“What are the first signs of dementia that need to get me worried? I have a history of dementia in my extended family and I don’t want to miss out on managing the condition at the earliest opportunity”
Your question is becoming increasingly important in modern day Kenya. We are coming to the sunset years of a group of men and women commonly referred to as “the baby boomer generation” that is, persons born soon after the Second World War.
Many are now in their 70s, an age typically referred to in the Bible as three score and ten. This is also commonly referred to as the “pill age group” because many take a pill or more a day, for one or other ailment. This is the true early evening in the lives of this generation that was present and active at the time of Kenya’s independence. Unlike their parents, many are well educated, travelled and exposed to the ways of the world. A significant number have few truly rural roots.
An easy example comes to mind by way of the disposal of their bodies after death. Because of their exposure in life, and the fact that many do not have true rural roots, a number have expressed their wish to be cremated, or buried in Lang’ata. Twenty years ago, only the poor and wazungu were disposed of in this way. The stories of the need to be buried near the placenta have little meaning to the many born at Pumwani Hospital. Almost all who grew up in Nairobi in the 50s and 60s fall in this category.
Another matter that is in the mouths of baby boomers is where “retirement” will take place. In the past, a person retired from say, the civil service and was given a wall clock, a wheelbarrow and a walking stick and off they went to their rural “home”. The first generation of true urban elders without rural roots now live in Nairobi, Mombasa, Kisumu, Eldoret and all major urban centres. For these people, rural life exists as places they used to visit their parents who are now mostly long dead.
For all their adult life, the city has provided the home where all social contacts have been made. The neighbours, Church, schools, hospitals and recently shopping malls are their familiar lifelong places of socialisation. The cousins and few aunts and uncles who live in the rural areas, only exist at Christmas or at funerals, and even these are now hardly attended. A new tribe of the Kenyan urbanite has come to be and its demands are new and growing. In the event of need, it is the city Church, or hospital that such persons turn to.
We now turn to your question. In the event of early dementia, it is those people that are closest to you that will notice. Indeed, the early signs of dementia will to some extent depend on where one lives, and with whom one lives. It will also depend on the age of the onset as well as the cause of the dementia. Things are not that simple.
Dementia is not one condition, and is not caused by one thing. The symptoms might be similar but the treatment is different. For this reason, you must seek the opinion of an expert in the event that you suspect a loved one has the condition.
Alzheimer’s type of dementia is the commonest and typically is age related, often starting in the 60s and becoming more common as one goes into the 70s and 80s. It is therefore age related. Other common causes of dementia include diseases of the vascular system (small frequent strokes), infections such as HIV and dementia associated with alcohol use.
Some forms of dementia are known to run in families and this is perhaps what you have in mind. Early memory loss is one of the earliest indicators. Losing keys, forgetting appointments and forgetting to check on the cooking pot are early signs. Then comes difficulties in solving simple problems or performing simple tasks.
In a recent example, a 75-year-old man who had lived in Nairobi all his life got lost in the city centre and could not locate his car. He was found wandering in Kijabe Street as he tried to get to Lavington. Another man kept accusing his wife of hiding things in the house only because he kept forgetting where he had placed personal items like his phone.
Typically, memory loss is for recent events e.g a conversation held with a spouse or shopkeeper. Memory for events during the emergency years or earlier could remain intact to the surprise of the family.