Dementia is an age-related syndrome that affects nearly 600,000 people in the UK and that number is rising. Dementia is becoming more and more important because we are living longer and dementia is now the most common disease in the elderly. By Cognitive Neuroscientist, Dr Lynda Shaw.

The most common cause of dementia is Alzheimer’s disease and there is currently no cure but many believe we can help ourselves prevent or at least slow down a decline into dementia, so that we can enjoy those precious later years.
During the course of the disease the chemistry and structure of the brain changes, leading to the death of brain cells.  Currently it’s difficult for doctors to make a clear diagnosis for the condition.  In the early stages the clinical symptoms can be quite ambiguous because cognitive impairment needs to be distinguished from brain changes during normal ageing. Dementia usually first appears as forgetfulness.

What is dementia?

Most types of dementia are non-reversible (degenerative) but some causes of dementia may be stopped or reversed if they are found soon enough, including after brain injury or chronic alcohol abuse.
Dementia is rare in people under age 60. The risk for dementia increases as a person gets older.

Four main types of dementia

 

Alzheimer's Disease

Alzheimer's disease (AD) is the most common cause of dementia and accounts for 50% - 60% of all cases. It destroys brain cells and nerves disrupting the neuro transmitters which carry messages in the brain, particularly those responsible for storing memories.  Alzheimer’s can affect memory, understanding, judgment, emotions and even personality and can be both frightening and exhausting for those with the condition as well as their loved ones.

Vascular Dementia

Vascular dementia is the second most common form of dementia and accounts for about 20% of all cases.  It affects men more than women and is due to cerebrovascular disease, which occurs where oxygen supply fails or is no longer efficient in the brain and brain cells are likely to die.  This can lead to strokes or infarcts (mini strokes) and there is an increased possibility of vascular dementia.

Dementia with Lewy bodies

Dementia with Lewy bodies is the third most common cause of dementia and may occur in up to 20% of cases. Dementia with Lewy bodies is similar to Alzheimer's disease and Parkinson’s disease in that it is caused by the degeneration and death of nerve cells in the brain. Lewy bodies are abnormal collections of protein deposits, found in the nerve cells of the brain.

Fronto-temporal dementia

Fronto-temporal dementia is relatively rare and affects people at a younger age.  It takes its name from the fact that damage to brain cells usually begins in the frontal lobe of the brain.

Symptoms

Dementia affects people differently but symptoms may include difficulty with many areas of mental function, including in language, memory, perception, emotional behaviour such as anxiety or agitatation and cognitive skills such as abstract thinking, or judgment and disorientation.

Mild cognitive impairment (MCI) is somewhere between normal forgetfulness due to ageing and the development of dementia. People with MCI have mild problems with thinking and memory that do not interfere with everyday activities and are often aware of the forgetfulness. Not everyone with MCI develops dementia.

Prevention

Most causes of dementia are not preventable but there are many things you can do to best protect yourself or slow down the rate of dementia.

  1. Mental exercise
  2. Quitting smoking and controlling high blood pressure and diabetes can help us reduce our risk of vascular dementia
  3. Eating a low-fat balanced diet may reduce the risk of vascular dementia
  4. Regular physical exercise may reduce the risk of vascular dementia
  5. Sleep well
  6. Managing stress
  7. There is also treatment with vitamin B this has had notable effects.  Folic Acid, B6 and B12 seem to do something to the reduction in the rate of brain atrophy.
  8. Identify MCI as quickly as possible.  In studies carried out in memory clinics, 10-15 per cent of people with MCI went on to develop dementia in each year that the research results were followed up.  It is therefore very important to identify people with MCI, as they may be in the very early stages of the disease and more likely to benefit from early treatment in the future. However, many people with MCI improve or remain stable, and do not develop dementia.

In recent years, however, treatments that can improve the symptoms of Alzheimer's disease are becoming available. Other treatments that may slow down the progression of the disease in the brain are also being developed. It is important that people with Alzheimer's disease are identified as early as possible, so that they can benefit from these treatments in the future. Identifying people with mild cognitive impairment (MCI) is one way to try to achieve this but so far, none of the techniques available are sufficiently developed to provide a definitive diagnosis in patients with MCI.

Helping those with dementia

  • Understanding and respecting the person with dementia
  • Helping the person feel valued – be tolerant; listen properly and slow down; be affectionate; address them with the name they prefer e.g. Mr or Mrs … be courteous, kind and non-judgemental
  • Respecting cultural values and privacy
  • Regardless of how bad the dementia is people still have feelings, so help the person feel good about themselves
  • Help them express their feelings
  • Choice is confusing – so keep it simple and easy
  • Remember each person with dementia is still that person with unique and valuable experiences
  • Isolation because of dementia is rife.  Help those with dementia still be sociable and connect with their loved ones and people of all ages

Helping families of those with dementia

  • Caring for a person with AD can have physical, emotional and financial costs.  The demands of day to day care, changing family roles, and difficult decisions about placement in a care facility can be hard to handle
  • Becoming well informed is really important
  • Developing good coping skills
  • Having a strong network of family and friends also are important
  • Staying physically active helps us cope emotionally to being a carer
  • Getting support groups for respite and expression of concerns

Dr Lynda Shaw runs an advisory service for loved ones of those with dementia. Visit her website here.