Dementia is a term used to indicate any decline in cognitive function and memory that interferes with the daily activities of a person. With advancing age, a person can develop dementia due to multiple causes. Due to lack of awareness of these reasons, dementia is wrongly attributed to ageing and a lose term, “senile dementia”, is used for any kind of memory loss seen in elderly.
With increase in the life span of people world over, more elderly individuals are seen having features of dementia. It is a worrying problem, but can be prevented. First, 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 brain damaged.
Memory loss is the earliest and common feature of dementia. One starts forgetting small things like house keys, important papers, consistently. With advancing dementia, the affected person fails to recall names of places and persons. He may fail to recognise a family member or the way to his house, language skills, to mention a few. In severe cases, daily activities like bathing and feeding are affected. The affected person may forget to eat properly with good table manners.
Reduction of blood supply to brain cells damages them. This occurs due to thickening/narrowing of walls of blood vessels. Long standing high blood pressure, high lipid levels, obesity, use of alcohol, smoking, old stroke, stress, lack of sleep, are some of the factors causing it. In Alzheimer’s disease, high levels of certain proteins damage the brain cells. Certain drugs like some anti-depressants, 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 correct balanced diet can help prevent dementia and can also help control some underlying causes like hypertension and high lipid levels. Diet should include more of 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, diabetes, should keep these conditions under control, by dietary measures and regular medications.
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 for this. Regular yoga and meditation are also helpful in achieving this and preventing dementia.
With 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 the youngsters, playing brain stimulating games like chess, Sudoku solving password puzzles, and etcetera. With electronic revolution, apps of brain training games are available for those who are tech savvy. In case of people who are computer illiterate, learning use of computers would be useful.
Family members and friends can help a person affected by dementia by lending their support. Talking to him would help him maintain/ regain communication skills. Explaining things to him patiently, not pointing out lapses in behaviour or activities, are 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 their effect is short lived.
Dr Rachna Pande is a specialist in internal medicine.