Dementia is a general term for the impaired ability to remember, think, or make decisions that interferes with doing everyday activities. Alzheimer’s disease is the most common type of dementia
updated on:2024-08-18 14:37:12
Reviewed by SIAHMSR medical team.
Dementia is a general term for the impaired
ability to remember, think, or make decisions that interferes with doing
everyday activities. Alzheimer’s disease is the most common type of dementia. Currently
more than 55 million people suffer from dementia globally. Among them, over 60%
of the people belong to low-and middle-income countries. There is an annual
spike of nearly 10 million new cases.
Dementia mostly affects old people; however
dementia is not simply forgetting something due to age related changes. It is
more complicated than the occasional forgetfulness in old people. The risk of dementia increases with ageing, particularly
after age 65.
In dementia there is destruction or degeneration to nerve cells of brain,
ultimately leading to deterioration in cognitive function (i.e. the ability to
process thought) and it is more complex than the age related changes in
cognition. While consciousness is not affected in dementia. The impairment in
cognitive function is commonly followed, and occasionally preceded, by changes
in mood, emotional control, behavior, or motivation.
Dementia runs in families in sometimes. But
every case of dementia is not familial. There wouldn’t be a positive family
history in all types of dementia. Older African Americans are twice more likely to have
dementia than whites. Hispanics 1.5 times more likely to have dementia than
whites. Smoking also enhances the risk for dementia.
Types of dementia
Alzheimer’s disease is the most common
cause of dementia, accounting for 60 to 80 percent of cases. The risk increases
by 10 to 30 percent with presence of Alzheimer’s disease in the family.
About 10 percent of dementia cases
are happening after strokes or other issues with blood flow to the brain. This
is known as vascular dementia.
Diabetes, high blood pressure and high cholesterol are risk factors for
vascular dementia.
Lewy body dementia is another type of dementia associated
with memory loss, balance problems, stiffness or trembling.
Fronto-temporal dementia is a peculiar type of dementia linked
with changes in personality and behavior because of changes in specific brain
areas. People with this dementia behave inappropriately, making offensive
comments without reason and start neglecting responsibilities at home or work. Their
language skills like speaking or understanding also affected.
In some
people more than one type of dementia may coexist, particularly in people aged
80 and older. Dementia due to Alzheimer’s disease and stroke may occur in the
same person. This is called mixed
dementia.
Other
reversible causes of dementia include side effect of medication, increased
pressure in the brain, vitamin deficiency, and thyroid hormone imbalance etc.
Dementia is currently the seventh leading
cause of death and one of the major causes of disability and dependency among
older people globally. Women
experience higher disability-adjusted life years and death from dementia.
Factors which enhance the risk for
development of dementia include:
· Old age (more common in those 65 or
older)
· high blood pressure (hypertension)
· high blood sugar (diabetes)
· Overweight
or obesity
· Smoking
· drinking too much alcohol
· Physical
inactivity
· Social isolation
· Depression
In dementia there will be a decline in
cognitive abilities that impacts a person's ability to perform everyday
activities. People with
dementia may experience various types of problems in:
· Memory
· Attention
· Communication
· Reasoning, judgment, and problem
solving
· Visual perception beyond typical
age-related changes in vision
Signs that
may indicate dementia include:
· Getting lost in a familiar
neighborhood
· Using unusual words to refer to
familiar objects
· Forgetting the name of a close family
member or friend
· Forgetting old memories
· losing or misplacing things
· getting lost when walking or driving
· being confused, even in familiar
places
· losing track of time
· difficulties solving problems or
making decisions
· Losing the ability to do things independently.
Changes in mood and behavior also follow or precede the main
symptoms of dementia and these include:
· anxious, sad, or angry mood about memory loss
· personality changes
· inappropriate behavior
· withdrawal from work
· indifferent to social activities
· not interested in other people’s
emotions
Usually most of the symptoms of dementia
worsen over time, while a few symptoms diminish for a particular period or only
occur in the later stages of dementia. As the disease progresses, the ability
to do things independently decreases.
Dementia has physical, psychological, social
and economic impacts. The people affected with dementia fail to recognize
family members or friends. There can be loss of control over their bladder and
bowls. They may have trouble eating and drinking .Aggressive behavior may
happen in dementia and it will be troublesome to care givers and the patient
too.
Diagnosis
The
diagnosis of dementia requires observation of a change from a person's usual
mental functioning and a greater cognitive decline than what is caused by
normal aging. Diagnosis
is usually based on history of the illness and cognitive testing with imaging
studies [ MRI, CT scans]. Blood tests may be done to rule out other probable
but reversible causes.
Treatment
The treatment
is decided based on the type of dementia and the underlying causes. In vascular
dementia stroke is the cause of dementia. It is addressed with post stroke
medications, nutrition and exercise programs.
Alzheimer’s
disease is a neurodegenerative disorder with genes as its most probable cause. There
is no effective cure till date.
Recently
oxidative stress by free radicals has been implicated with significance.
Therefore the role of nutrition and antioxidant rich food is included in the
treatment and prevention of Alzheimer’s disease and other neurodegenerative
disorders.
Being physically active or taking part in activities
and social interactions that stimulate the brain and maintain daily function is
important in prevention as well as management of dementia.
Medications
Some medications
in modern or conventional medicine can help manage dementia symptoms.
Cholinesterase inhibitors like donepezil are
used to treat Alzheimer disease.
NMDA
receptor antagonists like memantine are used for severe Alzheimer disease and
vascular dementia.
Medicines to
control blood pressure and cholesterol can prevent further damage to the brain
due to vascular dementia consequent to stroke.
Selective
serotonin reuptake inhibitors (SSRIs) can help with severe symptoms of
depression in people living with dementia if lifestyle and social changes found
ineffective. In aggressive dementia patients who are at risk of hurting themselves or others,
medicines like haloperidol and risperidone can help.
All the medications are to be recommended by a
board certified healthcare provider after careful analysis of each person
having dementia. Do not take over the counter medications.
Complementary & alternative
system of medicine
Following therapies
are available to mitigate the psychological, behavioral and speech related
problems.
· Occupational therapy
· Speech therapy
· Mental health counseling.
· Music or art therapy
· Homeopathy
Follow the
link below.
http://siahmsrwellness.in/dementia-loss-of-memory
Homeopathy for dementia
Several homeopathic medicines are
available for managing the symptoms of various types of dementia such as
ALZHEIMER’s disase, vascular dementia after stroke etc.
· Anacardium – for alzheimer’s disease.
Sudden loss of memory.
· Baryta carbonicum
Emotional instability, anxiety, sudden fits of passion from trifling
causes. Great weakness of memory. Aneurysm, history of apoplexy. It is an
indicated remedy for vascular dementia as well as Alzheimer’s disease [5].
· Hyoscyamus niger – is also an
important remedy fo Alzheimer’s disease with foolish gestures and talk.
· Other remedies include :
Conium,acid phosphoricum, picric acid, Stramonium etc.
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References
1. https://www.cdc.gov/aging/dementia/index.html
2. https://www.who.int/news-room/fact-sheets/detail/dementia
3. https://medlineplus.gov/dementia.html
4. materia medica by J.H .Clarke.bary.carb
5. Homeopathic medical repertory Mind
dementia [p- 1574]
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