PEOPLE GENETICALLY PRONE PRONE TO DEMENTIA ARE GETTING IT EARLIER THAN EVER.
“The patient didn’t suffer from delusions or hallucinations associated with other psychiatric illness and was speaking normally. But on questioning the family, we found that she had been displaying aggression, anger and lapses in memory for a year.” This raised her suspicious, leading her to run a series of tests, which confirmed that the patient’s symptoms aligned with dementia, despite being only 50.
Dementia, or a decline of cognitive function, used to be associated with people 70 years and above, but of late, there are more cases of early onset of dementia at ages 60 and even 50. As families don’t expect this condition in a younger person, treatment is delayed, which causes more damage as early detection is crucial in slowing down the cognitive decline.
While forgetting names, faces, and crucial tasks is fairly common in adults of all ages, what people need to watch out for is gradual and progressive memory loss. “Some display difficulty finding their way back home, confusing a similar looking street with one’s own. Losing vocabulary is common in early onset.”
In both cases, what helped was early detection – latest studies indicate symptoms begin to show a decade prior to actual onset. “The patient might start exhibiting behavioral changes in the pre-dementia stages.” “Someone who is usually calm might act irrationally or display hostility towards family, much before memory impairment begins to show. Monitoring is needed if a person displays uncharacteristic behavior.”
While poor mental health and other environmental factors cannot cause dementia perse, they can accelerate the decline in those with a predisposition. “Following the pandemic we have noticed a sudden increase in the incidence of dementia. Older adults who were active socially had to go through sudden and prolonged isolation and a sedentary life during the lockdown. Even after the lockdown was lifted, they remained glued to the mobile phone.” That increasing instances of social isolation, whatever the cause, including retirement or loss of a spouse could contribute. “Chronic stress could speed up the decline. Adverse life events and living constantly in survival mode age the brain faster; people stuck in an abusive marriage.”
Our brains start losing neurons by the age of 45, and for it to build neural circuits, one must work it in a productive manner. “Exercise, movement, learning new things such as languages or instruments, connecting with nature, keeping oneself socially active meaningfully engage the brain in a productive manner.” A sedentary nine-to-nine tech job might appear to work the brain but it’s not positive stimulation. “Over-stimulation from social media also has a negative impact on the brain.”
Dementia is termed irreversible clinically, but early diagnosis and identification can improve the quality of the lives of the patients as well as the caregivers. Medications are available to slow down the decline, though anti-psychotic medications can have side-effects. “We prescribe them only when the patient becomes hard to manage. A behavioral approach helps a lot, where we ask the family to engage the patient and develop a routine and a proper structure for them for the day.”
You have to reorient patients to the day, time, place, and people around them. “You are dealing with a brain that has lost touch with reality, so keep them connected with photographs and positive experiences, in familiar spaces.”
Right from an early age, healthy socialization and brain stimulation should be encouraged, which will push the onset of dementia even if someone is genetically prone to it.
At the Dementia Care Foundation Center at Thoraipakkam, they engage patients in cognitive behavioral therapy as well a swell as reminiscence therapy where they help them remember their past by asking them about their professions and by playing movies and songs. “We see a change in behavior once they start talking about themselves. We also engage them in sodoku, crossword puzzles and reading newspapers.”
At the center, they are seeing more cases in their 50s coming in and it can turn the family’s life topsy turvy.
“Financial difficulties crop up as care is expensive and few in the family would have been prepared for this.”
Dementia doesn’t lead to death like other major conditions and patients live with it to their 80s and 90s. “Its a caregiver’s disease, and when the patient is on the younger side, the impact can be higher. Caregivers too need counseling not just the patients.”
CAUSES & SYMPTOMS:
- Genetic tests are available to find out if one is prone to dementia. The facility is available in major hospitals in India.
- Symptoms of dementia are like those of other psychiatric illness and they must be ruled out first.
- Physical causes also must be ruled out — severe dehydration, post-Covid memory disturbances, uncontrolled diabetes, hypertension, or hypothyroidism; strokes and brain tumors; as well as prolonged drug and alcohol abuse.
- Sociological causes which could increase risk of dementia — lack of productive brain work, sedentary lifestyle, lack of meaningful communication, social isolation.
- Cognitive assessment tests should be done annually, as symptoms start showing even a decade ahead.
