Dementia is not a specific disease. It is a term used for a decline in mental ability severe enough to interfere with daily life. Memory is one of the common domains that is affected. Other domains affected include language, behaviour, reasoning and visual perception.
Alzheimer’s is the most common type of dementia. Alzheimer’s disease accounts for 60 to 80 percent of cases. Vascular dementia, which occurs after a stroke, is the second most common type. There are many other conditions that can cause symptoms of dementia, including some that are reversible, such as thyroid problems, hydrocephalus and vitamin deficiencies.
It is an incorrect belief that serious mental decline is a normal part of ageing. The earlier terminology of “Senile Dementia” is not in use anymore. Alzheimer’s is a neurodegenerative dementia that causes problems with memory, thinking and behaviour. Symptoms usually develop slowly and get worse over time, becoming severe enough to interfere with daily tasks. Alzheimer’s is more common above the age of 65 years. However, 5% of cases can occur in younger age group. The basic pathology in Alzheimer’s is due to abnormal protein deposition in the brain leading to the formation of plaques and tangles which in turn leads to neuronal cell death. These changes start well before the affected individual develops signs of memory disturbance. Some conditions like Parkinson’s disease, Stroke, Diabetes, high blood pressure and depression can increase the risk of developing dementia. Other contributing factors include chronic stress, smoking, obesity and genetics.
The most common early symptom of Alzheimer’s is difficulty remembering newly learned information because Alzheimer’s changes typically begin in the part of the brain that affects learning. As Alzheimer’s advances through the brain it leads to increasingly severe symptoms, including disorientation, mood and behaviour changes; deepening confusion about events, time and place; unfounded suspicions about family, friends and professional caregivers; more serious memory loss and behaviour changes; and difficulty speaking, swallowing and walking.
To date, there is no conclusive research that shows that we can prevent Alzheimer’s disease. Early diagnosis and treatment cannot reverse the effects, but can greatly improve quality of life. Currently, there are no medications available that can reverse brain deterioration, but a significant amount of research is being carried out to find an appropriate treatment for Alzheimer’s.
Although we have no control over our age or genetic makeup, there are some lifestyle changes that are widely believed to delay or prevent Alzheimer’s disease. It is important to ensure enough sleep as sleep deprivation has been associated with increased risk for heart disease, cancer and cognitive problems. No single lifestyle choice has as much impact on aging and Alzheimer’s disease as aggressive physical exercise. Challenge your brain by learning a new language or a new skill, read and stay socially active. Eat brain healthy foods such as Omega-3 fatty acids, fresh fruits and vegetables (MIND diet). It is important to avoid processed foods and foods rich in trans fats. It is also important to quit smoking and moderate the consumption of alcohol. Stress reduction and relaxation are both very important as prolonged stress can greatly increase Alzheimer’s risk.
Many people have memory loss issues but this does not mean they have Alzheimer’s or another dementia. There are many different causes of memory problems which can be diagnosed by a careful clinical evaluation.
by Dr. Anil Venkitachalam
Visiting Consultant (Neurology)
K J Somaiya Hospital, Super Specialty Centre