Dr. Mariecken Fowler, a neurologist with Winchester Neurological Consultants, explains how dementia attacks the brain, causing shrinkage of brain tissue and leading to cognitive impairments like memory loss and confusion.

Preventing and slowing dementia is largely about keeping the brain engaged.

Although there’s no cure for dementia, medical professionals say its progression can be slowed by a number of actions that include medication, diet, exercise and mental fitness.

Early detection is also a huge factor in helping prevent dementia, said Dr. Mariecken Fowler, a neurologist with Winchester Neurological Consultants.

Symptoms like memory loss and confusion are relatively late signs of the disease’s progression.

Symptoms usually don’t start until a person is 65 or older, but Fowler said they indicate a disease that started when a person is in his or her 50s or earlier.

Knowing 100 percent that someone will have dementia down the line will be a huge win for prevention, she said.

“How do we identify people 20 years before they’re diagnosed?” Fowler asked. That’s the “Holy Grail” of prevention.

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Alzheimer’s disease, the most common form of dementia, accounts for 60-80% of dementia cases, the Alzheimer’s Association explains at its website,

It’s a progressive disease that causes shrinkage of brain tissue, leading to problems with memory, coordination and general wellness.

Dementia is more of an umbrella term for various types of cognitive impairments that affect memory and movement or cause personality changes, Fowler said.

Though dementia usually presents at advanced ages, it is not a “normal” sign of aging.

It’s an atrophy or “death” of a part of the brain, said Crystal Larson, administrator at Lynn Care Center in Front Royal. The location of the damage affects where the cognitive problem is.

While dementia symptoms worsen over time, Alzheimer’s disease progresses over time into more symptoms of cognitive impairment, according to the Alzheimer’s Association.

Fowler said doctors differentiate between different types of dementia by looking at symptoms and how the disease presented, such as if it followed a stroke or traumatic brain injury.

Some drugs like anti-psychotics can also lead to dementia-like problems, Larson said.

There is hope, though.

“Our brains are pretty awesome and they will try to heal themselves,” Larson said. “New neural pathways will develop. So, there is hope for folks who have what they call vascular-type dementia.”

Surgery can also be an option, she said.

Dementia presents in different ways because everyone’s body is different. That’s why Larson recommends that people exhibiting symptoms see a neurologist as soon as possible.

Alzheimer’s tends to present foremost with memory issues, such as forgetting conversations or becoming confused about a sequence of events.

Other forms of dementia are not so much about memory loss but might concern personality changes or trouble handling more than one task at a time.

Because people with dementia are less active than others, they can develop illnesses or conditions that lead to a premature death, like blood clots or pneumonia.

Lack of mobility is a contributor, Fowler said, but the primary cause of death is usually an illness that probably would not have happened if they had not been so immobile.

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Treatment for dementia patients starts early.

“People in the early stages of dementia try their best to hide it,” Larson said.

They might not recognize that there’s a problem and be embarrassed if they can’t remember details they should.

They make excuses, she said, or set themselves excessive calendar reminders for dates they otherwise would have remembered. “They do really go to great efforts to compensate.”

It’s important to get a dementia patient treated as soon as possible because doctors can do a lot to slow the progression of dementia, such as through medication and assigning cognitive activities.

A big part of dementia treatment is “keeping your mind busy, always challenging your mind,” Fowler said.

That can be anything from crossword puzzles and other brain games to physical activity.

“Definitely those things help diminish the cognitive decline,” she said.

These things won’t reverse dementia, but they can help give a patient more time.

Contact Josette Keelor at