It is normal for people to forget things, places or people when they grow old. However, if the forgetfulness is accompanied by a decline in cognitive abilities such as the ability to make decisions, solve problems or plan things, it could be a sign of dementia.

Dementia is the term used to determine the decline in mental function severe enough to hamper daily activities. While the condition is more commonly seen in older people (at or above the age of 65 years), it is not necessarily a part of normal ageing. As per the World Health Organization (WHO), every year 10 million new cases of dementia are reported across the globe. In the late stages, the affected person may lose their ability to remember, reason, comprehend, calculate, judge, and learn new things. 

How is dementia different from age-related forgetfulness?

Not every individual suffers from dementia in their old age. As people grow old, they tend to experience bone loss, weakening of muscles, stiffening of blood vessels, and age-related memory loss. 

Unlike the loss of memory experienced in dementia, a person with age-related memory changes does not forget their old memories, experiences or a language they would have learnt over the years. Older adults may sometimes misplace their keys, forget the most recent events or the name of an acquaintance but their knowledge stays intact. Hence, a person with age-related forgetfulness, despite their occasional memory lapses, can function independently and carry out normal day-to-day activities.

A person with dementia, on the other hand, finds it difficult to perform daily activities. At the most severe stage, such an individual may need to depend entirely on others for carrying out basic daily activities.

What are the signs of dementia? 

The early signs of dementia include: 

• Forgetting recent events or information
• Losing track of time
• Misplacing commonly used items

• Getting lost at familiar places.

• Struggling to find the right words while communicating with others
• Repeated questioning
• Change in mood, behaviour and interests
• Requiring help for personal care

The signs of dementia in the later stages include:

• An increase in anxiety, aggression, agitation, confusion, sadness and mistrust 
• Inability to recognize relatives and friends
• Lack of ability to make decisions or solve problems
• Inability to complete basic daily tasks such as brushing teeth, using a toilet, operating a television remote and paying bills
• Sleeping pattern change
• Difficulty in walking
• Hallucinations (less frequent).

What causes dementia? 

Dementia occurs due to the damage caused to the brain cells, making it difficult for the brain to function properly. Different regions of the brain are responsible for different functions. For instance, the amygdala is responsible for emotional behaviour, while the hippocampus is responsible for episodic as well as recognition memory. The damage in the different regions of the brain results in various forms of dementia which include:

• Alzheimer's disease: This is the most common type of dementia that occurs when an abnormal protein surrounds the brain cells from outside, while the other protein damages their internal structure. This disrupts the chemical connection between the brain cells and kills them.
• Vascular dementia: This type of dementia is usually seen in people suffering from high blood pressure, severely hardened arteries, or those who would have experienced strokes. 
• Lewy Body dementia: This disease occurs when there is an accumulation of abnormal protein (Lewy bodies) in the brain, disrupting the communication between the brain cells. 
• Frontotemporal dementia: This dementia occurs when there is damage to the nerve cells present in the frontal and temporal lobes of the brain. 
• HIV-associated dementia: It is a serious consequence of HIV infection and is usually seen in the advanced stages of the infection. This type of dementia is usually seen in younger people.

Who is more prone to get affected by dementia? 

Anyone can suffer from dementia, but factors that may increase the risk of developing dementia include:

• Old age: People at or above the age of 65 years are at high risk of developing dementia.
• Family history: It has been found that people who have a parent or a sibling suffering from dementia are at increased risk of developing the same later in life. 
• Smoking: Studies have shown that smoking increases oxidative stress, inflammation, and harms the blood vessels which puts smokers at increased risk of developing dementia.
• Poor cardiovascular health: If not managed, obesity, high blood pressure and cholesterol levels can increase the risk of developing dementia.  
• Head injuries: People who have suffered a traumatic brain injury are at risk of developing dementia later in life.  

Can dementia be treated? 

There is no cure for dementia. However, early diagnosis and treatment options may help in managing the symptoms of dementia effectively. Medications such as anti-depressants, anti-anxiety drugs are given to people with severe behavioural changes. Things that may help in dealing with dementia include: 

• Consuming a healthy balanced diet loaded with vegetables, fruits, whole grains and fibres along with lots of fluids.
• Practising moderate-intensity exercise such as brisk walking or even gardening, regularly for at least half an hour.
• Quitting smoking and limiting the use of alcohol.
• Avoiding the consumption of caffeinated beverages before going to bed as it can disrupt sleep.
• Solving puzzles or games that help stimulate the brain.
• Counselling sessions with a therapist to improve aggressive and anxious behaviour.

The family and friends of people suffering from dementia can also support and improve their lives by: 

• Setting up a timetable to help affected people schedule their activities accordingly.
• Placing their keys or other necessary things at a place that is visible, such as in a large bowl in the hall.
• Keeping a list of emergency contacts next to the landline phone or on the refrigerator.
• Providing them with a pill organiser box that can help them remember which medicine to take and when.

Takeaway

Dementia can range from mild, where the person starts forgetting things, to severe, when they are completely dependent on others for their daily activities. Early diagnosis and optimal management can help improve the quality of life in people suffering from dementia. Doctors must also identify and treat the accompanying physical illnesses in these patients such as high blood pressure, high cholesterol and other metabolic disorders. By leading a healthy lifestyle and maintaining social contacts, one can decrease the severity of the symptoms of dementia.

For any questions on mental health, you can speak to our mental health expert.