Incontinence with dementia places a significant burden on caregivers for people living with dementia (or PLWD). Today’s presentation will review dementia and incontinence as a condition associated with dementia. We will look at the common types of dementia in some depth and how it affects a person’s normal functions and activities of daily living (or ADL’s). We will connect the dots on how dementia contributes to the development and progression of incontinence, including health and quality of life consequences. We will also review some recommended strategies for the treatment and management of incontinence in people living with dementia. And finally, we will list some resources for more information on dementia, incontinence, and specific issues faced by persons affected with the combination of dementia and incontinence. And at the end we will list some resources for caregiver support.

 

Types of dementia   Types of incontinence   Risk for incontinence in patients living with dementia (PLWD)   Management strategies

Dementia as a Syndrome

While we often think of memory or other lapses as “senior moments”, the issue of dementia is not actually considered a part of normal aging. Rather, dementia is an abnormal decline in mental function that is usually irreversible. This is a result of changes in specific brain regions that cause the brain’s neurons (nerve cells) to stop working—meaning they no longer communicate with each other normally and appropriately. Brain shrinkage seen in some types of dementia can particularly affect the frontal lobe and hippocampus areas that are responsible for cognitive function. Research has identified features of several types of dementia and risk factors that include lifestyle, environment, and even rare genetic variants in some people.

Dementia is an umbrella term Defined by abnormal decline in mental function Includes various forms that affect the brain differently

Thus, dementia is a syndrome rather than a specific disease. The term includes a few disorders that can cause memory losses and/or impaired thinking and reasoning skills. Mild cognitive impairment may not keep a person from performing routine functions, such a paying bills and driving well enough, even if those tasks take a little longer to complete. Moderate stages may start to affect a person’s ability to function normally. Progression to severe stages may include complete dependence on others for activities of daily living or ADLs, such as self-feeding. Dementia may be typically diagnosed when it becomes severe enough to interrupt daily life activities and assistance for ADLs is needed.

 

Forms and Impact of Dementia

Let’s differentiate the broader term of dementia from specific diseases and common forms of dementia within that spectrum. Five categories of dementia include:

-Alzheimer’s disease,

-vascular dementia (which is moving to the term “vascular cognitive impairment” or VCI),

-dementia with Lewy bodies,

-frontotemporal dementia, and

-limbic-predominant age-related TDP-43 encephalopathy or LATE.

 

We will also discuss some conditions and reasons for dementia symptoms that do not fall into these categories. These include conditions and diseases that may share symptoms of dementia and may result from some potentially reversible causes, such as alcohol consumption and vitamin deficiencies.

Keep in mind that it is also common for people to have mixed dementia or a combination of two or more types of dementia. Researchers have found evidence of multiple forms of brain changes associated with different types in older adults. It is also possible that one type of dementia may contribute to the development and progression of another type. Researchers are investigating underlying disease processes and how each type of dementia might influence or contribute to the development and progression of other types of dementia.