Dementia

Dementia is a combination of memory loss, confusion, and general intellectual decline. The affected person may not realize that there is anything wrong, but his or her condition is usually distressing for close friends and family. Poor memory alone is not a sign of dementia because some memory impairment is a natural part of aging. Dementia is relatively common in elderly people, with about 1 in 10 people in the UK over the age of 65 affected to some degree. Although dementia is usually progressive and cannot be treated, in about 1 in 10 cases the underlying cause is treatable. An elderly person with severe depression may seem to have dementia because the conditions have similar features, such as forgetfulness.


What are the causes?

The underlying abnormality in dementia is a decline in the number of brain cells, resulting in shrinkage of brain cells. Alzheimer’s disease, which occurs mainly in people over 65 and may run in families, is the most common cause of dementia. In multi-infract dementia, blood flow in the small vessels of the brain is blocked by blood clots. Less common causes of dementia include other brain disorders, such as Huntington’s disease. Parkinson’s disease, and Creutzfeldt-Jacob disease.

Dementia may also occur in young people. For example, people with AIDS related dementia. Long-term abusers of alcohol are at risk of dementia because of derect damage to the brain tissue and because their poor diet often leads to vitamin B1 deficiency. Severe vitamin B1 can cause the brain disorder called as WernickeKorsakoff syndrome. In pernicious anaemia, there is a deficiency of vitamin B12 due to impaired absorption in the digestive tract. A severe deficiency can result in dementia. The disorder may also follow a serious head injury. Certain drugs, such as anticovulsant drugs and mood-stabilizing drugs, may cause memory impairment similar to that of dementia.

What are the symptoms?

The symptoms may develop gradually over a few months or years, depending on the cause. They may include:

- Impairment of short-term memory.
- Gradual loss of intellect, affecting reasoning and understanding.
- Difficulty engaging in conversations.
- Reduced vocabulary.
- Emotional outbursts.
- Wandering and restlessness.
- Urinary incontinence.

In the early stages of the disorder, a person is prone to becoming anxious or depressed due to awareness of the memory loss. As the dementia gets worse, the person may become more dependent on others.

What might be done?

The doctor may arrange for the person to have tests to look for the underlying cause and to exclude other disorders. If memory loss is due to a deficiency of one or more of the B vitamins, injections of vitamin supplements may be given. Symptoms that are caused by certain drugs may be relieved by a change of medication. Most other causes of dementia cannot be treated, but drugs may relieve some symptoms. For example, depression may be treated with antidepressants.

A person who has dementia usually needs support at home and may eventually need full-time care in a nursing home. Carers may also need support.

CARING FOR SOMEONE WITH DEMENTIA

If you are taking care of someone with dementia, you need to balance his or her needs with your own. In the early stages, it is important to allow the person to remain as independent and active as possible. As the disorder progresses, there are several measures you can take which help to compensate for the person’s failing memory, loss of judgment, and unpredictable behaviour:

- Put up a bulletin board with a list of things that need to be done during each day.
- If wandering is a problem, persuade the person to wear a badge with your contact details and phone number on it.
- Place notes around the house that help the person to remember to turn off appliances.
- Consider installing bath aids to make washing easier.
- Try to be patient. It is common for people with dementia to have frequent mood changes.
- Give your self a break whenever you can by finding someone who can help for a few hours.
- Join a carers’ support group and investigate day centres and respite care opinions.