Dementia is a term used to indicate any decline in cognitive function and memory, which interferes with the daily activities of a person. With the increase in the lifespan of people the world over, more elderly individuals are showing signs of dementia. It is a worrying problem, but it can be prevented. Firstly, people have to know what causes dementia. It is caused by damage to brain cells. Different parts of the brain represent different functions. The symptoms vary as per the part of the brain damaged. Memory loss is the earliest and most common feature of dementia. One starts forgetting small things like house keys, and important papers, consistently. With advancing dementia, the affected person fails to recall the names of places and persons. He may fail to recognise a family member or the way to his house, language skills, and et cetera. In severe cases, daily activities like bathing or feeding, are affected. The affected person may forget to eat properly with good table manners or forget to eat altogether. The reduction of blood supply to brain cells damages them. This occurs due to the thickening/narrowing of the walls of blood vessels. Long-standing high blood pressure, high lipid levels, obesity, use of alcohol, smoking, old stroke, stress, and lack of sleep, are some of the causes. In Alzheimer’s disease, high levels of certain proteins damage the brain cells. Certain drugs like some anti-depressants and anti-allergy drugs like diphenhydramine can cause dementia. Under functioning of the thyroid, deficiency of vitamin B. complex, particularly B12, results in dementia. Brain cells degenerate with advancing age. Genetics also plays a part. One cannot correct hereditary and genetic factors implicated. Correction of other underlying causes, if identified, can help prevent and reverse dementia. A correctly balanced diet can help prevent dementia and can also help control some underlying causes like hypertension and high lipid levels. The diet should include more fresh fruits, vegetables, nuts, whole grains, and healthy meat products like fish. Alcohol and tobacco use should be avoided. Those suffering from diseases like hypertension, and diabetes, should keep the conditions under control through dietary measures and regular medication. Regular physical exercise helps in preventing dementia by controlling underlying risk factors and also by increasing blood flow to the brain, thus rejuvenating brain cells and preventing their degeneration. One should learn to avoid stress and relax totally. Getting adequate sleep is useful in this regard. Regular yoga and meditation are also helpful in achieving this and preventing dementia. From middle age onwards, an individual should do brain-stimulating activities on a daily basis. Such activities stimulate the brain cells and prevent their degeneration and decay. New brain cells and nerve cells are also regenerated. These activities include learning a new language or skills as per one’s ability, teaching known skills to youngsters, playing brain-stimulating games like chess, and Sudoku, and solving password puzzles, etc. With the electronic revolution, apps of brain training games are available for those who are tech-savvy. Learning the use of computers would be useful, in the case of people who are computer illiterate. Family members and friends can help a person affected by dementia by lending their support. Talking regularly would help them maintain/regain communication skills. Explain things to them patiently, and do not point out lapses in behaviour or activities, as this can be very useful in the long run. Diagnosing dementia can be challenging. It requires core mental functions to be impaired enough to interfere with daily living. They are memory, language skills, ability to focus, ability to reason and solve problems, and visual perceptions. Investigations help in identifying a treatable cause for dementia. Drugs are available to treat dementia. But they only provide some relief, but not a cure. Moreover, they can cause side effects like nausea, vomiting, muscle cramps, increased urination, etc. Dr Rachna Pande is a specialist in internal medicine rachna212002@yahoo.co.uk
