerge and research is continuing in the identification of other types of the disease. Nevertheless, the following types of degenerative dementia have been so far identified.
Delegate your assignment to our experts and they will do the rest.
Alzheimer’s’ Disease
According to research conducted by Diana (2016), on the different types of degenerative dementia, Alzheimer’s dementia has been noted as the most common type. It derives its name from Alois Alzheimer, an early twentieth-century psychiatrist who first described the disease. Over time, patients of Alzheimer’s disease often lose their ability to concentrate and their memory. Orientation in time and space become increasingly difficult, and management of everyday life activities becomes harder. A majority of people suffering from Alzheimer’s disease tend to need more support with the progress of the disease. Although it is possible to influence the course of the disease by various medications and non-drug treatments, there is difficulty in finding a permanent cure for Alzheimer’s disease, or to prevent it from progressing (Diana, 2016). The average life span of a person suffering from Alzheimer’s disease is eight years post-diagnosis, but most of them can live up to roughly 20 years based on other health conditions. This reality makes it more critical for people suffering from the disease to receive good care and consistent support. Thus, they require loving and stable socio-emotional relationships and a tolerant environment.
Aging has been identified as the largest risk factor in Alzheimer’s disease. However, the disease is not a normal part of aging (Diana, 2016). Although a considerable percentage of people suffering from Alzheimer’s are above 65 years, people below this age bracket are not exempted (Diana, 2016). Contextually, early onset of Alzheimer’s disease is commonly noticeable between 40 and 50 years, and approximately 5% of people suffering from the disease fall under this age bracket. Memory problems have been noted as the frequent formative symptoms of Alzheimer’s disease since most patients fail to remember things recently learned. Other symptoms include; confusion about times and place, inability to find appropriate words to speak, regular misplacement of objects, changes in personality, poor decision making, difficulty in organizing thoughts, newly occurring irritability, problems with numerical calculations, mood swings, constant repetition of things, and paranoia and distrust of people including close friends or family members (Diana, 2016). The exact cause of Alzheimer’s disease is still unclear. However, there are certain environmental, lifestyles, and genetic (Apolipoprotein E gene-APOE) factors with the potential to cause the disease. All the same, what is clear is that Alzheimer’s disease damages the brain including brain cells, and often leads to the shrinking of the brain. In most circumstances, the brain of a person suffering from Alzheimer’s disease exhibits two types of abnormalities; tangles and plaques. Tangles refer to the system tasked with carrying nutrients through a protein known as Tau to the brain. The brain of a person suffering from Alzheimer’s disease develops threads of Tau (neurofibrillary tangles), which then collects in the brain cells. Eventually, the collected tangles prevent the transportation of nutrients through the brain. Congruently, plaques refer to clumps of protein that usually impede communication between brain cells. This impediment eventually causes damage and even death of brain cells.
Lewy Body Dementia
Lewy Body Dementia, otherwise known as Dementia with Lewy Bodies, is a common degenerative dementia. Despite being common, this type of dementia is often undiagnosed or misdiagnosed. The name is derived from the protein deposits, Lewy bodies, which usually develop inside nerve cells within the brain regions responsible for memory, thinking, and movement (motor control) (National Institute on Aging , n.d). In most cases, people with Lewy Body Dementia experience a progressive reduction in mental illness. As such, most of them develop visual hallucinations and alteration in attention and alertness.
The disease is progressive. This means symptoms associated with the disease start slowly, but worsen over time as the disease progresses. Typically, Lewy Body Dementia (LBD) lasts for approximately 5 to 8 years after diagnosis till death. However, the usual period often varies from 2 to 20 years (National Institute on Aging , n.d). There is also a variation in how quickly the symptoms of the disease develop and change, and this variation depends on age, overall health, and severity. During the initial stages of the disease, the symptoms can be mild and the affected person may function normally. However, as the disease progresses, people suffering from LBD are more help-dependent due to reduced thinking and movement abilities. In the last stages, people with LBD often require maximum assistance and usually depend on others for care ( National Institute on Aging , n.d).
Lewy bodies, the protein associated with the disease, are composed of alpha-synuclein protein. In a healthy human brain, this protein plays various important roles in nerve cells (neurons) within the brain, more so, at the synapses where communication between brain cells occurs ( National Institute on Aging , n.d). In the brains of people with LBD, the alpha-synuclein protein forms into clumps within the neurons, beginning with the areas of the brain tasked with controlling aspects of movement and memory. This process affects how neurons work and result in their ineffectiveness and eventual death. This is in addition to affecting the activities of certain brain cells. Ultimately, this results in a widespread damage certain particular brain regions and eventual decline in the functionalities of the affected brain regions.
The most commonly affected regions include; the cerebral cortex which usually controls functions such as perception, language, information processing, and thought (National Institute on Aging , n.d). Lewy bodies also affect the limbic cortex which performs an integral role in behavior and emotions, the hippocampus which is critical in the formation of new memories, the brain stem which is integral in maintaining alertness and sleep regulation, and the midbrain and basal ganglia responsible for movement ( National Institute on Aging , n.d). Like other types of degenerative dementia, the exact cause of LBD is still unknown. However, age is presently considered a top risk factor since most people with LBD are over 50 years. Other considered factors include; diseases and health conditions such as REM sleep behavior disorder and Parkinson’s disease, genetics through variants in APOE, GBA, and SNCA genes ( National Institute on Aging , n.d).
Vascular Dementia
Vascular dementia is a degenerative dementia commonly attributed to a reduced flow of blood in the brain. It is estimated that more than 150, 000 people currently suffer from vascular dementia (Hill, 2008). Similar to other types of degenerative dementia, vascular dementia is progressive and often worsens over time. During the initial years of its discovery, vascular dementia was commonly known as multi-infarct dementia since it was largely attributed to small strokes as major causes (Hill, 2008). However, its name changed to the present vascular dementia as a reflection of the array of conditions that impair the ability of blood to circulate to the brain. Over the recent years, a section of physicians has coined the term ‘’vascular cognitive impairment’’ concerning the disease probably due to its ability to capture a wide range of cognitive decline (Hill, 2008). In most cases, vascular dementia occurs alongside Alzheimer’s disease and results in mixed dementia. On average, approximately 1 to 4 percent of people above 65 years suffer from vascular dementia (Hill, 2008). The risk of developing the condition increases dramatically with age, and it accounts for approximately 10 to 20 percent of all identified dementia cases (Hill, 2008).
Common conditions that have been noted to cause vascular dementia include; infarction (stroke), especially those that block a brain artery. Chronically damaged or narrowed brain blood vessels have also been identified to cause vascular dementia. Risks factors include; mini-strokes, history of strokes, aging, mini-strokes, or heart attack, high cholesterol, smoking, atrial fibrillation, high blood pressure, diabetes, obesity, and atherosclerosis, and abnormal aging of blood vessels (Hill, 2008).
Frontotemporal dementia
Frontotemporal dementia (FTD) is a progressive type of degenerative disease often affecting people between 45 and 65 years (Mohandas, 2009). It is at times called Frontotemporal lobar degeneration (FTLD) though the latter term usually encompasses a larger group of disorders with FTD as one of the subgroups (Mohandas, 2009). FTD typically occurs in 5-15 percent of people with dementia with equal frequency in both sexes (Mohandas, 2009). Typical age of onset is commonly between 45 and 65 years but may range from 21 to 81 years with mortality within 6-8 years post-diagnosis (Mohandas, 2009). Unlike other degenerative dementia diseases, FTD has a strong genetic correlation with family history linkage noted in 40-50 percent of the studied cases. Genetic linkage reveals FTLD loci on chromosome 9p, 9, 17q, and 3p. The most common genes are microtubule-associated protein tau (MAPT) and progranulin (PGRN) (Mohandas, 2009), both located within chromosome 17q21 (Mohandas, 2009). Over 15 different pathologies underlie Frontotemporal dementia and related disorders with different features including; microvacuolation without neuronal inclusions and taupositive and microvacuolation nuerofibrillary tangles (Mohandas, 2009). Behavior changes are identified as common initial symptoms of Frontotemporal dementia in addition to speech and language problems (Mohandas, 2009).
Factors Impacting Mental Health Services
Although mental problems are key health and social concerns in contemporary society, accessing mental health services has proved difficult for a majority of the affected population and their family. This phenomenon is attributed to several factors. One of such factors stems from stigma and distrust associated with seeking mental health services. According to a recent survey, only 1 in 3 patients suffering from mental illness within the United States seeks professional help. Across Europe, approximately 27% of the population suffers one form of mental illness or the other, but 74% of this population fails to seek treatment (Tirintica, 2018). Much of the evidence blames distrust and stigma to psychiatric treatment as major factors in failure or delay in seeking professional assistance (Tirintica, 2018).
Other significant barriers to seeking professional psychiatric services by people with mental illnesses have also been observed. These barriers include religious beliefs which advocate for prayer as a preferable intervention to mental health problems and general distrust to entrust personal problems such as mental health issues with others regardless of their professional capacity to find a panacea to such problems. Economic barriers have equally been noted to impact on mental health services.
To that end, It should be noted that the problem of mental health is expansive and includes individuals occupying both the upper and lower economic segment of society. While people falling under the former category may access mental health services given their comparative economic power, those within the lower economic bracket are mostly excluded. This is partly because they lack the financial capability to pay for diagnosis or treatment, especially in cases involving private mental health care service providers, or lack the health insurance required in attaining such services from public mental health care facilities (Tirintica, 2018). On a micro level, denial of psychological problems has negatively impacted mental health service. This is because people who fail to acknowledge the mental health challenges they face rarely visit mental health care facilities even when such problems create adverse effects on both their mental and physical health.
References
Diana K. Wells. (2016, March 9). What is Alzheimer's Disease? Retrieved from https://www.healthline.com/health/alzheimers-disease-overview#symptoms
Hill, C. (2008, April 18). An Overview of Vascular Dementia. Retrieved from https://www.verywellhealth.com/vascular-dementia-98802
Mohandas, E. (2009, January). Frontotemporal dementia: An updated overview. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3038533/
National Institute on Aging. (n.d.). What Is Lewy Body Dementia? Retrieved from https://www.nia.nih.gov/health/what-lewy-body-dementia
Tirintica, A. (2018, December 7). Factors that influence access to mental health services in South-Eastern Europe. Retrieved from https://ijmhs.biomedcentral.com/articles/10.1186/s13033-018-0255-6
