An article by Natalia Julia, Medical specialist in Neurology,
and Marina Romera, Graduate in Psychology, both from – My Three Towers Clinic
He progressive aging of the population due to the longer life expectancy has also entailed a increase in people with dementia. Dementia is not a specific disease. Dementia is a general term, encompassing a wide range of symptoms that compromise memory, learning, judgment, attention, concentration, language and thinking.
All this is often accompanied by behavior changesin addition to affectation and repercussion in the usual activities, in the social, work and family environment of the patient. The clinical course is usually chronic, progressive, and generally entails complete dependence, both in relation to physical and mental function, over the course of years.
At the moment there are more than 50 million people in the world diagnosed with dementiaand the World Health Organization (WHO) predicts that in the year 2050 this number will reach 152 million cases, with one case being diagnosed every 3 seconds. Dementia can be caused by many different diseases, with Alzheimer’s disease being the most common cause.. This represents between 60-70% of cases, existing in Spain, more than 800,000 people with this diagnosis.
Alzheimer’s is a progressive dementia, with memory deficit being one of its earliest and most pronounced symptoms.
Alzheimer disease
He Alzheimer’s is a progressive dementia that appears from the accumulation of protein plaqueswith memory deficit being one of its earliest and most pronounced symptoms. The disease usually develops slowly, calculating a duration of between 7 and 15 years from its diagnosis. During this time, the person’s cognitive deterioration advances and different changes are experienced in behavior and in their level of autonomy. In short, This progress has been divided into 3 phases:
- mild phase:
A progressive deterioration of episodic memory is observed, especially of recent events, which is accompanied by a slight disorientation regarding the environment (it can get lost in familiar places) and increasing difficulties in the ability to concentrate. On an emotional level, loss of interest in doing activities, loss of initiative and motivation, as well as sleep disturbances may appear. - moderate phase
Memory and orientation problems are accentuated, and difficulties appear in language (not finding precise words when speaking), in learned movements (making daily tasks such as dressing or using cutlery difficult) and perceptual recognition (for example, of faces). There may be some difficulty in inhibiting behaviors or emotions, and sometimes there are distortions in perception in the form of hallucinations. - advanced stage
The person loses the ability to speak, understand, walk, eat, has incontinence and may not recognize some of their closest relatives. The deterioration is widespread, so support measures must be prioritized to guarantee their well-being.
Beyond Alzheimer’s
In addition to Alzheimer’s disease, there are other conditions that can cause dementia and that they will have some particular characteristics. First of all, mention the treatable ones, among which are included those secondary to vitamin deficiency, thyroid disease, depression, respiratory disorders such as severe sleep apnea syndrome, as well as secondary to infectious diseases such as syphilis and HIV.
Between the neurodegenerative dementiasthey appear vascular dementiacaused by the sum of small cerebrovascular accidents produced over a long period of time, Lewy body dementia which is further characterized by changes in movement, sleep and behavior, frontotemporal dementia that usually associates important changes in behavior and personality, among others.
What to do if you think you or a family member may have dementia?
If you or a loved one is experiencing memory difficulties or other changes in thinking skills, don’t ignore it. Quickly consult a neurologist or internist to determine the cause. There is no single test that determines if a person has dementia.
Diagnosis is based on clinical history, through the presence of the characteristic changes of the disease and a thorough and detailed physical examination. In addition, the complementary tests such as laboratory tests and neuroimaging tests will complete the diagnosis. In this way doctors will be able to determine if a person has dementia with a high level of certainty.
Sometimes, it is difficult to determine the exact type of dementia, because the symptoms and changes in the brain of different dementias can overlap. In some cases, a doctor can diagnose “dementia” and do not specify the type. If this occurs, it may be necessary to see a neuropsychologist to perform a more thorough examination or request some more advanced neuroimaging test.
Is there treatment?
Treatment of dementia depends on its cause. On the one hand, there are treatable dementias, such as those secondary to a vitamin deficiency or due to depression. On the other hand, in the case of the progressive dementias such as disease Alzheimer’s, there is no treatment that can cure or reverse its evolution.
Still, there are different drugs to preserve the abilities of the affected person, slow the progression of the disease and improve the quality of life. Also exist non-pharmacological measures focused on stimulating intellectual functions such as cognitive stimulation, music therapy, art therapy, among others.
All these measures they will be more effective if started early. In addition, it has been shown that following a combined treatment (pharmacological and non-pharmacological) is more effective to carry out each one separately. It should be noted that early diagnosis allows a person to take full advantage of available treatments early with the intention of slowing down the disease, as well as giving the patient and family more time to plan for the future.
What else can I do for the person with dementia?
The patient forgets recent and past events. He does not recognize his spouse or his children. However, retains emotional memory almost throughout the course of the disease. This fact should always be present in the mind of whoever deals with it. Besides, To maintain your quality of life it is very important to create and maintain routines for your day to day, as well as preserve their will, their tastes and preferences.
Risk, prevention and lifestyle habits in dementia
Some risk factors for dementia, like age and genetics, cannot be changed. But researchers are still exploring the impact of other risk factors on brain health and dementia prevention. Some of the most active areas of risk reduction and prevention research include cardiovascular factors, physical fitness and diet.
As for the cardiovascular risk factorshandle diseases very well such as arterial hypertension, diabetes mellitus, cholesterol disorders, among other. Also, there is evidence to suggest that it is possible that exercise benefits brain cells by increasing blood and oxygen flow to the brain.
The Mediterranean diet they may also help protect the brain. A Mediterranean diet includes relatively little red meat and emphasizes whole grains, fruits, vegetables, fish, shellfish and nuts, olive oil, and other healthy fats.
He psychological treatment It has been a fundamental element in the treatment of dementia and cognitive impairment. Frequently, anxiety and depression appear in patients suffering from such impairments. It has been shown that psychological interventions maintain a positive impact on the improvement of the symptoms described.
Among the objectives of psychological therapies are the improvement in quality of life and ability to maintain daily activities with the utmost normality. Maintaining in this way, the independence of the patient to the extent that the cognitive deterioration allows it.
It is worth noting the great importance exercised by caregivers. In dementia, it is not only the patient who undergoes a life change but also their family members and caregivers. Attending to behavioral problems that entail different levels of dependency and care. Likewise, the environment may feel vulnerable to high levels of stress.
The decrease in usual activities to attend to the needs of the sick person it can also affect caregivers. In this way, it would be interesting to incorporate the caregiving environment into the therapeutic intervention plan, with the objective of preventing mental health.
Recommended readings:
- The 36-Hour Day: A Practical Guide for Families and Caregivers of Alzheimer’s and Other Dementias. New revised and updated edition (Disclosure): An essential guide for those who must care for loved ones with Alzheimer’s or some other type of dementia. With it, family members and caregivers will find indications that will help them cope with the challenges that this disease presents and how to deal with their own emotions and needs.
- https://alzheimercatalunya.org/en/what-we-do/formate/families/
- http://www.alzfae.org
- https://alzheimer.ca/en (English and French