What is Dementia?

Dementia is most often associated with forgetfulness.  A loss of neurons is a significant cause of forgetfulness.  As Shakespeare might have said, 

‘Some people are born forgetful,

 some develop forgetfulness, 

some have forgetfulness thrust upon them.’

But forgetfulness is not the only symptom of dementia; all result from neuron loss or becoming ineffective.  Dementia is the loss of cognitive functioning.  It is a chronic (long-term) or progressive condition.  Some of the neuron loss is due to the natural aging process.  Some dementias result from traumatic injuries, which affect the brain’s cognitive function  (the ability to think.) 

We are not surprised when elderly members of our families or friends are forgetful and wander, lose or repeat themselves (MCI Mild cognitive impairment).

 It is more challenging to come to terms with the advanced stages of dementia when, at a relatively early age, loved ones show signs of dementia.  These symptoms include movement problems such as shaky hands or difficulties with balance and walking.

How many people are affected by dementia?

In the United States, at least six million people live with one of the four significant forms of dementia (Alzheimer’s and dementia 2021).  The most familiar and recognized of these is Alzheimer’s (between 60%-70%).

Although dementia is not part of the natural aging process, it is more prevalent among older people women.  It is estimated that of those older than 55, about six women and 1 in ten men will develop dementia.  At age 85 or older, about one-third of people are likely to suffer from dementia.  Worldwide about fifty-five million people are living with dementia.  (WHO)  

These numbers are significant, but although aging is not the direct cause of dementia, we become increasingly susceptible to it as we grow older.  One consequence is that as life expectancy in the population increases, we can expect that the incidence of dementia will also rise.  It is predicted that the number of people living with dementia will increase from 6.5 million to 9 million by 2030 and approach 12 million by 2040.  (Alzheimer’s disease fact and figures, 2021 and  fact sheet US dementia trends)

What are the signs of dementia?

The early signs of dementia are hard to detect.  But as we age, we increasingly notice things we struggle with or can no longer do.  We become forgetful, lose track of time, or lose ourselves in familiar places.

Perhaps it is not ourselves that causes the most concern.  It may be an older member of the family that worries us.  A helpful approach is keeping a log or diary of events, happenings, or behaviors out of character or becoming noticeably more frequent or severe.

What are the signs?  In its early stages, dementia is difficult to detect because the onset can be so gradual that changes go unnoticed.

In the early stages, the symptoms of dementia based on memory loss

-increasing forgetfulness
-losing track of time
-losing memory of place

In the middle stages, dementia symptoms develop more quickly and  become more evident

-forgetfulness of recent events and the names of even familiar people
-being confused even in familiar environments such as home
-increasing difficulty in recalling even familiar words
-displaying behavior changes which may include aimless wandering and repeated questioning
-increasing need for assisted self-care

In late-stage dementia, the symptoms outlined above become more pronounced and are evidenced by

-being increasingly unaware of time and place
-increasingly uncoordinated, e.g., when walking
-failing to recognize even family  and friends
-increasing dependence on assisted self-care
-displaying behavior change which in some cases may become aggressive

Is there a cure for dementia?

The neural damage caused by the diseases which cause dementia is irreversible.  There is no cure for dementia.  Various medicines and treatments counter the underlying conditions and inhibit their progress.  Given the scale of the problem, it is hardly surprising there are many ongoing research projects.  Some are at the clinical trial stage, aiming to improve the efficacy of the available treatments.

What are the risk factors?

The most significant risk factor for dementia is age.  The most recognizable feature is cognitive decline.  There is little we can do to prevent physical aging.  There are steps we can take to influence the course of cognitive decline.

Studies show that people can lessen the risk of cognitive decline (dementia) by

  • being active
    • physically
    • mentally
  • not using nicotine (smoking)
  • avoiding alcohol misuse
  • controlling weight
  • eating a healthy diet
  • maintaining healthy levels of
    • blood sugar (cholesterol)
    • blood pressure

How can I help friends or family who suffer from dementia?

Suppose you think a friend or one of your family is showing signs of mild dementia (MCI).  There, the cause of the impairment must be identified/confirmed by a physician, usually a primary care physician.  Given the condition’s progressive nature, early confirmation is essential to halt or restrain further development.  Do not be persuaded that the symptoms you detect are “normal aging.”

Early diagnosis gives you longer to prepare the network of support and caregiving that will become necessary as the condition develops.

Early diagnosis offers a better chance of benefiting from treatment.

Early diagnosis lets sufferers make lifestyle changes that may preserve their cognitive function.

Don’t be slow to seek information, advice, and support. The Alzheimer’s Association of America (Caregiving – Alzheimer’s & Dementia | Alzheimer’s Association ) is an excellent place to start.

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