Dementia

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February 26, 2022 / By thadmin2

What is Dementia?

 

Dementia is frequently associated with forgetfulness, but that is not all. Dementia is the weakening of cognitive functioning abilities such as thinking, memory and social abilities. Cognitive functions may be affected to an extent where a person’s daily life is affected. Some people with dementia will also lose their ability to control their emotions, and experience a change in personality as the symptoms deteriorate. Dementia ranges in severity from mild stage where there is mild cognitive impairment to severe stage where full-time assistance is needed to accomplish daily activities (NIA.NIH, 2021).

 

Symptoms and diagnoses

 

Dementia in its early stages can be hard to identify, but the symptoms are observable from the behaviours portrayed. An individual with dementia will experience trouble with memory related tasks, with the short-term memory affected in particular (NIA.NIH, 2021). They might be able to recall events years ago but have difficulty remembering recent events. Repetitiveness is another observable behaviour and can take many forms. Repeating activities, to repetition during conversations (Prestige Care, n.d.) are some examples of repetitive behaviours. In addition, inability to communicate effectively is also a common sign of dementia (Prestige Care, n.d.). Early signs of dementia are often overlooked because they are subtle and not disruptive.

 

According to the Diagnostic and Statistical Manual Version 5 (DSM-5), these are some of the main criterias and symptoms in diagnosis of major neurocognitive disorder (Previously Dementia)

  1. Evidence of significant cognitive decline from a previous level of performance in one or more cognitive domains:
  • Learning, memory, language
  • Executive functions, complex attention
  • Perceptual-motor
  • Social cognition
  1. The cognitive deficits interfere with independence in everyday activities. At a minimum, assistance should be required with complex instrumental activities of daily living, such as paying bills or managing medications.
  2. The cognitive deficits do not occur exclusively in the context of a delirium.
  3. The cognitive deficits are not better explained by another mental disorder (eg, major depressive disorder, schizophrenia).

Causes and Risk Factors

There are several risk factors that contribute and lead to the onset of dementia. (Mayo Clinic, 2021). 

  1. Age: After the age of 65, the risk of dementia is increased. However, dementia does not exclusively happen to people after that age. Dementia can also begin for some people at a younger age (Mayo Clinic, 2021). 
  2. Family history: Having family history of dementia signifies an increased risk of developing the same condition (Mayo Clinic, 2021).
  3. Diet and exercise: Studies have shown that the lack of exercise and active lifestyle increases the risk of dementia (Mayo Clinic, 2021). Although no specific food has been identified to be related to the onset of dementia, research indicated a greater prevalence of dementia in people who have an unhealthy diet in comparison to people who follow a nutrient-rich diet (Mayo Clinic, 2021).
  4. Alcohol abuse: Drinking large amounts of alcohol has been known to affect the brain. Excessive drinking may cause brain damage and increase the risk of developing dementia (Mayo Clinic, 2021). Drinking in moderation has not been conclusively linked to an increase in dementia.
  5. Smoking: Smoking increases the risk of vascular problems which are linked to stroke and microbleeds in the brain. This is also a risk factor for dementia.

There are a myriad of possible reasons for the onset of dementia. Apart from the above mentioned risk factors, according to Stanford Health Care (2018), some diseases such as Vascular dementia, Parkinson’s disease, Lewy body dementia, Frontotemporal dementia, and last but most prominently, Alzheimer’s disease holds the spotlight for the most common cause of dementia that contributes to 60 – 70% of all cases (APA, 2015). Severe head injury can also result in dementia. 

Dementia : How can it be prevented?

There is currently no set formula to prevent the onset of dementia, and no cure for dementia. Dementia can be caused by various reasons such as diseases or other forms of damage to the brain. Thus, reducing the risk factors for these specific factors that may cause dementia is an ideal way to prevent its onset. 

  1. Lifestyle: Adopting a healthy lifestyle will also be a life changing habit as physical activity can reduce the risk of heart diseases and other other diseases that are linked to dementia (NHS, 2020). 
  2. Drinking and smoking habits: Other changes in habits involve avoiding excessive drinking, as well as smoking which can be detrimental to the body and the brain (NIH, 2017).
  3. Nutritional diet: A healthy change in dietary habits is strongly recommended (NHS, 2020). Getting enough nutrients and vitamins from a healthy diet will also be a strong deterrence to diseases that may result in dementia (Mayo Clinic, 2021). 
  4. Cardiovascular System: Last but not least, managing cardiovascular risk factors which supply enough blood to the brain can contribute to the development of dementia (Mayo Clinic, 2021).
  5. Engaging the Mind: Keeping the mind active with mentally stimulating activities and brain exercises can reduce the risk of developing dementia. Engaging in mentally stimulating activities is associated with better cognitive functions while reducing cognitive decline (Stuart, 2020). With reduction in cognitive decline, dementia is more likely to delay in its onset. 
  6. Family Activities: Some activities family members can do with their family members who have dementia are: board games, sudoku and other puzzles, reading and listening to radios, learning new skills and language also challenges the brain to be mentally active (Stuart, 2020). Combining mental, physical and social factors into the activities reaps the best benefits in terms of reducing dementia risk. 

Interventions and treatment options

Psychologists can help manage the changes in mood and behaviour of the individual struggling with Dementia. In long-term care settings, psychologists come in to develop treatment plans to manage behavioural changes (APA, 2015). They work with individuals and their families to design better living environments, implement necessary tools and procedures in place that allow a person with dementia to function well (APA, 2015). This can include working with family to design a room that gives the person with dementia a calm feeling, it can be a room that reminds them of a time in the past when they felt good.

Neurocognitive Therapy (NCT) helps to enhance the brain’s ability to sustain attention and focus for a longer period of time. This intervention works on the auditory, visual processing, sequencing, and memory (Restore Behavioural Health, 2016). As specific areas of the brain responsible for our executive functions are continuously stimulated through the exercises, symptoms of dementia can be curbed along with improved cognitive ability in other areas of the brain. 

Dementia not only affects the individual, it can also take a toll on their loved ones as taking care of a dementia patient requires a large amount of effort and can be stressful. Seek professional help promptly, if you feel that you are experiencing care-giver burnout.

Conclusion 

Dementia can be dreadful for individuals struggling with it and their loved ones. However, it is important to not let dementia define their identity. Knowing the risk factors that make one more susceptible to developing Dementia can help in preventing its onset. Family and friends can also play a big part in shaping the life of an individual, and helping them adopt a healthy lifestyle to avoid dementia. At Thrive Psychology Clinic, we are committed to providing effective and efficient support for every child, adolescent and adult in their mental health. If you believe that your friends or loved ones around you may be struggling with behavioural/mental health issues, encourage them to seek professional help. Feel free to contact us via email: info@thrivepsychology.com.sg or call: 6962 9753 and we will be happy to assist you.

 

References

  • APA. (2015). Living well with dementia. American Psychological Association. Retrieved January 20, 2022, from https://www.apa.org/topics/aging-end-life/living-dementia
  • Mayo Clinic. (2021, June 17). Dementia. Mayo Clinic. Retrieved January 20, 2022, from https://www.mayoclinic.org/diseases-conditions/dementia/symptoms-causes/syc-20352013
  • NHS. (2020, June 26). Can dementia be prevented? NHS choices. Retrieved January 20, 2022, from https://www.nhs.uk/conditions/dementia/dementia-prevention/?tabname=living-with-dementia
  • NIA.NIH. (2021, July 2). What is dementia? symptoms, types, and diagnosis. National Institute on Aging. Retrieved January 20, 2022, from https://www.nia.nih.gov/health/what-is-dementia
  • NIH. (2017, August 29). Risk factors for heart disease linked to dementia. National Institutes of Health. Retrieved January 20, 2022, from https://www.nih.gov/news-events/nih-research-matters/risk-factors-heart-disease-linked-dementia
  • Prestige Care. (n.d.). Five early signs of dementia: Recognizing cognitive decline. Prestige Care, Inc. Retrieved January 20, 2022, from https://www.prestigecare.com/five-early-signs-of-dementia
  • Restore Behavioural Health. (2016, May 25). Neurocognitive therapy. Restore Behavioral Health. Retrieved January 20, 2022, from https://restorebehavioralhealth.com/treatment/neurocognitive-therapy/
  • Stanford Health Care. (2018, August 1). Causes. Stanford Health Care (SHC) – Stanford Medical Center. Retrieved January 20, 2022, from https://stanfordhealthcare.org/medical-conditions/brain-and-nerves/dementia/causes.html 
  • Stuart, A. (2020, October 16). Brain exercises for dementia: How they help the mind. WebMD. Retrieved January 20, 2022, from https://www.webmd.com/alzheimers/guide/preventing-dementia-brain-exercises