Dear Doctor, I am in my mid-60s, and I'm worried I might be getting more forgetful than normal for my age. I function fairly well most of the time. But sometimes I'll forget something like details of a phone conversation I recently had.
Dear Doctor,
I am in my mid-60s, and I’m worried I might be getting more forgetful than normal for my age. I function fairly well most of the time. But sometimes I’ll forget something like details of a phone conversation I recently had.
Sometimes I fail to remember even the biggest news making headlines on TV, radio or newspapers yet these are things that I never used to forget. Could I be developing dementia? Teddy
Dear Teddy
Forgetfulness can be due to several causes, like mental stress, being preoccupied with several things at same time, being euphoric for some matter or a lot of work at hand. These are common causes that cause one to forget small trivial things. But all forgetfulness is not dementia.
Dementia is a general term for the decline in mental ability, severe enough to interfere with daily life. Memory loss is an example. Other symptoms mayinclude decline in memory capacity of a person, decline in skills otherwise well known to a person, decline in the ability to carry out daily activities. As the disease progresses, one loses simpleself-care skills like washing and dressing.
It occurs due to damage or degeneration of brain cells. Age is one factor which cannot be reversed, as part of aging, brain cells also degenerate. But not all elderly people develop dementia. Only about 47% people above 65 years of age develop dementia. There are other causes as well, apart from aging. The most common cause is, and can be a sequel to cerebrovascular accident or stroke.Dementia can also be attributed to chronic alcohol and tobacco use or brain trauma. Alzheimer’s disease occurs due to degeneration of the part of brain dealing with emotions and behavior, i.e. the hippocampus, frontal, parietal lobe parts among others.Diseases like hypothyroidism, vitamin B12 deficiency, neurosyphlis can also lead to dementia. But these are curable.
In other causes of dementia, the progress can be delayed by early intervention.
Prevention of dementia involves diet to prevent atherosclerosis(i.e. deposition of fat over the inner lining of blood vessels, thus preventing stroke). This means a diet low in fat, rich in whole grains, vegetables and fruits. Regular physical exercise and relaxation are also important. Tobacco and alcohol are harmful in multiple ways including dementia and it is better to avoid them.
Other than that, it is good to participate in various activities, learning new things like a new language or skill; reading/writing, making handicrafts, anything that can stimulate brain cells.
Dementia is not diagnosed by a single test or clinical feature. It is diagnosed by a set of neurocognitive tests. Specific tests like thyroid function tests, serum vitamin B12 levels, C.T. scan among others are done to exclude organic causes, some of which are treatable.
Once somebody develops dementia it is irreversible. He/she needs physical and emotional support. In mild cases, a person requiresmonitoring by a close family member or friend who can observe him/her, remindthem of things they forget and see that no harm comes their way due to forgetfulness. If the disease is in advanced stages, the affected person has to be taken care of like an infant, with proper attention paid to his feeding and hygiene.
Dr. Rachna is a specialist in internal medicine at Ruhengeri Hospital.