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Old age or disease?
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When a loss of memory begins to create problems in daily life, it is time to take note that it may not be a natural part of growing old. Rather, it may be the first signs of dementia. This year's World Alzheimer's Day campaign — September 21 — and National Dementia Awareness Week — September 16 - 22 — focus on the importance of recognising the early symptoms of the disability.
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ONE may think that becoming forgetful or repeating oneself is a natural part of growing older. However, sometimes, memory loss could be an early sign of dementia. Old age does not cause memory loss but when it starts to disrupt daily life, it could be time to get help.
Dementia is a progressive, degenerative disease that affects the brain and results in impaired memory, thinking and behaviour. Alzheimer's Disease is the most common form of dementia. Others include vascular dementia (caused by damage due to poor blood supply to the brain), dementia with Lewy bodies (associated with abnormal collection of proteins in the brain) and Fronto-temporal dementia (associated with changes in the frontal lobe of the brain).
Dementia knows no boundaries — social, economic, ethnic or geographical. It affects one in 20 people over 65 years and is more common among the elderly, though it can affect the young too. As the disease progresses, the affected person becomes dependant on others for help with all aspects of daily life. At some point a person with dementia will need 24-hour care including assistance with routine activities like eating, dressing or going to the toilet.
Each person is unique and the disease affects people differently — no two people will follow the same course. An individual's personality, general health and social situation are all important factors in determining the impact of dementia.
No cure has yet been found, but newer medicines are useful especially in the early and middle stages of the problem. Recognising the symptoms is the first step towards receiving a diagnosis. This can help reduce the anxiety of the affected person and their family, allow a greater chance of benefiting from existing treatments, access to resources and information and provide more time to plan for the future.
E-mail: alzheimr@md2.vsnl.net.in
or adi@alz.co.uk
Website: www.alzheimerindia.org or http://www.alz.co.uk
Early symptoms
Memory loss: Declining memory, especially short term, is the most common early symptom of dementia. People with ordinary forgetfulness can still remember other facts associated with what they have forgotten. But a person with dementia also forgets the context and other associations.
Difficulty in performing familiar tasks: People with dementia often find it hard to complete everyday tasks that usually do not require thought. The patient may not know in what order to wear clothes or the steps for preparing a meal.
Problems with language: Occasionally everyone has trouble finding the right word but an individual with dementia often forgets simple words or substitutes unusual words making their speech or writing hard to understand.
Disorientation: People with dementia often get lost in familiar places, forget where they are going or how they got there and not know how to get back. They can also confuse night and day.
Poor or decreased judgment: For example, dressing inappropriately.
Keeping track of things: Finding it difficult in following a conversation or keeping up with paying bills.
Misplacing things: Everyone misplaces things but a person with dementia may put things in unusual places like the iron in the fridge.
Changes in mood or behaviour: A person with dementia may become unusually emotional and experience rapid mood swings for no apparent reason. Or he/she may show less emotion than was usual previously.
Changes in personality: The patient with dementia may seem different in ways that are difficult to pinpoint.
He may become suspicious, irritable, depressed, apathetic, anxious or agitated especially in situations where memory loss causes difficulties
Loss of initiative: While everyone gets tired, a person with dementia may become very passive, sleeping for hours or appearing to lose interest in hobbies.
Recognising the problem
Recognise the early symptoms: Poor memory or any other symptoms should be acknowledged and investigated, not put down to being a "normal part of aging".
Listen to the person: Most people experiencing symptoms common to dementia may not have dementia. Depression may cause similar symptoms and this also needs to be identified and treated. A person may just be worried and want to discuss the symptoms. Reassurance and explanation are an important part of care. Sometimes it is helpful to arrange a further assessment after six to 12 months to review the situation.
Listen to the carer: One of the best ways to identify dementia is to listen carefully to someone who knows the person well - either the spouse, relative or close friend. A story of developing memory loss and mental decline is important and requires further investigation.
Seek professional advice: If you are concerned that either you or a family member has some symptoms of dementia, seek professional advice. This will depend on what health facilities there are in your community. Sometimes referral to a specialist may be needed where diagnosis is difficult.
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