KOCHI: The world marked Alzheimer’s Day on September 21. And there were several discussions about dementia. Here we look at the basics of the condition. Dementia is a general term for a decline in cognitive function severe enough to interfere with activities of daily life. It affects memory, thinking, reasoning, and social abilities. Dementia is not a specific disease but a group of symptoms caused by various underlying conditions, most commonly Alzheimer’s disease.
Symptoms of dementia:
Memory loss
Difficulty with problem-solving or reasoning
Confusion or disorientation
Difficulty in communication, like finding the right words or understanding language
Personality changes
Difficulty performing daily activities
What are the causes?
Dementia can be caused by damage to brain cells. This damage interferes with the brain cells’ ability to communicate with each other, affecting thinking, behaviour, and emotions.
Primary causes:
Alzheimer’s disease: The most common cause of dementia linked to abnormal protein deposits (amyloid plaques and tau tangles) in the brain disrupts cell function.
Vascular dementia: Caused by reduced blood flow to the brain, often due to strokes or conditions like hypertension and diabetes
Lewy body dementia: Caused by abnormal clumps of protein (Lewy bodies) in the brain.
Frontotemporal dementia: Results from the degeneration of the frontal and temporal lobes of the brain.
Parkinson’s disease dementia: Similar to Lewy body dementia, it involves protein clumps in the brain.
Chronic traumatic encephalopathy: It is caused by repeated head injuries or concussions.Often seen in athletes, particularly in contact sports like boxing and football.
Infections: Conditions like AIDS, Creutzfeldt-Jakob disease, and syphilis can lead to dementia.
Nutritional deficiencies: A lack of vitamin B12 or thiamine (common in alcoholics) can cause dementia-like symptoms.
Thyroid disorders: Hypothyroidism or hyperthyroidism can lead to cognitive impairment.
Alcohol abuse: Chronic heavy drinking can cause alcohol-related brain damage, leading to dementia (Wernicke-Korsakoff syndrome).
Medications: Certain drugs, particularly sedatives or painkillers, can impair cognitive function in older adults.
What is Alzheimer’s dementia?
It is the most common form of dementia, accounting for 60-80% of all cases. It is a progressive neurodegenerative disorder that primarily affects memory, thinking, and behaviour. Alzheimer’s dementia is caused by the accumulation of abnormal proteins in the brain.
Risk factors:
Age: It’s the most significant risk factor. A majority of Alzheimer’s patients are over 65.
Genetics: Family history and certain genes, like the APOE-e4 gene, can increase risk.
Lifestyle and heart health: Poor cardiovascular health, obesity, diabetes, smoking, and a sedentary lifestyle can heighten risk.
Down syndrome: Individuals with Down syndrome have a higher risk of developing Alzheimer’s earlier in life.
Treatment
While there is no cure, treatments can help manage symptoms and improve quality of life
Medications: Drugs like cholinesterase inhibitors (e.g., donepezil, rivastigmine) and NMDA receptor antagonists (e.g., memantine) can improve memory and symptoms by enhancing communication between brain cells.
Lifestyle adjustments: Exercise, cognitive stimulation, social engagement, and a healthy diet may help slow cognitive decline.
Supportive care: As the disease progresses, caregiving becomes critical. This includes creating a safe environment, managing behaviour, and providing emotional and physical support.
Alzheimer’s disease progresses differently for everyone, but the average life expectancy after diagnosis is typically 4-8 years, though some people live longer.