Understanding Dementia

A few months ago, a long-time patient brought her 69-year-old mother into the clinic for a consultation. The well-dressed, well-spoken, retired mother of three had become increasingly confused when driving long distances. She’d also lost her way a number of times during walks in her own neighbourhood.

After a detailed examination, I noted other signs of short-term memory loss and difficulty with decision making. My diagnosis was late-onset Alzheimer’s disease, a type of dementia that develops after the age of 60.

What is dementia?

Dementia is the loss of mental capacity—such as thinking, memory, and reasoning—severe enough to interfere with a person’s daily functioning. Common symptoms include loss of memory, intellect, and social skills accompanied by abnormal emotional reactions.

Although most people with dementia are older, dementia is not a normal part of aging. Typically occurring in people after 60 years of age, the disease can also affect individuals in their 40s and 50s.

Types of dementia

There are several different types of dementia that can occur in older adults. A proper diagnosis can make a difference in the treatment protocol.

Alzheimer’s disease
Alzheimer’s disease is the most common type of dementia. Throughout the disease, abnormal protein deposits destroy cells in the cerebral cortex that control memory and mental functions.

Although each person experiences Alzheimer’s in a unique way, many common symptoms exist. In the early stages, the most common symptom is memory loss, specifically difficulty remembering recently learned facts. As the disease advances, symptoms include confusion, irritability, aggression, language breakdown, long-term memory loss, and general withdrawal.

Vascular dementia
Vascular dementia, including multi-infarct dementia, is the second most common type of dementia and is caused by poor circulation to the brain. In multi-infarct dementia, many tiny strokes occur that cut off the blood supply to parts of the brain. With this type of dementia, controlling blood pressure, maintaining proper blood sugar levels, and not smoking may help to slow the progress.

Parkinson’s disease
People with Parkinson’s disease typically experience impaired motor skills and speech problems. The classic symptom of limb stiffness can cause a shuffle when walking, along with a notable tremor or shaking at rest. Dementia may develop late in the disease, affecting reasoning, memory, and judgment. Recent studies suggest a link between low vitamin D levels and the onset of Parkinson’s.

Lewy body dementia
Lewy body dementia is caused by abnormal microscopic deposits of protein that destroy nerve cells over time. These deposits can cause symptoms typical of Parkinson’s disease as well as dementia similar to that of Alzheimer’s disease. Lewy body dementia is more likely to affect thinking, attention, and concentration rather than memory and language.

Alcohol-related dementia
Dementia can also be brought on by excessive alcohol consumption. Some warning signs include memory loss, difficulty performing familiar tasks, impaired judgment, and language problems.

Prevention

Preventing dementia requires much more research—however, evidence suggests that individuals can take steps to protect brain function and help delay the onset of dementia.

Vitamin B
Researchers have observed protective benefits of regular vitamin B supplementation on brain function. In a study looking at cognitive decline in older men, participants who had higher levels of B vitamins, particularly folate, also experienced better memory recall.

B vitamins seem to lower homocysteine levels, a toxic metabolite associated with dementia, which tends to rise with age. One milligram of folate and 400 mcg of vitamin B₁₂ daily can help neutralize homocysteine and provide a protective effect on brain function.

Vitamin E
Vitamin E has shown potential in warding off dementia by protecting the delicate neurons of the brain from damage. A study involving 1,033 participants found that those with low blood levels of vitamin E had a higher incidence of dementia and cognitive impairment.

Although researchers are not sure if supplementation will slow or reverse disease progression, the study proposes a benefit from regular vitamin E supplementation.

Fish oil
Eating fish three times a week may also help prevent the onset of dementia by almost half. A study in the Archives of Neurology found that participants with the highest DHA levels at the beginning of the study were 47 percent less likely to get dementia and 39 percent less likely to get Alzheimer’s disease during the study than the rest of the group. Researchers concluded that individuals with an intake of 180 mg of DHA per day had a decreased incidence of dementia.

Curcumin
Studies have shown that curcumin, the yellow component of curry spice, may have protective effects on the brain. Populations that consume high amounts of curcumin have some of the lowest rates of Alzheimer’s in the world. Scientists theorize that a diet rich in curcumin protects the brain from free radical damage and also has an anti-inflammatory effect.

Along with supplementation, regular physical exercise can also be helpful in slowing the onset of dementia. Engaging in routine mental exercises such as word puzzles and social activities such as volunteering can also help to keep the brain strong and ward off dementia at any age.

Signs of dementia

Dementia may be indicated when someone:

• Repeats a story during a conversation
• Repeats a story week after week
• Reads or hears a news story and repeats it many times during the day
• Repeats a story even when told he or she has already told the story
• Says the same word or phrase over and over
• Asks the same question repeatedly
• Asks what the time or day is repeatedly
• Asks about things that have already occurred that he or she has forgotten

Ensure that your family member or friend sees a health practitioner for assessment.