Dementia – Slow Transition of familiar into unfamiliar

According to the WHO, around 55 million people in the world suffer from Dementia currently and the number continues to grow as the population continues to age. There is often so much ambiguity associated with the disease that it is hard to catch it in its early stages. However, it is extremely important to understand the symptoms and stay on top of the diagnosis and prognosis. This article offers insight into:

  • understanding Dementia,
  • its causes,
  • the modifiable risk factors and
  • the action points to help you prevent, delay and improve dementia
·         55 million people in the world suffer from Dementia
·         These numbers can triple in near future
·         Alzheimer’s disease contributes for 60-70% of cases.
 
·         Due to its similarities with aging, dementia often goes unnoticed in the early stages.
·         Hampers language, memory, emotions, cognitive functions and overall personality
·         It is incredibly difficult to watch a loved one morph into someone else or start losing parts of their personality
 
·         Lack of exercise increases the risks of dementia
·         A Mediterranean-style diet reduces the risks of dementia.
·         Alcohol increases risk of dementia
·         People with diabetes or hypertension more likely to develop dementia
·         Exposure to air pollution, sleep apnea, nutrient deficiency and head trauma increase risk
·         Certain medications can worsen memory
 
·         Learn about how to reduce the risk and avoid dementia in the article.

Understanding Dementia

The brain, one of the most intricate systems in the human body, is made up of network of brain cells, nerve fibers, and blood vessels all working in careful synchronicity. Connections start to break down when these cells become damaged leading to sharp decline in cognitive processes in people. The area of the brain where the damage occurs determine the symptoms a person experience. For context, a person’s vision and coordinationmight be affected if the nerves in the back of their head are damaged. Communication and language skills can suffer if the nerve cells on the side of the brain are damaged.

Dementia is a mental disorder affecting brain functions and thinking processes. It is a degenerative disorder that gets worse over time and affects the way people live their lives.Not a specific disease,it is a term used to describe a group of symptomscharacterized by the impairment of at least two brain functions, such as memory loss and judgement. Due to its similarities with aging,which causes forgetfulness and loss of cognitive functions,dementia often goes unnoticed in the early stages. However, it differs from aging in that it is the result of physical diseases that damage the brain and cause accelerated cognitive decline in a person.

Dementia hampers a person’s ability to use language, memory, emotions, and cognitive functions like solving problems. Furthermore, it is extremely harmful to the personality-defining aspects of a person.

The Experience of Dementia

Dementia is a disorder that can transform the familiar into unfamiliar. It can be a disorienting experience for anyone due to the slow-paced manifestation of the symptoms. The changes in behavior or memory loss can start off subtly and can be hard to pinpoint at first. Some normal behaviors and traits can become distorted or exaggerated in the beginning. Patients tend to start losing their grasp on reality. As the disease progresses, the decline in cognitive abilities and normal function becomes stark enough that it can cause problems in everyday functioning. It can be very confusing and frightening for a person as they slowly lose themselves to the disease.

It makes it extremely hard on the family members or loved ones of those affected. It can be incredibly difficult to watch a loved one morph into someone else or start losing parts of their personality. It is difficult to imagine the sate of a girl who shared everything with her mom and now her mom doesn’t even recognize her. Or a man not able to concentrate at work as he is worried about his dad at home who wanders out sometimes unattended. Since the reality-perception of a person is affected, it can unknowingly cause emotional, mental or sometime physical hurt to the caretakers.

Personality-changes associated with dementia can cause the person to be moody and angry with others, especially the primary caretakers, and can come across as apathetic and angry. The mental trauma which the caretakers undergo is not limited to seeing their loved one suffer but also feel the heat of their anger and frustration.

Scientific study suggests that dementia can surely be slowed down and sometimes completely avoided and that makes it very important to detect the symptoms of dementia early and keep a watch over it.

What can cause dementia?

There are four main diseases with overlapping symptoms related to dementia. These are:

All 4 of these diseases have their specific symptoms and their manifestations can vary from person to person, depending on the area of the brain affected by the disease. The symptoms common in all 4 types include memory loss, confusion, personality changes, communication difficulties, and affected reasoning ability.

The most common cause of dementia is Alzheimer’s disease which according to WHO contributes to 60-70% of cases.

Often, the hippocampus is one of the first areas of the brain to be affected by Alzheimer’s. Hippocampus controls aspects of our memory and navigation. Therefore, one of the first symptoms of Alzheimer’s to manifest are forgetfulness and Absent- mindedness such as getting lost in familiar places.The damage of the nerve cells is caused by the buildup of two proteins in the brain: tau and amyloids. These proteins, which are usually present in the brain start to behave unusually and begin to clump together. A mixture of factors such as age, genetics, diet, lifestyle and other variables such as poor health of the heart can make a person susceptible to Alzheimer’s disease.

The buildup of harmful proteins is another one of the key factors behind other diseases associated with dementia, like dementia with lewy bodies and frontotemporal dementia. The damage can easily spread from one part of the brain to another as the condition progresses. Symptoms of frontotemporal dementia get worse over time. These include lack of social awareness, changes in personality and food preference, cognitive decline, language problems, and losing interest in other people. Slowly, aspects of everyday function can become difficult for people to perform.

Dementia with lewy bodies bears a strong resemblance to the symptoms of Parkinson’s disease, mainly, increased impairment of bodily functions and control. In the early stages, these symptoms can include delusions, restlessness, sleep problems, movement issues, and urinary problems. Subsequently, it can cause extreme speech difficulties, rigidity of muscles, and a compromised immune system.

Vascular dementia progresses in distinct steps after an event such as a stroke, in stark contrast to other forms of dementia which slowly spread through the brain over time. After a person suffers a stroke or if the blood vessels in their brain are in poor health, they can develop vascular dementia. It slows down a person’s ability to think, pay attentionand plan. Over time, with the progress of the disease, it can cause memory problems for the person as well.

Experts estimate that as the global population ages, these numbers can triple. As of now, there are no cures or treatments shown to permanently treat dementia. Researchers all over the world are studying how to slow down the spread of the disease and treat it to stop its harmful symptoms. Depending on the cause, some symptoms can even be reversed. With care, people can avoid the risk factors altogether.Diet and lifestyle choices have shown to delay dementia can even be useful to reversing it in people to lesser or more degree.

Risk Factors for Dementia:

The 2020 report on dementia prevention, intervention, and cure by The Lancet Commission included the following as modifiable risk factors for dementia:

Diabetes or heart-related diseases: People with diabetes or hypertension early on in their lives were more likely to go on to develop dementia in their old age.Having diabetes, hypertension, prehypertension, and smoking during midlife can also increase the chances of a person having a stroke. Strokes, in turn, can cause vascular dementia. Cholesterol and diabetes should be treated seriously, especially if there is a family history of dementia. However, Cholesterol and Diabetes can be controlled with the right diet and lifestyle changes and these health problems can be reversed in as little as 45 days.

  • : Studies show that adults of 50 or over years of age who had experienced a traumatic brain injury (TBI), also experienced greater risk of dementia and Alzheimer’s disease and the risk increases in people with more severe and multiple TBIs.
  • Low levels of vitamin D, vitamin B-6, vitamin B-12 and folate can increase the risk of dementia. Several “special foods” are associated with preventing or mitigating the degenerative processes related with age, particularly B vitamins, flavonoids, and long-chain omega-3 fatty acids. Vitamin D is the easiest to acquire, which is by sunbathing. Some studies have shown that nutritional supplements can improve cognitive function in patients with Alzheimer’s disease.
  • Sleep disturbances: A good sleeping schedule is necessary for the healthy functioning of the brain. Sleep is also the time when the brain reinforces and consolidates memories, and most importantly tries to repair any wear and tear. Given this, people who have sleep apnea and other sleep disturbances might be at higher risk of developing dementia.
  • Low Social Activity: Studies have found that interpersonal relationships, conversations & social activity gives necessary stimulation to the brain drastically reducing the risk of dementia.Researchers have found that Global cognitive decline rate was 70% less in people who were frequently socially active.
  • Healthy Gut Flora: Several studies show the role of Gut bacteria on dementia. The gut brain axis communication shows that it is bidirectional and brain receives more information from the gut than it sends. Certain hormones produced in the gut play an important role in stress management which also has an impact on dementia prognosis.
  • : Medicines that help in sleep-related problems, especially those containing diphenhydramine (Advil PM, Aleve PM), sedatives, sleeping tablets, and medications used to treat urinary urgency such as oxybutynin (Ditropan XL), can indirectly cause the memory to worsen. These medications directly work on the nervous system and can severely affect its functioning in the long run. It is better to consult the doctor if you start to experience memory problems while using these medications.

Avoiding the Risks of Dementia:

With proper care, the onset of dementia can be delayed. These are some of the recommended methods to avoid the risks of dementia:

  • Avoid unhealthy fats, fried or processed food. Instead, adopt a healthy diet rich in fruits, nuts, and seeds. Dark chocolate can also be very good for your health. A diet rich in fruits, vegetables, whole grains and omega-3 fatty acids, which are commonly found in certain fish and nuts can promote health and lower your risk of developing dementia.
  • Most Vitamins, minerals, flavonoids and antioxidants shown to slow the progression of dementia are found in the bran of the grains. Eg: Vitamin B6 is found in the cover of most lentils and legumes, Vit B1 in Rice bran. Avoid consumption of polished grains and always opt for whole grains.
  • Gut Bacteria play a vital role in our brain health and communication. It is advisable to keep the gut flora healthy by consuming fermented foods like curd, brine pickles, sauerkraut, supplements if necessary and also prebiotic foods rich in fiber like vegetables, sprouts, nuts, seeds, whole grains etc. Also the microorganisms that are unhealthy for us mostly feed on sugars and processed foods which should be avoided as much as possible.
  • Sunbathing: Exposing skin in direct sunlight produces Vitamin D from cholesterol. Enough vitamin D and Lower Cholesterol levels both lower the risk of dementia.
  • Quit smoking. According to The Lancet Report among 50 000 men aged older than 60 years, stopping smoking for more than 4 years, compared to continuing, substantially reduced dementia risk over the subsequent 8 years 
  • Reduce excessive use of alcohol. Limit alcohol use, as alcohol misuse and drinking more than 21 units weekly increase the risk of dementia drastically. Our recommendation would be to avoid it completely.
  • Focus on nasal breathing as mouth breathing can lead to sleep disturbances. Sleep disturbance can increase the risk of dementia.
  • Solve puzzles, learn new skills and languages. This will help keep your cognitive functions like problem solving and language skills sharp so that it can reduce the effect of dementia.
  • Try to have a more engaging and challenging job.Research from The Lancet Report has found that people who had cognitively stimulating jobs had a 23% lower risk of developing dementia compared with people whose jobs were non-stimulating.
  • Studies show being more socially active, meeting people, having conversations reduces the risk of dementia by 70%. Make sure you have your tribe and hang around with them more often. Join our facebook group of health enthusiasts here.
  • Take care of the health of your heart. Pay special attention if you have cholesterol or diabetes.In most cases these are reversible by diet and lifestyle. Opt for such programs.
  • Exercise has clearly shown a positive effect in delaying and avoiding dementia and must be a part of our daily routine. Any exercise that you like is good to adopt.
  • Whenever possible avoid taking medicines such as pain killers, sedatives, sleeping pills, incontinence medications etc. All these medicines directly impact the nervous system and increase the risk of dementia over a period of time. Most of these medicines can be avoided by taking proper dietary and lifestyle measures.
  • Learning a new language is a great way to reduce the risk of dementia and also a fun activity. It can also help in increasing social engagement by making new friends in some other part of the world.
  • When dealing with dementia, it is important to catch it early. Get regular checkups with your doctor after your fifties. If you start to experience the symptoms, do not blame them on age but take them seriously. Also, look out for your family members and friends. Notice if anyone around you is starting to experience the symptoms.

There is nothing in the above list that you cannot do. Take control of your health in your own hands and empower yourself. DO NOT WAIT FOR THE FAMILIAR TO BECOME UNFAMILIAR.

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