Global statistics on dementia are alarming. According to the WHO, 50 million people in the world live with the condition and 10 million new cases add to the count every year. If these figures were referring to efforts in curbing a health threat on the global population, we would have to admit that we are achieving little. After all, the world population records around 7.7 billion people today.
We are, however, speaking about a whopping 50 million persons living with a syndrome that compromises the quality of their lives. Dementia patients rely on a carer, have to forego their daily work commitments, and cannot perform their daily life tasks normally. It is a disabling condition. What’s more, dementia is listed 7th among the top leading causes of death.
So what exactly is dementia?
An umbrella term for multiple progressive mental conditions
If you are among the many people who think dementia as a mental disorder characterised by forgetfulness, then you need to note these two facts:
- Dementia is not a mental disorder but a neurological disorder which is clinically approached by focusing on the physical conditions impacting on a person’s mental capacity among other aspects.
- Memory loss is one of the many symptoms of the dementia syndrome.
With the two points noted, we can underscore that dementia is the umbrella term which describes a wide range of progressive mental conditions. And even though the number may vary from different sources, it is estimated that there are about 100 conditions of the dementia syndrome but a few are most common, hence, more researched. These common forms of dementia include:
- Alzheimer’s disease (most common among the types)
- Vascular dementia
- Dementia with Lewy bodies
- Dementia from Parkinson’s disease and related conditions
- Frontotemporal dementia
- Creutzfeldt-Jakob disease.
Despite the unique indications that may characterise each of these conditions, there are several symptoms that typify dementia. On these common signs is build the general definition of dementia: a chronic and progressive syndrome caused by deterioration in the cognitive ability to process thought, hence affecting the thinking and memory functions and leading to behavioural deficits when carrying out daily activities. But what are the specific symptoms of dementia?
A Universal Criterion for Dementia Symptoms (Diagnostic Signs)
Variation often characterises the way people look at a particular phenomenon. Dementia is no exemption. To evade the confusion from this diversity, we describe the symptoms of dementia as listed in the DSM-V and the International Classification of Diseases (ICD); two widely accepted references for the classification of diseases. The symptoms of dementia presented in the two standard diagnostic tools are similar. And as presented in the tools, the symptoms serve as diagnostic signs. We discuss these signs in reference to the cognitive and behavioural function they point to.
Learning and memory
Learning is the capacity to acquire, manipulate and retain new information or skills. It is closely linked to the mental capacities of the short and long-term memory in controlling information retention, association, and recall.
Dementia patients cannot retain information or retrieve it in an organised manner. They will often give you a blank face when you ask them about the information that has just been given them. They will also consistently repeat a piece of single information during a conversation. Planning is difficult for these persons because they can only keep in mind a single event or item at a time, which may also disappear abruptly. Besides, they have difficulty sticking to the task at hand, confuse time and places and manifest repetitive behaviour. You’ll risk losing your dementia patient by sending them to a place with only an address to remember.
Attention describes the behavioural and cognitive capacity to focus on a stimulus while ignoring others. As such, it affects the way we process information in a specific environment.
Persons with dementia have attention difficulties in the context of multiple stimuli. They will struggle to sustain a conversation when the TV is on and fail to concentrate on reading a newspaper when the noises of playing children can be heard on the background.
Executive abilities have to do with making and executing plans and decisions, acting on information, and flexibility in relation to change in situations.
These are difficult tasks for people with dementia. They cannot follow plans or decisions because details may not be readily retrieved from the brain when the tasks need to be executed. In addition, their judgment fails them in relation to time or even the details of a task. As a result, they have to rely on others which is also a challenge when they cannot keep a logical conversation with the person trying to help them.
Perceptual-motor functions include navigating space and movement which are also closely related to the use of the visual-spatial sense.
Patients with dementia struggle with motor activities they could previously perform with ease and with finding their way in familiar surroundings. They may lose their capacity to write and just scribble or are unable to tell where a neighbour they have always visited lives.
Fluency, selection of words, eloquence, correct use of grammar, and sentence structure are all core in language use.
Persons with dementia struggle with all these aspects and tend to be general and ambiguous. They may, for example, refer to someone as ‘that person’ and cannot call them by their proper name even when they have known the person for a lifetime. At its advanced stages, dementia will rob the patience of the joy of calling their loved ones by name.
Cognitive social ability allows us to fit our behaviour within acceptable social norms. It also has to do with using acceptable social symbols such as language, clothing or even relational gestures with familiar or unfamiliar persons.
Impaired social cognition makes the dementia patient lose their emotional and behavioural control. If patients do not have a consistent caregiver, this aspect will be observed in their lack of grooming. They may also manifest inappropriate social behaviour such as wearing different shoes on each foot or claiming something that may not belong to them. Persons who are unaware of their condition may not notice that all this is done without malice.
What causes dementia?
Forms of dementia syndrome are linked to the build-up of abnormal proteins or of normal proteins in atypical states. The accumulation of these proteins in the body cells triggers neurotoxic, inflammatory and irregular vascular effects that give rise to the symptoms of the neurodegenerative condition. The anomalous processes related to these proteins are, however, associated with a range of other underlying factors some of which are discussed below.
Age is the number one risk factor for neurodegenerative dementias. Despite this, the syndrome is not considered a normal experience of ageing. In other words, you do not have to suffer from dementia because you are ageing. Nevertheless, the age-related deterioration in the function of the brain cells or their eventual death may alter the protein synthesis in the brain cells and trigger the symptoms of dementia.
The age risk for dementia is thought to be ‘normal’ after 65 years. Dementia symptoms manifesting before this age suggest early onset dementia.
You may need to point a finger to your parents if your doctor says you have a genetic predisposition to dementia. This may have two implications: first, you inherited a dementia-causing gene, and second, you inherited a mutated gene that places you at a greater risk for the disease. For example, inheriting certain variations of the Apolipoprotein gene may predispose you to the syndrome. The gene commands the production of apolipoprotein which acts with body fats to form lipoproteins. The proteins then package and carry cholesterol and other lipids across the bloodstream. A mutated Apolipoprotein gene does not allow this process to be carried out normally.
Disease and medical conditions
Medical conditions that negatively impact on the heart, otherwise described as cardiovascular diseases, predispose people to the dementia syndrome. These include high blood pressure, high blood cholesterol levels, obesity, and type 2 diabetes among others.
Other medical conditions and diseases that are risk factors for dementia include depression, having suffered a stroke, brain tumours, HIV, and abnormalities in the thyroid glands among others.
Traumatic injuries to the brain can cause dementia. These may come from serious falls, car accidents, blows on the head as with boxers and sportsmen, and other non-physical traumatic experiences like consistent exposure to loud bangs.
Lifestyle choices that threaten cardiovascular health are risk factors for dementia. These include a sedentary lifestyle, excessive alcohol consumption, smoking and an unhealthy diet with predominantly saturated fats, and excessive salt and sugar.
Is Dementia Preventable/Curable?
3 reasons lead us to ask whether dementia can be prevented or cured.
Reason 1: Knowledge on the neurological disorder, its causes, and the acute symptoms that come with the disorder puts in perspective the seriousness of the condition and will lead anyone to wonder if something can be done to pre-empt or revert the condition.
Reason 2: Data by WHO indicates that about $818 billion are spent annually for the management of dementia, an immense economic burden for the global community. Could the funds be used for a cause that would instead lead to the prevention of new cases?
Reason 3: Due to its disabling characteristics, the adverse effects of dementia are not only felt by the patient but by family and other caregivers who offer consistent support to the person with the condition.
From the foregoing, the response to the question can be read from the ‘good and bad news’ perspective.
There is no Cure for Dementia but the Condition can be managed
Unfortunately, there is no known cure for neurodegenerative forms of dementia. The condition may, nevertheless, be managed using recommended therapies. They include:
- Medication: to control the altered neural chemicals associated with brain cell damage and death. Antidepressants and antipsychotic drugs are prescribed for the control of mood-related neurotransmitters such as serotonin and dopamine.
- Recollection therapies: in which family members or professionals can either talk to or encourage dementia patients to talk about pleasant memories of their past life.
- Cognitive stimulation therapy: group programmes aimed at having persons with dementia take part in activities that engage their mental capacities such as singing, cognitively stimulating games, working puzzles among others.
- Lifestyle training: dementia symptoms will become acute if patients do not change lifestyle elements that impact negatively the symptoms. Patients should be trained in positive lifestyle choices for the management of dementia including a healthy diet, steady sleep routines, and safe exercises.
From a prevention approach, it is widely upheld that a healthy lifestyle can help keep dementia at bay. Here are some quick tips for healthy lifestyle practices that may avert dementia.
- Maintain an active life
- Avoid smoking and excessive use of alcohol
- Eat a balanced diet
- Keep your blood sugar and cholesterol levels under check
- Keep your brain stimulated
- Visit your general physician annually to assess your heart health; a healthy heart ensures a healthy brain.
- Treat and manage any dementia-predisposing health conditions you may already suffer from.
- Steer clear of stressful and depressing situations.
- Be faithful to your daily 8 hours sleep
The neurodegenerative condition, commonly referred to as dementia, affects 50 million people in the globe. Unfortunately, an equally noteworthy number of people augments the number of dementia patients every year.
As a chronic and progressive syndrome caused by deterioration in the cognitive ability to thought processing, dementia is specifically manifest in a series of symptoms including impaired attention, learning and memory, executive ability, perceptual-motor functions, language and social cognition. All these symptoms adversely affect the normal daily activities of the patient and of those who give them consistent care.
Neurodegenerative conditions are irreversible. Nevertheless, they can be managed through medication and lifestyle therapies. A healthy lifestyle is also key to pre-empting dementia.