As a child growing up, I had an elderly neighbor whom I thought was a little too interested in my career prospects; every time I was in his house to play with his children, he would ask me whether I was the one who wanted to be the doctor or it was my brother, and then go on and on about how Medicine was a great profession. Sometimes, this conversation would take place twice in the 4 hours I was there. It turns out what he was exhibiting were the early stages of dementia. Now, 15 years later, he does not ask me about my career, because he does not remember me at all. He also does not remember his wife’s name, he never knows when last he ate or what he ate, and is prevented from going out of the house unaccompanied since the last time he did, he could not find his way back.
Dementia is a generic term for a progressive decline in mental ability (memory, judgement, language, etc) severe enough to interfere with daily life. The very popular Alzheimer’s disease is the most common form of dementia. Another common form of dementia is vascular dementia, which occurs after a stroke.
Dementia is typically a disease of the aged and it very rarely occurs before 65 years, so do not fret if you are 35 and you misplace your keys every now and then or forget a friends name occasionally.
Before a diagnosis of dementia can be made there must be significant impairment in at least 2 of the following brain functions:
Memory
Communication and language
Ability to focus and pay attention
Reasoning and judgment
Visual perception
But even before this severe state of impairment is reached there are usually warning signs that should raise eye brows. The Alzheimer Society of Canada outlines these 10 early warning signs;
- Memory loss affecting day-to-day abilities – forgetting things often or struggling to retain new information.
- Difficulty performing familiar tasks – forgetting how to do something you’ve been doing your whole life, such as preparing a meal or getting dressed.
- Problems with language – forgetting words or substituting words that don’t fit the context.
- Disorientation in time and space – not knowing what day of the week it is or getting lost in a familiar place.
- Impaired judgment – not recognizing a medical problem that needs attention or wearing light clothing on a cold day.
- Problems with abstract thinking – not understanding what numbers signify on a calculator, for example, or how they’re used.
- Misplacing things – putting things in strange places, like an iron in the freezer or a wristwatch in the sugar bowl.
- Changes in mood and behaviour – exhibiting severe mood swings from being easy-going to quick-tempered.
- Changes in personality – behaving out of character such as feeling paranoid or threatened.
- Loss of initiative – losing interest in friends, family and favourite activities.
Early identification of these signs will allow for early diagnosis and make the family and patient better placed to cope with the symptoms and effects of dementia. Since dementia is a progressive disease, early diagnosis allows the affected person to make important decision- e.g. about their will and final testament- while they have the capacity to.
There is currently no cure for Alzheimer’s, and most dementias. However, there is treatment that can help deal with some of the symptoms. Much research is ongoing and a new drug, solanezumab, seems to be showing a lot of promise in delaying the progression of dementia caused by Alzheimer’s disease.
It is nearly impossible to determine who will develop dementia, with only a few genetic and chemical markers being our best bet at a confident prediction. There is also no proven way to prevent dementia, but the Mayo Clinic proposes the following as possible ways of delaying its onset;
Keep your mind active. Mentally stimulating activities, such as puzzles and word games, and memory training may delay the onset of dementia and help decrease its effects.
Be physically and socially active. Physical activity and social interaction may delay the onset of dementia and reduce its symptoms.
Quit smoking. Some studies have shown smoking in middle age and older may increase your risk of dementia and blood vessel (vascular) conditions. Quitting smoking may reduce your risk.
Lower your blood pressure. High blood pressure may lead to a higher risk of some types of dementia. More research is needed to determine whether treating high blood pressure may reduce the risk of dementia.
Pursue education. People who have spent more time in formal education appear to have a lower incidence of mental decline, even when they have brain abnormalities.
Researchers believe that education may help your brain develop a strong nerve cell network that compensates for nerve cell damage caused by Alzheimer’s disease.
Maintain a healthy diet. Eating a healthy diet is important for many reasons, but a diet rich in fruits, vegetables and omega-3 fatty acids, commonly found in certain fish and nuts, may promote overall health and lower your risk of developing dementia.
Dementia can be a scary state for both the patient and the family. We all need to be aware of the existence of this disease and its effects on the patient and family. It is only when we are in the know that we can cope with the tragedy of slowly losing someone who is not yet dead.
The conversation continues this Wednesday on the Citi Health Chat
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By: K.T. Nimako (MB ChB)
Dr. Kojo Nimako is a private medical practitioner with an interest in public health and Citi FM’s Chief Medical Correspondent. He is also the Executive Director of Helping Hand Medical Outreach, an NGO focused on health education.
E-mail: [email protected]
Twitter: @KTNimako