Dementia

What is dementia?
Dementia is caused by the destruction of brain cells from ageing, illness or injury. It is commonly associated with aging, although it can affect adults of all ages. The first sign is usually memory loss, although not all memory loss is an indication of dementia.
A person with dementia might forget where he lives or how to put away the groceries. Over time, dementia affects a person’s ability to reason,communicate and focus. It can cause their personality to change.

1.2 What are the different types of dementia?
Alzheimer’s is the best-known and most common type of dementia – it accounts for about half of all cases. Over time, people with Alzheimer’s lose their memory and their ability to speak or understand language. They cannot make decisions or solve problems. They don’t recognize friends or family. They don’t know their own name or know where they are.
Vascular dementia is the result of small strokes that cause bleeding in the brain. The bleeding damages that area of the brain. If the bleeding occurs in the language area of the brain, for instance, the speech will be affected.
The damage is not always reversible but if the cause of the strokes is treated, then further bleeding can be stopped. This type of dementia is the second most common type (around 20% of dementia patients suffer from vascular dementia).

Dementia with Lewy bodies is similar to Alzheimer’s. It gets its name from abnormal collections of protein (Lewy bodies) which occur in the nerve cells of the brain. But unlike Alzheimer’s, it includes elements of Parkinson’s disease such as muscle rigor, trembling, shuffling gait and slurred speech. Hallucinations may also be experienced.
Pick’s Disease is the rarest form of dementia and causes personality and behavior changes. It is caused by degeneration in the front temporal lobe of the brain that controls judgment and social behavior. This type of dementia can occur in people in their 40s.

1.3 What causes dementia?
All dementia is caused by damage in the brain. Sometimes the damage is reversible, sometimes not. It is important not to jump to conclusions.
Memory loss or some other symptom of dementia could be caused by something minor and treatable. You should always consult a knowledgeable physician.
Alzheimer’s and Lewy body dementias are caused by areas of protein that develop in the brain. The clumps of protein – called plaques and tangles -- scramble the messages sent in the brain. Researchers aren’t sure what causes the proteins to develop, but they suspect inflammation is partly responsible.
Vascular dementia is caused by strokes that produce bleeding in the brain. Treating the underlying cause can stop further damage.
Certain lifestyle choices can cause dementia, too. Poor diet, smoking, excessive drinking, not exercising, can all adversely affect brain health.
Recent studies have found that being a smoker increases your risk of dementia by 50% - another great reason to give it up! Something as simple as dehydration can affect mental function.
Severe head trauma such as is seen in boxers can also result in dementia.
Researchers are now seeing a link between head trauma and the onset of dementia years later.
Reactions to medications, especially in older people with slower liver function, can also cause dementia. Dementia from these causes can usually be reversed by lifestyle changes.
Several research studies have suggested a possible link between aluminium and Alzheimer’s disease and some research suggest that people living in an area where there is a high concentration of aluminium in the water supply may be more likely to develop Alzheimer’s – but this evidence is not conclusive. Using deodorants or drinking tea, where there is low exposure to aluminium has not been linked to an increased risk of Alzheimer’s disease.
Exposure to mercury (e.g. in dental fillings) is also unproven to cause Alzheimer’s although mercury can be toxic to the central nervous system.
A variety of diseases can be accompanied by dementia:
1 Sexually transmitted diseases like syphilis and AIDS
2 Pellagra, a lack of niacin or B-3
3 Pernicious anaemia, a lack of B-12
4 Hypoglycaemia, caused by lack of sugar in the bloodstream
5 Hypothyroidism, decreased thyroid function
6 Severe brain infections like meningitis and encephalitis
7 Creutzfeldt-Jakob disease, a brain infection
8 Huntington’s, a hereditary brain disease
9 Parkinson’s
10 Down’s syndrome
It’s interesting that in countries like India and China, people are less than half as likely as people in western countries to suffer from Alzheimer’s. This is a clear sign that the difference is to do with diet, lifestyle or other environmental factors. It’s unlikely to be due to the difference in genetics, as people emigrating from these countries to western regions, soon catch up in terms of a greater risk of dementia.

1.4 Who is at risk?
Dementia can occur at any age, although it is typically a disease of old age. Almost half of people over 85 suffer from Alzheimer’s, but only about 5% of people between 65 and 74 are diagnosed with it.
A person with a parent or sibling with Alzheimer’s has a higher risk of developing it. Early onset dementia that occurs at midlife is believed to be hereditary.
Women are more likely than men to have Alzheimer’s, possibly because they live longer. Researchers also think women who take hormone replacement therapy after age 65 increase their risk for dementia.
Researchers are finding that people who chronically use antacids such as Tagamet, Pepcid and Zantac have 2 ½ times the normal risk for Alzheimer’s.
In addition to acting on stomach acid, the drugs also inhibit the brain’s cholinergic system, which is involved in memory and cognition.
Education levels also seem to be an indicator. Research has found that people with lower levels of education are at greater risk. The theory is that mental stimulation may be a preventive.
Relationships have also been found between the development of Alzheimer’s and disturbances in insulin and glucose metabolism. This may explain why people with diabetes have a much higher risk of developing Alzheimer’s disease.

1.5 Is dementia preventable?
There’s is no proven way to prevent dementia such as Alzheimer’s but keeping to a healthy diet and staying physically and mentally active seems to reduce the risk. Mental fitness is particularly important. Solving puzzles and engaging in hobbies are recommended as ways to exercise the brain.
Studies show that the use of anti-inflammatory drugs such as ibuprofen (Motrin and Advil), naproxen sodium (Aleve) and indomethacin (Indocin) may reduce the risk. But they should be used with caution because they can cause gastrointestinal bleeding.
Statin drugs like atorvastatin (Lipitor), rosuvastatin (Crestor) and simvastatin (Zocor) that are used to treat high cholesterol may also reduce the risk, but researchers are not sure how.
Another drug, raloxifene (Evista), that is used to treat osteoporosis seems also to reduce mild cognitive impairment, a memory disorder that precedes Alzheimer’s.

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