Dementia is an umbrella term used for a number of neurocognitive disorders which adversely affect various cognitive functions and behaviour of a person and hence can lead to disruption of day to day activities. Although dementia can occur at any age, it mostly affects the elderly. With the increase in life expectancy the proportion of elderly population is also increasing, and with it the prevalence of elderly suffering from dementia is also increasing. Most of the dementias are due to neurodegenerative diseases like Alzheimer’s or Lewy Body Dementia which have a progressive deteriorating course.
Studies have concluded that early detection and treatment initiation can delay the progression of dementias and can also improve the quality of life of these patients. Hence it is important to detect and diagnose dementia at an early stage so that appropriate management is started early in the course of the illness. Keeping this in mind, the Alzheimer’s Disease International (ADI) has chosen“Know Dementia, know Alzheimer’s “as this year’s theme for the World Alzheimer’s Month in September, so that the family members/carers are able to identify the early changes which occur in dementia and seek treatment at the early stage. Inthis article we will discuss some of these common early signs of dementias and how to identify them.
Memory & Learning
• Has difficulty in recalling recent events and conversations
• Occasionally may repeat sentences or questions
• Cannot keep track of list of items to be bought while shopping
• Occasionally misplaces routine items like keys, mobile etc
• Requires frequent reminders to keep track of things
Attention & Concentration
• Normal tasks take longer than previously
• Begins to find errors in routine tasks, needs double checking
• Has difficulty in environments with multiple stimuli (TV, radio, conversations) gets easily distracted
• Has difficulty in recalling phone numbers or conversations just said
• Has difficulty in calculations, handling money etc.
• Needs more effort in tasks like knitting, carpentry, sewing etc.
• Has difficulty in parking cars and driving
• Needs maps or finds himself lost if not concentrating
• Occasionally may lose his/her way back home
• Is more confused at dusk and evenings
• Has difficulty in following shifting conversations e.g, in large gatherings
• May feel fatigued due to extra effort required to organize, plan and decision making
• Has difficulty in multitasking or doing multistage projects like cooking, using ATM
• Has to seek help of others in doing complex tasks or completely abandons them
• Has noticeable word finding difficulties while speaking
• May use general term than specific names (e.g, “that thing” rather than “glass”)
• May forget names of acquaintances
• May have grammatical errors while speaking or writing
• May have difficulty in understanding spoken language
• Has subtle changes in behaviour and attitude recognized by family as change in personality
• Has less empathy, seems unconcerned, withdrawn
• Occasionally may become more extrovert, talk or behave inappropriately in social situations
• Becomes more rigid, makes reckless decisions, childlike behaviour
• Has stereotypic behaviour (tapping hands, clapping) or compulsive behaviour (excess washing)
As family members/carers it is important to look for these symptoms/signs in your elderly loved ones and not to ignore any of these symptoms. If you find any one or more of these symptoms do not waste time and seek help from a psychiatrist, neurologist or even your family physician for early diagnosis and management.
(Author is Assistant Professor of Psychiatry, GMC Baramulla and Post Doc Fellowship Geriatric Psychiatry-NIMHANS Bangalore. He can be reached at: firstname.lastname@example.org)