co-written by Rick Olazabal, BSc, BN
A large number of people over the age of 65 experience some form of memory loss. When the memory loss is not due to any underlying medical condition, the term age-related memory loss or impairment is applied.
This is a normal process. On the other hand, brain diseases like Alzheimer’s disease are very severe and often begin with serious memory loss. This article briefly explores the basics of what you need to know about dementia…
What is dementia?
Dementia is not a specific disease. Many diseases can cause dementia—the cornerstones being Alzheimer’s disease and stroke-related vascular dementia. The term “dementia” is used for a set of specific symptoms caused by disorders affecting the brain. Collectively, these symptoms are severe enough to reduce a person’s ability to perform everyday activities and include memory loss, difficulties with thinking, difficulty with problem-solving or language.
What are the different types of dementia?
There are several diseases that lead to signs of dementia. This section addresses the three most common ones:
- Alzheimer disease: most commonly known type of dementia. Characterized by an insidious onset and slow deterioration. It involves memory, speech, personality impairment, as well as impairment in decision making and other higher-level cognitive functions. The cause of Alzheimer disease is unclear.
- Vascular dementia: may present with deterioration of cognitive functions, with or without language and motor (movement) dysfunction (e.g. shaking, also known as parkinsonism). It usually occurs in the presence of vascular risk factors (diabetes mellitus, hypertension, arteriosclerosis, and smoking), and thus the onset is more sudden than Alzheimer.
- Lewy body dementia: involves insidious impairment of cognitive function with parkinsonism and visual hallucinations. Nighttime disturbances may be so common that the risk of falls greatly increases.
There are other causes – although relatively rare – but they may include alcohol-related dementia, Huntington disease, HIV infection, syphilis, trauma (e.g. subdural hematoma), and some cerebral tumors.
What are the symptoms?
Dementia is characterized by memory loss, difficulty with decision making or exercising complex tasks (i.e. loss of executive functions), and changes in personality. This condition is progressive i.e. symptoms gradually worsen as more brain cells become damaged and die.
The decline is so serious that affects all aspects of social and work life. A person with dementia may also experience changes in mood or behaviour. For this reason, it is important to exclude other conditions like depression and/or delirium.
At what age we might suffer from dementia?
According to the American Academy of Family physicians, about 6% of persons older than 65 years and 30% of persons older than 90 years have some form of dementia. Before the age of 60 it is very rare to develop it. Alzheimer disease and vascular dementia are each estimated to account for 35-50% of dementia, and Lewy body dementia is estimated to account for up to 5% of dementia in older persons.
Who is prone to suffer from dementia?
Down syndrome, cardiovascular risks, and lower premorbid intellect may be risk factors for Alzheimer disease. Vascular dementia is related to cardiovascular risk factors, such as smoking, arteriosclerosis, hypertension, and diabetes. Most individuals with the relatively rare condition of early-onset Alzheimer disease (before 60 years of age) exhibit genetic mutations affecting some important brain proteins.
When to consult doctor?
As previously mentioned, many diseases can cause dementia. Those conditions can have similar and overlapping symptoms and may be treatable. Some conditions that can produce symptoms similar to dementia include vitamin deficiencies, thyroid disease, sleep disorders, etc. It is important to see a qualified health care provider if you have any doubt, or if a family member starts to notice changes in your memory and/or cognition. Timely medical assistance can provide you with the resources and support you require.
How to prevent it?
There is no actual way to really prevent all types of dementia. As we saw, there are various diseases that lead to dementia, so they each need to be addressed individually to minimize risk.
However, a healthy lifestyle may lower your risk of developing it as you are older. By focusing on cardiovascular risk factors, you may reduce the risk of strokes and/or heart attacks (associated with vascular dementia). To reduce your risk of developing signs of dementia it has been recommended that people:
- eat a balanced diet (provides minerals and vitamins)
- maintain an appropriate weight (maintains proper blood pressure)
- exercise regularly (enhances clearance of bad fats and maintains blood vessel health)
- don’t drink alcohol (affects blood pressure)
- quit or avoid smoking (affects size of blood vessels)
- regular check ups
What can be done to help
Diet, exercise, socializing…they all have great benefits on your health. Some people like to supplement their lifestyle with additional products such as ginkgo and omega-3s. While these have been shown to be safe and effective in some conditions, strong scientific evidence is lacking in their use strictly for the prevention of dementia.
Once again, as we saw, dementia is not a disease, but a set of signs and symptoms that results from disease. However, the Alzheimer Drug Discovery Foundation states that, based on limited evidence, ginkgo can be of benefit to someone with mild cognitive impairment—a finding not observed in healthy people.
Ginkgo may be as effective as approved drugs (e.g. Donepezil) in managing memory symptoms in people with Alzheimer and vascular dementia. It is worth noting that ginkgo does not slow down the disease itself, nor it is a cure. For more information speak with your physician or licensed naturopathic doctor about your medical and complementary options.