Dementia

Dementia, also known as memory loss, is a brain disorder that makes it difficult for the person to remember, learn, and communicate. Such changes eventually make it hard for people who have dementia to take care of themselves. Dementia may also cause changes in mood and personality. These changes are often small in the beginning, but later on, they become severe enough to affect daily life.

Types of Dementia

Dementia is of two types

  • Cortical dementia-It arises following the diseases that affect cerebral cortex such as Alzheimer disease and stroke. These diseases result in the impairment of cognitive functions such as praxis, visuospatial functions, and language.
  • Subcortical dementia-It results from the diseases affecting subcortical regions of the brain in the patient that lead to changes in their speed of thinking and ability to initiate activities.

Symptoms

  • Day-to-day memory loss
  • Normal tasks of daily life become complex such as cooking, shopping, driving, etc.
  • Difficulty with planning & organizing
  • Difficulty in communicating the right words
  • Changes in personality & social behavior
  • Impaired judgments (e.g., distances on stairs) and seeing objects
  • Confusion of the date or day

Causes

Dementia is caused by damage to the brain cells that may result from head injury, stroke, brain tumor, or diseases (such as Alzheimer’s disease). It interferes with normal thinking, behavior, and feelings.

Other reasons which may lead to dementia include:

  • Reduced oxygen supply to the brain- Due to narrowing or blockage of blood vessels, some brain cells become damaged or die
  • Alzheimer’s is the most common cause of dementia. Chemistry and structure of the brain changes, leading to the death of brain cells.

Risk Factors

Many factors lead to dementia, such as:

  • Age-The risk of Dementia greatly increases as we age, especially after 65 years of age.
  • Family history- Risk of developing dementia increase if we have someone in the family who has dementia.
  • Heavy alcohol use
  • Depression
  • Smoking
  • Obesity

Complications

Dementia may lead to many problems, including:

  • Improper nutrition
  • Difficulty taking medicines
  • Difficulty in sleep
  • Delusions and hallucinations

Prevention

We can delay dementia by taking the following steps:

  • Stay active-Be physically active and involve yourself in memory puzzles and word games. It may delay dementia and help decrease its effects
  • Physical exercise- It helps by directly benefiting the brain cells, increasing the oxygen and blood flow to the brain
  • Maintain a healthy diet-Diet rich in fruits, green leafy vegetables, and omega-3 fatty acids, commonly found in certain fish and nuts, helps to promote overall health and lowers the risk of developing dementia.
  • Cardiovascular risk factors-Maintain blood pressure, cholesterol levels helps in preventing dementia.

Management

Some causes of dementia are treatable. However, once brain cells get destroyed, they cannot be regenerated. The available treatments show benefit by slowing down or stopping the damage of more brain cells. In cases where dementia can’t be treated, proper care is given to help the person in performing daily activities.

Management of Dementia includes:

  • Cognitive and behavioral interventions: It provides counseling, psychotherapy, and behavioral therapy.
  • Pharmacotherapy with :
    • Cholinesterase inhibitors (Donepezil, Rivastigmine, and Galantamine) can be helpful
    • NMDA receptor agonists (amantadine and memantine) prevents a decline in learning and memory
    • Antipsychotic medicines
    • Controlling disease like hypertension, cholesterol, and diabetes may help to slow down the progression of Dementia

Most dementias are progressive and cannot be cured. Sometimes treating the cause of dementia helps to treat dementia. Dementia can be managed by:

  1. Regular intake of vitamins to treat deficiency of vitamin B12
  2. Take thyroid hormones medicines for hypothyroidism
  3. Surgery to remove a brain tumor
  4. Stop medicines that lead to memory loss or confusion
  5. Taking prescribed medicines regularly to treat an infection
  6. Taking proper medication to treat depression

Points to Remember

  • Keep the mind active. Do mentally stimulating activities, such as puzzles and word games, etc.
  • Be physically and socially active.
  • Quit smoking. It may increase the risk of dementia in middle age or older.
  • Maintain a healthy diet. A diet rich in fruits, vegetables, and omega-3 fatty acids lowers the risk of developing dementia.

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