Dementia

By Dr Julie Taylor

Dementia is an umbrella term given to around 200 different conditions that cause progressive problems with brain function. The most common types are Alzheimer’s disease, vascular dementia, Lewy Body dementia, frontotemporal dementia and mixed dementia. Dementia can affect people at any age, but most commonly it affects people over 65 years. Everyone experiences dementia differently, but the most common symptoms are memory problems, difficulties processing information (cognitive impairment), problems with communicating and effects on mood and behaviour.

Do I have dementia? Becoming forgetful can be a normal part of aging. As people get older, gradually changes occur in all parts of the body including the brain. You may find that you it takes you longer to learn new things, you might misplace things or you might not remember information as well as you used to. Every one of us ages differently. The extent to which we experience these changes and the point at which they become more noticeable varies from person to person. About 40% of people over 65 years will have mild memory problems. About 5-8% will develop dementia.

Age-associated memory loss does not noticeably disrupt day to day living. You might have the occasional word finding problem but you can still hold a conversation. You might forget where you have put your keys on occasion. Mild cognitive impairment is a condition between normal aging and dementia. This means that you are experiencing problems with your memory, speaking and disorientation but not so severe to disrupt your normal daily function and routines. Dementia is diagnosed when your memory problems are so severe that they affect your daily life and ability to stick to your normal routine. You find it difficult to complete tasks that you are familiar with and others will notice that you are struggling.

Why else might I have memory problems? There are other reasons why you may struggle with your memory. Emotional problems such as stress, anxiety or depression can make a person more forgetful. In older people, this is often mistaken for dementia. Thyroid problems, shortage of vitamin B12, drinking too much alcohol, head injuries and medication side effects are other causes of memory problems.

Can I prevent this from happening? Your brain is like any other part of the body – use it, stay physically and socially active and eat healthily to keep it healthy.

Use it or lose it. Exercising your brain helps to keep it healthy. This could be something as simple as using your non-dominant hand to dial a phone number, playing games that challenge your brain, take up a new hobby or learn a new language. Even breaking your usual routine or trying something you are not good at is a small challenge.

Being physically active can reduce the risk of developing dementia, depression, diabetes, high blood pressure and high cholesterol. It doesn’t matter what you do to stay active; a walk in the park, dancing, swimming or something gentle like Tai Chi are all good choices. Go with someone to help keep yourself

Having a good social life helps to prevent depression and social isolation. If you feel lonely, look for opportunities to engage with others, even if just a quick conversation with a shop worker or whilst waiting at the bus stop. There are lots of groups out there – you could base your socialisation around a physical activity or hobby, or you could consider volunteering. Get back in touch with old friends through the phone, text, email or social media. A healthy diet is good for your whole body. Reducing processed food and sweets, instead eating lots of fruit and vegetables, whole grains, fish and healthy oils such as olive oil will be beneficial for your overall health. Excess alcohol can harm your brain and smoking causes changes to the blood vessels in your brain, heart and around your body.

Finally, manage your stress and mood. Stress can affect your emotions, your ability to concentrate and remember, can lead to eating in excess or drinking too much alcohol and cause physical health problems such as headaches, insomnia and fatigue.

What help is there for people with dementia? There are no treatments to cure dementia. If you are diagnosed with Alzheimers dementia, medication may help to lessen symptoms or may slow down progression. If your dementia is due to changes in blood supply to the brain (vascular dementia), it is important to control your blood pressure, cholesterol and diabetes and to stop smoking. The advice above about stimulating your brain, physical and social activity, a healthy lifestyle and managing stress is also important.

Practical tips such as using calendars, post it notes, white boards and other prompts can help someone with memory problems. Carers may find it difficult if their loved one becomes agitated due to their dementia. Gently reassure them. Make sure there is nothing that has caused this – are they hungry or thirsty? Are shadows caused by lighting upsetting them? Is it too noisy or are they bored? Distraction such as going for a walk or folding laundry can help. Give them something to occupy their hands such as a soft toy or worry beads. Music and aromatherapy can also help. You will get to learn what the triggers are and works for them. You don’t need to reorientate them to the current time by telling them someone died years ago. Instead, get them to talk about that era. If there is a sudden change in behaviour, this could be due to pain, constipation or an infection. Contact your GP for an assessment.

Alzheimers and Dementia Support Services can provide advice to carers, day centre services through to support at home and a 24 hour helpline (www.alz-dem.org).

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