Forget me not!
Over the next 15 years, the number of Indians living with dementia will almost double, meaning more Indian families will become caregivers, writes VIBHA SINGH
Thanmathra, a critically-acclaimed award-winning Malayalam film, made in 2005 centres around an intelligent, active and popular government employee, Ramesan (played by Mohan Lal) slipping into dementia. He is still in employment, and with school-going kids, when he starts facing cognitive difficulties, among other problems, which keep increasing and becoming more obvious and serious. Initial symptoms are assumed to be stress, but as he deteriorates and his behaviour becomes distinctly odd, people around him realise he needs medical advice. The movie shows the diagnosis, and the way care begins.
But for thousands of senior citizens suffering from Alzheimer’s and dementia, the lack of good care facilities have led to rising cases of getting lost when they had gone out for a walk or some household chore. According to recently released Indian National Crime Records Bureau 2016, reportedly there are a total of 30,767 missing senior citizens. In 2016 alone, 13,236 were reported missing; 17,531 were reported missing from the previous years, and only 9,467 were found.
This incident highlights the risks faced by senior citizens affected by Alzheimer’s, dementia and other mental illnesses. Sailesh Mishra, director, Silver Innings, author of the book, Remember me: You, me and Dementia said, “Frequently, we get messages of elderly people who have gone missing. Families need to take this seriously, as 90% of the time these elders are not found, as they suffer from memory loss.”
The problem
If you have a loved one who has been diagnosed with mild cognitive impairment or early dementia, there’s much you can do now to lay the groundwork for smoother future care. The more you understand the challenges that dementia can bring, the better you will be able to cope. A 76-year-old woman was brought to her general practitioner by her children, because she was becoming forgetful. She used to pay her bills independently and enjoyed cooking, but has recently received overdue notices from companies and finds it difficult to prepare a balanced meal. She has lost 3.5 kg in the past three months, and left the water running, flooding the bathroom. When her children express their concerns, she becomes irritable and resists their help. Her house has become more cluttered and unkempt. On a past visit to her physician, she had normal laboratory tests for metabolic, haematological, and thyroid function.
The number of people living with dementia worldwide is currently estimated at 47 million and is projected to increase to 75 million by 2030. The number of cases of dementia are estimated to almost triple by 2050, according to the World Health Organisation (WHO). Dementia is a progressive brain disorder, which is basically a decline in mental ability severe enough to interfere with daily life. Memory loss, is an example. According to Mishra, “Alzheimer’s is the most common type of dementia. It is progressive, which means the symptoms will gradually get worse. How fast dementia progresses, depends on the individual. It is caused by damage to brain cells. This damage interferes with the ability of brain cells to communicate with each other. When brain cells cannot communicate normally, thinking, behaviour and feelings can be affected.”
Warning signs
Memory loss that disrupts daily life including forgetting recently learned information, date, time, names. Rakesh Shrivastva, software professional, took care of his mother who suffered from dementia at the age of 68 for eight years. He says, “We started noticing changes in her, like she was not able to do cooking and pay monthly bills. Many a times she was not able to locate places and was disorientated about time and location. Also, she had trouble understanding visual images, colour, spatial relationships, reading, and judging.”
Dementia patients, many face new problems with words in speaking or writing and forgetting familiar words and repeating the same incident again and again. They misplace things and lose the ability to retrace steps: Not able to trace things, they end up leaving things in unusual places like keys in fridge and vegetable in cupboard. The biggest sign is when they start withdrawing from work or social activities and are disinterested in grooming.
Who is at risk?
Mostly 60 plus age group mainly who are socially inactive. But recently in has been found that there are even people in the age group of 45-50 suffering from dementia. However, dementia isn’t a normal part of ageing, and dementia can occur in younger people who are suffering from high blood pressure (hypertension), cholesterol, fats in artery walls (atherosclerosis) and obesity. Although not yet well-understood, late-life depression might indicate the development of dementia. If you have diabetes, you might have an increased risk of dementia, especially if it’s poorly controlled. People who snore and have episodes where they frequently stop breathing while asleep or people who sleep less and don’t get good sleep may have reversible memory loss.
Is it curable?
There is no cure for dementia and related disorder, but diagnosis at early stage with a right combination of medicine and baring stimulation activity, love and care help in treatment. Mishra explains, “While most changes in the brain that cause dementia are permanent and worsen over time, thinking and memory problems caused by the following conditions may improve when the condition is treated or addressed: brain stroke, depression, medication side effects, excess use of alcohol, thyroid problems, vitamin deficiencies and socially inactive.” Drugs have been developed that can temporarily alleviate some of the symptoms of Alzheimer’s disease in the early to middle stages. These drugs act in the brain to maintain supplies of an important chemical called acetylcholine. But there are many cases of side effects too.
Prevention is better
There is evidence that a healthy lifestyle can help reduce your risk of developing dementia when you are older. It can also help prevent cardiovascular diseases, such as stroke and heart attacks, which are themselves risk factors for Alzheimer’s disease and vascular dementia, the most common types of dementia.
Jyoti Chauhan, yoga and zumba exponent says that, “One can help reduce your risk by: eating a healthy, balanced diet, maintaining a healthy weight, exercising regularly, keeping alcohol to a minimum, stopping smoking and keeping blood pressure at a healthy level. So do regular exercise, yoga, eat healthy, sleep well, laugh, listen to music and dance .”