Dementia

The term ‘dementia’ refers to the state of experiencing symptoms such as loss of memory, cognitive (problem solving) function, thinking and language due to damage in the brain. This state can be caused by several different diseases, Alzheimer’s being the most common of them.

Being degenerative in nature, dementia is known to affect older people more (although it is not unheard of in younger individuals). Thus, an increasing human life-span means that it is currently the largest cause of dependence and disability in older people around the world. It is estimated that there are about 50 million people affected by dementia in the world at a given point of time. This figure is expected to rise.

Symptoms

The brain is divided into different lobes, or parts, each of which is responsible for different functions of the body. Hence, symptoms or disabilities may vary depending on which part of the brain has been affected and to what extent.

Different parts of the human brain and their functions
Illustration from spencerssolicitors.com

The World Health Organisation categorises the progress of symptoms into three stages:

  • Early stage – general forgetfulness, losing track of time, difficulty navigating in known places
  • Middle stage – forgetting names and recent events, repeating questions, wandering, difficulty in navigating at home, difficulty in communicating, needing some assistance with self-care
  • Late stage – difficulty recognising family and friends, losing track of time and surroundings, difficulty in walking, requiring increased assistance with self-care, behavioural changes such as aggression, lack of interest in socialising and usual activities, loss of empathy

Causes

Alzheimer’s disease is the leading cause of dementia and is reportedly responsible for between 60-80% of dementia cases. It is a physiological disease where excessive protein build up causes formation of plaque and tangles which eventually kill the affected neuron. This subsequently causes loss of nerve tissue in that part of the brain, affecting respective body functions. Additionally, Alzheimer’s also causes a reduction of neurotransmitters (chemical messengers) between neurons, thereby reducing signals transmitted from or received by the brain and further affecting functionality. The learning and memory center of the brain (hippocampus) is usually the first to be affected by Alzheimer’s, hence memory loss is often one of the first symptoms.

Brain of a healthy person (L) and that of an Alzheimer’s dementia patient (R)
Image from Dementia Care Central
Cross-section of a healthy brain (L) and one that has undergone degeneration due to Alzheimer’s (R)
Image from Science Source

Pulmonary dementia is another common form of dementia and is caused by a series of small strokes. Other forms include dementia caused by Lewy bodies (protein aggregates inside neurons) and frontotemporal dementia (which affects the frontal lobe of the brain first).

There are also instances where thyroid dysfunction and vitamin deficiency could cause symptoms of dementia.

Prevention

Some research suggests that there may be hereditary links to dementia. If you have a known family-history of dementia, or even otherwise, following are a few practices that help to maintain sound mental health:

  • not smoking
  • limiting consumption of alcohol
  • being aware of potential side effects of long-term medication
  • seeking support and treatment if you suffer from depression
  • refraining from subjecting oneself to excessive stress or pressure
  • getting at least 6-8 hours of quality sleep every day
  • keeping your body active (e.g. play a sport, walk, dance, practise yoga)
  • keeping your mind active (e.g. solve a crossword, play an instrument, learn a new language, design something new)

Dementia – like most diseases – does not discriminate, and there is no guarantee that any practice would prevent its occurrence. However, a healthy lifestyle could reduce its likelihood.

Diagnosis

Following observation of obvious or suspect symptoms, an MRI (Magnetic Resonance Imaging) or CT (Computed Tomography) scan of the brain would help to determine the extent and location of loss of nerve tissue. The images below show comparisons between a normal brain, and that of a dementia patient affected by degeneration caused by Alzheimer’s.

Image from Pharmaceutical and Bioscience Journal

Treatment

Generally, dementia is a progressive process for which there is no known treatment. Increasing research is being carried out on the condition, but these have been mostly helpful in tracing causes rather than finding treatment to slow down or reverse the damage.

However, in the case of dementia caused by thyroid dysfunction or vitamin deficiency, some (limited) reversal may be possible if these underlying conditions are treated effectively. In cases where Alzheimer’s is the source of dementia, medication to curb the reduction of neurotransmitters has shown some degree of mild improvement, yet this only helps to a very limited extent.

It is equally important in the case of dementia patients to provide help and support for their care-givers. Long-term progressive diseases like dementia take a heavy toll on the physical and emotional health of the patient’s family. For this reason, Alzheimer’s organisations and associations the world over put a great deal of emphasis on providing support and guidance for families – rightly so. In most cases, paying attention to symptoms for an early diagnosis may help prepare both patient and care-giver(s) a little better for what lies ahead.

Cover illustration from depositphotos.com.

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