What is dementia?
Getting to grips with dementia
What is dementia? Dementia is a collective term for a variety of illness that affect the brain and the ability to perform everyday tasks. There may be many causes of dementia but Alzheimer’s dementia is one of the more common types. Dementia not only affects people’s memory but can also affect rational decision making, mood and behaviour, language and comprehension skills.
Who gets it? It is quite normal as we age to become forgetful. The chances of getting dementia increases with age but it is not a part of normal aging. 1 in 5 people over the age of 80 will have dementia (1). There are some risk factors that increases the chance of developing dementia such as having had a stroke, family history and certain genes are indicative of developing younger onset dementias (less than 60 years of age). Diet and exercise also play an important role in reducing risk of this disease.
What are the symptoms? The types of symptoms vary, and your doctor will be able to diagnose the type of dementia accordingly. They can include
Short term memory loss – forgetting things that are happening now or don’t remember things that have recently been told or where they have put things.
Loss of initiative or motivation – don’t show much willingness to do anything
Language problems – subtle signs include difficulty finding the right word, using the wrong word or just not making sense.
Difficulty performing certain task – it is common for people to lose the ability to do complex tasks as they get older but a person with dementia can’t think how to do simple tasks too (e.g. getting dressed). We call this task apraxia.
Poor or decreased judgement - this can be subtle but best observed when making the right decision is important, like driving or finances
Personality and behaviour change – increased suspiciousness, lack of humour or empathy, irritability, aggression or being over-familiar.
How is dementia diagnosed? An early identification is really important. Family members are often the first to notice changes in a person’s behaviour or mood. Your family GP along with a referral to a geriatrician or a memory service will assists with accurate diagnosis which then leads to proper treatment. Sometimes the dementia is reversible. Most times the diagnosis of dementia requires a treatment plan and further discussion with the family regarding the future of that person.
What are the risks of having dementia? Most people with dementia live normal and happy lives. 65% of people with dementia live at home or in the community (2). It is important that they and their family are considerate of how dementia can present risk to various tasks such as driving, cooking, selfcare and managing finances. This requires you and your family to have a discussion and may include external help to aid in managing this condition.
What is the treatment? There is no cure for most types of dementia. The management is aimed at slowing cognitive function, improving quality of life and supporting independence.
Medical therapies can be used to improve quality of life but they are not right for everybody. A specialist geriatrician is usually required to assess appropriateness. Managing physical health needs, including vascular risk factor, as well as stopping potentially harmful medications can improve thinking slow progression.
Lifestyle is really important for quality of life and supporting independence. People with dementia need a familiar environment and routine to maintain independence but they also need stimulation and need to be challenged. Studies have shown that regular exercise and appropriate nutrition slows cognitive decline as well as improving overall health (3).
Family support is tremendously helpful for maintaining independence. Often it isn’t enough and sadly carer stress is very common for those who shoulder the majority of the support needs, especially when difficult behaviours develop. To try and manage risk and prevent carer burn-out, additional community supports or funding are required. Sadly many people with dementia will need to go to a nursing home when care requirements become too much for the carer.
References
Australian Bureau of Statistics (2020) Causes of Death, Australia, 2019 (cat. No.3303.0)
Australian institute of Health and Welfare, Dementia snapshot, July 2021
Tiia Ngandu, J.Lehtisalo, A.Solomon, E.Levalahti, S.Ahtiluot, R.Antikainen et al. A 2 year multidomain intervention of diet, exercise, cognitive training and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial. Vol 385, Issue 9984, pg 2255-2263, June 06 2015. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)60461-5/fulltext
