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MEMORY LOSS AND DEMENTIA

Many people find that they become more forgetful as they become older. This is common and is often not due to dementia.There are also other disorders such as depression and an underactive thyroid that can cause memory problems. Dementia is the most serious form of memory problem. It causes a loss of mental ability, and other related symptoms. Dementia can be caused by various diseases or disorders which affect parts of the brain involved with thought processes. Most cases are caused by Alzheimer's disease or vascular dementia. Symptoms of dementia develop gradually and progress over a number of years. Many persons with dementia are unaware of their problems and are uninterested to know about them. At times they know their handicaps and become depressed about them. Dementia (except treatable dementia) is progressive and hence has no cure. Despite this fact, memory loss in dementia can be delayed during the early stages using medicines and the person can carry out activities of daily life for a longer time than without medication. The most important part of treatment for dementia is good-quality support and care for the person with dementia.

What is memory loss?

Everybody forgets things from time to time. In general, the things that you tend to forget most easily are the things that you feel do not matter as much. The things that you tend to remember most easily are the things that are important to you - for example, a special birthday. However, some people just seem to have a better memory than others, and some people are more forgetful than others.

There are certain situations that can affect your memory and make you become more forgetful than you normally are. They can include the following:

  • Poor concentration

  • Depression

  • Physical illness

  • Drugs

  • Age

Dementia

Dementia is a condition of the brain which causes a gradual loss of mental ability, including problems with memory, understanding, judgement, thinking and language. In addition, other problems commonly develop such as changes in personality and changes in the way a person interacts with others in social situations. As dementia progresses, a person's ability to look after them self from day to day may also become affected. There are various causes of dementia.

What are the different causes of dementia?

Alzheimer's disease

This is the most common type of dementia, causing about half of all cases. It is named after the doctor who first described it. In Alzheimer's disease the brain shrinks and the number of nerve fibres in the brain gradually reduce. The amount of some brain chemicals is also reduced. Alzheimer's disease gradually progresses (worsens) over time as the brain becomes more and more affected.

Vascular (blood vessel) dementia

This causes about a quarter of all cases of dementia. It is due to problems with the small blood vessels in your brain. The most common type is called multi-infarct dementia. In effect, this is like having many tiny strokes, that otherwise go unrecognised, throughout the 'thinking' part of the brain. So, the section of brain supplied by that blood vessel is damaged or dies (an infarct occurs). After each infarct, some more brain tissue is damaged. So, a person's mental ability gradually declines. Vascular dementia can also sometimes happen after a more major stroke.

Dementia with Lewy bodies (DLB)

This causes about 15 in every 100 cases of dementia. Lewy bodies are tiny abnormal protein deposits that develop in nerve cells in the brain of people with this condition. Lewy bodies interfere with the normal working of the brain. If Lewy bodies develop in a part of the brain called the brain stem, as well as symptoms of dementia, someone may also develop symptoms similar to Parkinson's disease. For example, stiffness, slowness of movement and a shuffling walk with difficulty in starting, stopping, and turning easily.

Mixed dementia

Some people can have a degree of two different types of dementia at the same time. For example, both Alzheimer's disease and vascular dementia, or both Alzheimer's disease and DLB.

Other causes of dementia

  • Alcohol abuse

  • Infections such as syphilis

  • Some vitamin deficiencies

Who gets dementia?

Dementia is a common problem. Sometime after the age of 65yrs about 1 in 20 people will develop dementia. Over the age of 85yrs, about 1 in 5 people are living with dementia. Rarely, dementia affects younger people, if it comes on before the age of 65yrs.

There are some groups of people who are known to have a higher risk of developing dementia. These include people with:

  • Down's syndrome or other learning disabilities.

  • Parkinson's disease.

  • The risk factors for cardiovascular disease (high blood pressure, smoking, high cholesterol level, lack of exercise, etc) are also risk factors for all types of dementia.

  • Severe psychiatric problems.

  • Lower intelligence. Some studies have shown that people with a lower IQ and also people who do not have very high educational achievement are more likely to develop dementia.

  • A limited social support network.

Dementia also seems to run in some families so there may be some genetic factors that can make someone more likely to develop dementia. Some of the more rare causes of dementia can be inherited (can be passed on through genes in your family).

Dementia can manifest in various forms:

  • A person might forget what he has been doing a few minutes ago and repeat the same activities several times.

  • May find it difficult to get the right word during conversation or find it difficult to name common objects.

  • May find it difficult to do daily activities, such as dressing, cooking, washing and so on.

  • May find it difficult to carry out fine movements despite good muscular power, such as tying the shoelace, putting on buttons, turning the tap on and others.

  • May not recognise known people.

  • May talk or write in un-understandable language.

  • May develop frequent mood changes or personality changes.

  • May find it difficult to recognise familiar places and identify the time of the day.

How does dementia progress?

The speed in which dementia progresses varies greatly from person to person. It can also depend on the type of dementia that someone has. Typically, symptoms of dementia tend to develop slowly, often over several years. In the early stages of the disease, many people with mild dementia cope with just a small amount of support and care. As the disease progresses more care is usually needed.

In the later stages of dementia, speech may be lost and severe physical problems may develop, including problems with mobility, incontinence, and general frailty. This can make people more susceptible to other health problems such as infections. Often, people with dementia die from another health problem such as a severe chest infection. So, the dementia isn't the cause of their death but has contributed to it.

Dementia progress chart

Treatment of Dementia

Treatment with medication and support and care is the most important part of management.Since the disease is progressive, round-the-clock care of the person finally rests on the caregivers. Some changes around the home can help people who look after a patient with dementia, to care for him more comfortably.

  • Keep the corridors bright and devoid of barriers, such as flower pots and so on.

  • Keep the garage locked to prevent the person from driving away in the car.

  • Use unbreakable plastics rather than breakable crockery.

  • Switch off the gas after use, keep the matches securely and hot vessels away from reach.

  • Lower the temperature of the geyser so that the person does not get scalded.

  • Keep insecticides, mosquito repellents and so on locked.

  • Keep sharp instruments out of reach of the person.

  • Install locks for the doors so that the person does not wander away.

  • Install locks for the doors so that the person does not wander away.

  • Keep the refrigerator locked so that the person does not leave it open after use.

  • Change the lock of the bathroom to avoid the person locking himself in.

  • Discourage the person from smoking.

  • Keep the nails cut and clean to avoid infection.

  • Encourage regular walking to give better sleep, reduce gloomy feelings, and avoid constipation.

Other possible treatments

There are some other treatments and things that may be helpful for some people with dementia, particularly in certain situations. These include the following:

  • Regular physical activity

  • Walking

  • Dancing etc,

may help to slow down the decline in mobility that is common in people with dementia. It may also help if depression is a problem.