By 2050, 152 million people will be living with dementia globally; 68 percent in low-middle income countries alone
Every year the month of September is marked worldwide as the World Alzheimer’s Month and 21st September as the World Alzheimer’s Day as a part of an international campaign to raise awareness about dementia and challenge stigma. This year the theme of World Alzheimer’s month is “Let’s Talk About Dementia.” Through talking we help break down the fear and the stigma. Also, we encourage people to seek information, support and advice something which has become acutely necessary during Covid-19 pandemic. It has been observed that two out three people worldwide believe that there is little or no understanding of dementia in their countries. This article is a brief effort to raise awareness and reduce stigma towards dementia.
What is Dementia?
Dementia is a collective name for progressive degenerative brain syndromes which affect memory, thinking, behaviour and emotion. Dementia knows no social, economic or geographical boundaries. Although each person will experience dementia in their own way, eventually those affected are unable to care for themselves and need help with all aspects of daily life. There is currently no cure for most types of dementia, but treatments, advice, and support are available.
How prevalent is it?
Dementia affects >1 percent of people aged 60-64, and the prevalence doubles every 05 years after 60 years, reaching 30-50 percent of people >85 years. Dementia is going to be the future global epidemic. Presently, every three seconds someone in the world is being diagnosed with dementia and the incidence rate is increasing. It is estimated that by 2050, 152 million people will be living with dementia globally, 68 percent in low-middle income countries alone. Dementia is now widely recognised as one of the most significant health crises of the 21st century.
There are numerous factors which can cause dementia ranging from impaired blood supply to brain, head trauma, infections, vitamin deficiencies, etc., but the most common cause of dementia are the neurodegenerative illnesses like Alzheimer’s disease, Parkinson’s disease etc. Alzheimer’s disease alone accounts for nearly sixty to seventy percent of all dementia cases. Alzheimer’s disease usually presents in the seventh decade of life. It is a gradually progressive disease in which the brain parenchyma gets filled with abnormal protein clumps which leads to the death of neurons (brain cells) and shrinkage of the brain mass (grey matter).
A family history of dementia, chronic medical conditions like hypertension and diabetes, alcohol abuse, depression are some of the factors which increase the risk of developing dementia at a later age.
People suffering from dementia usually present with forgetfulness, often misplacing items, forgetting names, appointments etc. Gradually, they also have difficulty in navigating paths, recognizing familiar faces and places, difficulty in speech etc. Ultimately, the person becomes more and more dependent on caregivers for routine daily activities. Other symptoms like change in social behaviour, lack of self-care and concern for others, suspiciousness, hearing noises/seeing images which are not around, may also develop as a result of which patient may become irritable/aggressive.
Early detection and diagnosis is important for proper management of the illness. If any elderly individual has memory issues, he/she should visit his/her GP who may refer them to a psychiatrist or a neurologist. There is no specific diagnostic test for Alzheimer’s disease, however, the doctor may write series of investigation like blood tests to rule out other causes of memory loss. He/she may also have to undergo CT/MRI brain to detect the degree and site of brain atrophy. Currently many newer diagnostic tests are coming up but, most of them are in experimental stage at present.
The goal of treatment in dementia is to improve the quality of life of these patients so that they can live a life of dignity. There are both pharmacological and non-pharmacological methods of management. The most widely used medications in dementia are the cognitive enhancers which slow down the progression disease to some extent. In addition, the various behavioural changes which occur with dementia like agitation, wandering, compulsive behaviour etc. can be managed with various psychotropic medications. However, non-pharmacological methods play a vital role in managing these behavioural changes. It is here that the patient’s family member’s/care givers play a vital role in caring for them. They can not only ensure that the patient takes medications at right dose and time but with proper training they can also manage various odd behaviours.
Is it preventable?
Dementia is not completely preventable but it has been observed that regular physical exercise, formal education, maintaining adequate blood pressure and blood sugar levels etc. are somewhat protective.
What can I do as a dementia caregiver?
Since dementia is a chronic progressive illness, there is a lot of burden on caregivers which can lead to depression and anxiety in caregivers as well. Caregivers of these patients are under a lot of stress and they should take care of their own mental and physical health also. There is no harm in seeking help from the treating doctor or even keeping a nurse or a helper just to ease out the burden. However, it has been observed that various protective factors like high self-esteem, control, good social support and religious beliefs play a major role in alleviating caregiver burden and improves resilience in them.
What can I do as a citizen?
If any of your family members, friends or relatives complain of memory problems, don’t wait but advise him/her to seek medical consultation. Help to spread awareness about the illness and reduce the stigma faced by the patients or their relatives. Help the caregivers of dementia in whatever ways you can, because who knows tomorrow you may be in their position.
Author is Assistant Professor of Psychiatry, Government Medical College, Baramulla