Dementia is defined as “a chronic or persistent disorder of the mental processes caused by either brain disease or some injury, which is marked by memory disorders, personality changes and impaired reasoning and thinking ability.”

It is not a specific disease but a group of symptoms that are caused by several different diseases or conditions which affect parts of the brain that are involved with learning, memory, decision-making and language (both written and spoken). Since people with dementia forget even to eat, bathe, dress properly or groom themselves they eventually have poor nutrition and remain unhygienic. The incidence of dementia increases with increasing age. As the life span of the community has increased, more cases of dementia are seen. Alzheimer’s disease is the most common form of dementia.

Who is more at risk?

The single most significant risk factor is age, which is beyond our control; other risk factors that we can control or manage are

• Use of Illicit drugs and Alcohol abuse: risk is proportional to consumption
• Atherosclerosis (deposition of cholesterol in arteries) decreases the blood supply to the brain thus causing vascular dementia
• Blood pressure: uncontrolled high blood pressure increases the risk
• Lipids (fats in blood): High levels of LDL (bad) cholesterol increases the risk of dementia as severe atherosclerosis occurs
• Diabetes: Diabetes is an important risk factors for Alzheimer’s disease and vascular dementia
• Smoking” smokers form clots much easier than nonsmokers; smoking increases the risk
• Obesity increases the risk
• Head injury — either single episode of severe head injury or multiple not so severe injuries (in boxers)

Symptoms:

A combination of some of the following changes, where an organic disease has been ruled out raises the suspicion of dementia.

• Memory loss
• Difficulty communicating
• Difficulty with planning and organizing
• Difficulty with coordination and motor functions (writing, moving hands & feet in co-ordination)
• Getting lost
• Personality changes
• Inability to reason
• Inappropriate behaviour
• Paranoia
• Agitation
• Depression and/or anxiety
• Balance problems
• Tremors
• Difficulty in eating or swallowing
• Delusions (often believing people are stealing from them, talking against them) or hallucinations
• Memory distortions (believing that an event has already happened when in reality it has not; thinking an old memory is a new one; combining two memories or confusing different people in a memory event)

Treatment:

• There is no sure shot treatment/ cure of most types of dementia. One can only slow down the progression of symptoms. Family support is very important. Since memory loss is not uniform the care giver (family member) thinks the person is faking the symptoms and start questioning the afflicted – ‘How can you remember your friends and forget mine?’ This should be understood and avoided as it causes unending grief to the afflicted.
• Changing the environment: Clearing up untidiness makes it easier to focus and function.
• Drug treatment as advised by the physician

Dr Chander Asrani, is a post-graduate in Family Medicine. He has over 36 years in family practice and has witnessed several kids going awry because father was just a shadow in their life. He writes on various subjects of wellness; learning to live with chronic ailments and stress. Know more about him at about.me/drasrani.