Last update: 04-Dec-2013 12:33 pm
Wednesday, December 04, 2013
Trinidad & Tobago Guardian Online
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Minding your mind against dementia
While dementia mainly affects older people, it is not an automatic feature of ageing. People with dementia may have problems with short-term memory, keeping track of a purse or wallet, paying bills, planning and preparing meals, remembering appointments or travelling out of their neighbourhood (www.alz.org). Geropsychiatrists are advocating for primary care physicians to recognise this and other treatable mental illnesses in older patients, saying it’s increasingly important to have early diagnosis in order to stem the increase or onset of degenerative diseases in the elderly. These diseases may be masquerading as other ailments and may go untreated, but research shows that those who have received the required care live for many years after the onset of symptoms of dementia, enjoying a good quality of life. Dementia is a syndrome, usually of a chronic or progressive nature, caused by a variety of brain illnesses associated with loss of cognitive and intellectual abilities.
According to the Alzheimer’s Organization’s Web site, dementia is not a specific disease. It’s an overall term that describes a wide range of symptoms associated with a decline in memory, judgment or other thinking skills severe enough to reduce a person’s ability to perform everyday activities. According to different estimates, between two and ten per cent of all cases of dementia start before the age of 65. The prevalence doubles with every five-year increment in age after 65, resulting in a 50-50 chance of dementia over the age of 85. The World Health Organization gives the total number of people with dementia globally in 2010 as an estimated 35.6 million and is projected to nearly double every 20 years, to 65.7 million in 2030 and 115.4 million in 2050. The total number of new cases of dementia each year worldwide is nearly 7.7 million, implying one new case every four seconds. Prevalence and incidence projections indicate that the number of people with dementia will continue to grow, particularly among the oldest old (www.alz.co.uk). The disease accounts for 60 to 80 per cent of dementia cases. Vascular dementia, which occurs after a stroke, is the second most common dementia type.
There are many conditions that can cause symptoms of dementia, including some that are reversible, such as thyroid problems and vitamin deficiencies. Quite apart from the fact that people, and especially the elderly, do not quite understand mental health issues and its symptoms, is the pervading incidence of stigmatisation that causes the elderly not to seek assistance. Mental illness has had a long history of negative associations, and the stigma that remains with mental disorders continues to affect people negatively. Like all other mental illnesses, the world is faced with a lack of awareness and understanding of dementia, at some level, in most countries, resulting in prejudice, barriers to diagnosis and care, and affecting caregivers, families, and societies. With education and understanding about the facts on mental illness, we can begin to eliminate stigma and increase the quality of life and access to treatment of those who are coping with it. The stigma of mental illness should not prevent people from leading normal lives in the community or getting the treatment that they need.
Treatment and Care
Treatment of dementia depends on its cause. In the case of most progressive dementias, including Alzheimer’s disease, there is no cure and no treatment that slows or stops its progression.
But there are drug treatments that may temporarily improve symptoms. The same medications used to treat Alzheimer’s are among the drugs sometimes prescribed to help with symptoms of other types of dementias. Non-drug therapies can also alleviate some symptoms of dementia (www.alz.org). While symptoms of dementia can vary greatly, at least two of the following core mental functions must be significantly impaired to be considered dementia:
•Communication and language
•Ability to focus and pay attention
•Reasoning and judgment
Many dementias are progressive, meaning symptoms start out slowly and gradually get worse. If you or a loved one is experiencing memory difficulties or other changes in thinking skills, don’t ignore them; early diagnosis allows a person to get the maximum benefit from available treatments. Some self-help strategies that can help reduce the onset of disease in older adults are:
•Taking regular exercise
•Keeping a healthy diet and avoiding abuse of alcohol and cigarettes
•Planning for major life transitions such as retirement
•Seeking support from family and friends in bereavement from long-term relationships
•Maintaining interests, activities and social involvement, including learning and other intellectual activities like Scrabble or crossword puzzles.
Dementia is overwhelming not only for the people who have it, but also for their caregivers and families. It is one of the major causes of disability and dependency among older people worldwide.
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