Imagine striving to work harder so that you can enjoy a relaxed, long retirement only to live a life where you are not capable of recognising your loved ones or surroundings and cannot do basic things like dress and feed yourself without assistance.
That is what dementia, a degenerative brain disease does.
Dr Sylvia Mbugua, a consultant Neurologist at Aga Khan University Hospital, Nairobi helps shed some light on this disease.
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Is Dementia a disease, or simply the process of ageing?
Dementia is a neurological disease characterised by deterioration in memory, thinking, behaviour and the ability to make decisions and perform everyday activities. Although dementia mainly affects older people, it is not a normal part of ageing. “Early-onset dementia” is rare but can occur.
Is Dementia and Alzheimer’s disease one and the same?
Alzheimer's disease is the most common form of dementia in people who are over 65 years and contributes to about 60 to 70 per cent of dementia cases. Dementia can also result from a variety of conditions including chronic alcoholism, stroke, Wilson’s disease, herpes virus and HIV infections, thyroid disease and vitamin deficiency.
What are the risk factors?
Although age is the strongest known risk factor for dementia, some people will develop dementia, while others live to a ripe old age with their mind as sharp as a 20-year-old. Several things determineyour risk of developing dementia – age, genetic factors, certain health factors and your lifestyle. If you have a family history of dementia, you stand a higher risk of developing dementia with time.
High blood pressure, obesity, high cholesterol and diabetes are also risk factors for dementia. Many studies have shown that people with one of these conditions during their midlife are about twice as likely to develop dementia later in life. If you have more than one of these conditions, your risk is even higher. Smoking and alcohol also put you at risk.
What can one do to reduce the risk?
There is nothing you can do about ageing or your genes, but you can do something about your health. Keeping your weight within the appropriate bracket, managing blood pressure, cholesterol and blood sugar at healthy levels are important for your brain. Avoid head injury, smoking and depression.
Regularly exercising as well as challenging your brain through cognitive mental and social activities is associated with a lower risk of dementia. A healthy diet, low in red meat and high in Omega 3 fatty acids, coconut and olive oil, lots of fruit and vegetables, nuts, whole grains, legumes and vitamin E is recommended.
How do you diagnose dementia?
Unfortunately, there is no one test to determine if someone has dementia. Doctors diagnose Alzheimer's and other types of dementia based on a careful medical history, a physical examination, MRI scans and the characteristic changes in thinking, day-to-day function and behavior associated with each type.
Laboratory tests and MRI imaging are also done to exclude other causes of dementia which could be treatable, especially in younger patients.
What are the symptoms?
Although the early signs vary, common symptoms include progressive forgetfulness, losing track of time and inability to recognise familiar places.
As dementia progresses to the middle stage, the signs and symptoms become clearer and more restricting. These include becoming forgetful of recent events and people's names, getting lost at home, having increasing difficulty with communication, needing help with personal care, experiencing behaviour changes, including wandering and repeated questioning.
The late stage of dementia is one of near-total dependence and inactivity.
Is the condition treatable?
In the case of most progressive dementias, including Alzheimer's disease, there is no cure and no treatment that stops its progression. But, there are drug treatments that may temporarily slow down its progression.
Once the neurologist has made a diagnosis, he will advise on medication that can help the patient. Dementia resulting from infective, thyroid problems and vitamin deficiency can be reversed.
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