Dementia
Global statistics from 2010 revealed that more than 35.6 million people worldwide are living with dementia, a brain disorder that results in the loss of global cognitive ability in a previously unimpaired person beyond what is expected in the normal ageing process. With the prevalence of the disease projected to double every 20 years, dementia is an increasing concern for medical care providers and general society. Taken from the Latin words de-, meaning “madness,” and ment-, or “mind,” dementia is not a new phenomenon. In fact, the earliest mention of it in Western medical texts was by the 7th century BC physician and mathematician Pythagoras. However, the rise in incidences of dementia has renewed public interest in the condition.
Dementia is by far most common in the geriatric population, as the risk for the condition doubles every five years after the age of 65. It can occur in people between the ages of 40 and 65, however, and this form is referred to as “early onset dementia. But regardless of the age of onset, the causes of dementia will depend on whether it is static or progressive. Static dementia is the result of a traumatic brain injury that causes generalised damage to the white matter of the brain. This form of dementia can also result from strokes, from infections that affect the brain such as meningitis or encephalitis, or from prolonged epileptic seizures that have long-lasting effects on cognition.
Progressive dementia, on the other hand, has a gradual onset that worsens progressively over time. It is usually caused by neurodegenerative disease, a condition that primarily affects the neurons of the brain. It results in irreversible loss of function of the neural cells, and eventual complete deterioration of the brain. Progressive dementia is far more common and is largely agreed to be the more difficult to deal with for both patients and caretakers.
Regardless of whether the dementia is static or progressive, it can affect memory, attention, language, reasoning and judgement, mood, and problem solving, to name a few. It reduces the ability to learn, to reason, to retain or recall past experiences, and to control one’s emotional reactions. There is also disruption in patterns of thoughts, feelings, and activities. This means that a person’s behaviour may become disorganised, restless or inappropriate. It’s not uncommon for people with dementia to wander day or night without knowing to where they are going. They can also experience what are known as “catastrophic reactions,” which occur when a person with dementia finds themselves in situations beyond their capacity to handle and have sudden emotional shifts to tears or anger.
Another very common symptom of dementia is the inability to recognise one’s own relatives. A person may see their own son and ask who they are, unaware of the relation. As frustrating as this is for relatives, it is even more frustrating and demoralising for the person with dementia. It’s thus no surprise that 20 to 30 percent of people with dementia suffer from depression, and that around 20 percent have severe anxiety. In addition, dementia is often accompanied by psychosis, agitation, and aggression. And in the later stages, dementia sufferers become so disoriented in time, place, and person that they require full-time care.
Depending what form of dementia is presented, the condition can take months to years to progress. The forms of dementia include Alzheimer’s disease, vascular dementia, frontotemporal dementia, and demantic dementia. An estimated 10 percent have what is known as mixed dementia, which can be a combination of Alzheimer’s disease and vascular dementia. But all kinds of dementia have the same fate, which is a progression into a final stage in which the individual loses the ability to respond to their environment, carry on a conversation, and control movement. As a result of inactivity, late-stage dementia sufferers experience muscle deterioration and the inability to digest food, and eventual death. While medication and cognitive therapy can alleviate some of the symptoms, there is as of yet no cure.
The burden on family and caretakers of individuals with dementia is quite severe, and can lead to both psychological and financial repercussions. Caregiver burnout is very common for those who day in and day out have to sacrifice their time to tend to the needs of someone who isn’t able to recognise them and who often displays angry or aggressive behaviour. This can be particularly difficult on a partner or spouse who is losing their significant other in the process. And the financial fallout can be equally as devastating, given the amount of time and resources required to provide full-time care to dementia sufferers.
Our modern social structure is not fit to handle the challenges of this condition. Whereas in more traditional societies elderly care is woven into the social fabric, today we have struggle with how to even care for our healthy elderly. Few can afford to not have all members of a household working, but the costs of elderly residential facilities are equally cost-prohibitive. Thus, when illness strikes, it can deplete a family’s entire savings and investments. For this reason, people affected by dementia and medical professionals alike are strongly urging governments to find more effective means of addressing this prevalent social issue.