9 Frequently Asked Questions About Dementia

What is Dementia?

Dementia is a general term used to describe the progressive decline of memory or other mental faculties that prevent a person from performing normal everyday activities.

People with dementia can have short term memory problems, such as remembering appointments, keeping track of a wallet or a purse, paying their bills or traveling out of their neighbourhood – or problems with communicating, interacting socially, planning and judgment and performing daily activities.

Dementia mostly affects elderly people, though younger people can also have it (rarely).

Most dementias deteriorate with time, i.e. the symptoms start out slowly but gradually become worse. If you or a loved one is struggling with memory problems or thinking skills, don’t ignore them – especially if you’re more than 60 years old. See your doctor to determine the cause of the problem. Professional evaluation may detect a condition that is treatable. And even if the symptoms suggest dementia, early diagnosis helps because it allows for:

• maximum possible benefit via treatments


• time to plan for the future

What are some of the key facts about dementia?

Some of the key facts about dementia, according to a World Health Organization (WHO) factsheet, are:

• Dementia is a medical condition that results in deterioration of memory, thinking, behaviour and the ability to perform everyday activities.


• Although dementia mainly affects older people, it is not a normal part of ageing.


• Worldwide, 47.5 million people have dementia and there are 7.7 million new cases every year.


• Alzheimer’s disease is the most common cause of dementia and may contribute to 60-70% of cases.


• Dementia is one of the major causes of disability and dependency among older people worldwide.


• Dementia has physical, psychological, social and economic impact on caregivers, families and society.

What are the most common types of dementia?

The four most common types of dementia are:

• Alzheimer’s DiseaseIt is the most common type of dementia and accounts for 60-70% of all cases. Common symptoms include:
  i. Memory Loss
  ii. Confusion
  iii. Difficulty in communicating
  iv. Anxiety


• Vascular DementiaAlso known as multi-infarct dementia or post-stroke dementia, it occurs after a stroke and is the second most common type of dementia.


• Dementia with Lewy Bodies (DLB)Also known as Lewy Body Disease, DLB is characterized by abnormal deposits of protein, (called Lewy bodies) appearing in the nerve cells of the brain’s stem. These deposits disturb the normal functioning of the brain, thereby impairing cognition and behaviour, and also causing tremors.


• Mixed DementiaIt is caused by more than one medical condition, and hence the name. The most common type of mixed dementia is caused by Alzheimer’s and vascular disease.


• Other types of dementia include:
  i. Parkinson’s Disease 
  ii. Frontotemporal dementia or Pick’s disease
  iii Creutzfeldt-Jakob Dementia (CJD)
  iv. Huntington’s Disease
  v. Wernicke-Korsakoff Syndrome
  vi. Mild Cognitive Impairment (MCI)

How does a person get dementia?

Dementia is caused when brain cells get damaged, resulting in their inability to communicate normally among each other. When this happens, thinking, behaviour and feelings may be affected, thereby leading to dementia.Dementia can be caused by:

• Familial or genetic factors
• Medical conditions
• that progressively attack brain cells and connections
• that disrupt oxygen flow and deprive the brain of blood and oxygen
• like high blood pressure, heart disease, diabetes and hypertension
• like infection or illness that affects the central nervous system
• Poor nutrition, dehydration or substance abuse (i.e. drugs and alcohol)
• Trauma to the brain via injury or accident

Although most changes in the brain that lead to dementia are permanent and worsen with time, thinking and memory problems caused by the following conditions can improve if the condition is properly treated or addressed:

• Depression
• Vitamin deficiencies
• Thyroid problems
• Medication side effects
• Excess use of alcohol

How is dementia diagnosed?

There is no single test to determine if someone has dementia. Doctors diagnose dementia – whether it’s Alzheimer’s or some other type of dementia – based on:

• Medical history
• Clinical examination
• Diagnostic tests
• Changes in thinking, day-to-day function and behaviour associated with each type of dementia

Doctors can successfully determine – with a high level of certainty – that a person has dementia. But they generally find it harder to determine exactly what type of dementia a person has. That’s because the symptoms and brain changes of different types of dementia can overlap. In some cases, a doctor may diagnose the condition as dementia but not specify the type. If this occurs, it may be necessary to visit a specialist.

How is dementia treated?

How dementia is treated will depend on its cause. Unfortunately, most progressive dementias (including Alzheimer’s disease) cannot be cured, and there is no treatment to slow it down or stop its progression.However, cognitive (i.e. mental) and behavioural symptoms of dementia can be temporarily improved via:
i. drug treatments
ii. non-drug therapies

Sometimes, treating conditions such as diabetes, metabolic disorders and vitamin deficiencies may reduce or even almost eliminate the symptoms of dementia.

How can dementia be prevented?

Risk factors for dementia such as age and genetics cannot be changed. However, among the most active areas of research in risk prevention and reduction include physical fitness, diet and cardiovascular health.

• Physical Exercise Regular physical exercise can help reduce the risk of some types of dementia. Medical evidence suggests that regular exercise may directly benefit brain cells via increased flow of blood and oxygen to the brain.


• Diet Your diet may have the greatest impact on the health of your heart and brain. Current medical evidence suggests that healthy, proactive eating habits, such as a balanced and nutritive diet, may also help protect the brain. A balanced and nutritive diet includes relatively less or no red meat and emphasizes more on fruits and vegetables, whole grains, nuts, fish, olive oil and other healthy fats.



• Cardiovascular Health Your brain receives its nourishment from your blood vessels via your cardiovascular system. And anything that damages or blocks your blood vessels anywhere in your body can impact the blood vessels in your brain – by depriving brain cells of food and oxygen – and lead to vascular dementia, Alzheimer’s disease and dementia with Lewy bodies. Such changes in your blood vessels may also interact to accelerate the decline and make the impairment more severe.

  
  You can, however, protect your brain by protecting your heart in the following ways:
  i. Drink less 
  ii. Don’t smoke
  iii. Eat a healthy diet 
  iv. i.e. keep your blood pressure, cholesterol and blood sugar within recommended limits
  v. Maintain healthy weight
  vi. Exercise regularly
  vii. Challenge your mind 
  viii. Get regular and restful sleep
  ix. Minimize stress

What are the most common symptoms of dementia?

Dementia can include several symptoms, such as memory loss, change of personality and impaired intellectual functions caused by disease or trauma to the brain. With the onset of dementia, there will most likely be a noticeable decline in communicating, remembering, learning and problem solving. These changes may take place very slowly or quickly, depending on the type of dementia and the area of the brain that is affected.

A person with dementia will most likely:

• Ask the same questions repeatedly


• Be disoriented or feel lost in familiar places


• Unable to follow simple directions


• Be disoriented with regard to date, time, place or event


• Fail to recognize familiar people


• Find it difficult to perform routine tasks like
  i. paying bills
  ii. remembering appointments
  iii. traveling out of their neighbourhood


• Neglect personal safety, hygiene and nutrition


• Hallucinate, be continually agitated or suffer from paranoia

What is the state of dementia in India and the world?

According to World Alzheimer Report 2015, a “UK study has estimated that the health and social care costs for dementia almost match the combined costs of cancer, heart disease and stroke. In a Swedish study, the annual costs of dementia exceeded those of depression, stroke, alcohol abuse and osteoporosis. “Dementia in India is becoming more prevalent with the increase in population, average income and life expectancy. According to Alzheimer’s Association India, “More than 60% of people with dementia are from low and middle income countries like India. This number will rise to more than 70% by 2050. “A brief snapshot of the state of dementia in India and world is given below:

• Around 47 million people are living with dementia around the world, out of which 4.1 million are from India


• Nearly half of all people with dementia globally will live in Asia by 2050


• These numbers will nearly double every 20 years


• There are more than 9.9 million new cases of dementia each year worldwide, implying one new case every 3.2 seconds


• India is expected to overtake USA in number of people with dementia (PwD) by the end of 2015. This will have a marked impact on the states’ infrastructure and healthcare systems, which are generally ill prepared in many regions


• More people die of Alzheimer’s disease and dementia in India than in developed countries (13.5 per 100,000 males and 11.1 per 100,000 females vs 6.7 per 100,000 for males and 7.7 per 100,000 for females)


• Compared to other chronic medical conditions (heart diseases, cancer and stroke), Alzheimer’s disease is the fourth leading cause of death in the Asia Pacific region



• The rate of growth of people with dementia is expected to be:

  
  i. the highest in India, China, South Asia, and western Pacific regions(around 336%)
  ii. 235-393% in Latin America and Africa
  iii. the lowest (100%) in developed regions


• Compared to China and Latin America, Indian relatives are much less likely to acknowledge that the elders in their households suffer from memory loss (which could mark the onset of dementia)

The findings above point to the urgent need for a better quality of life for people living with dementia – via:

• Timely diagnosis
• Policies and legislation to fight against the stigma of dementia
• Dementia-friendly communities
• Post-diagnostic support and improved access to support and care

What other interesting information can you share with us about dementia? Do let us know – we’d love to hear from you!