The unkind decline of the mind

Dementia is listed by the Centers for Disease Control and Prevention as one of the leading causes of death in the United States and the world.

According to a recent study published in the medical journal of the American Academy of Neurology, Alzheimer’s disease, a type of dementia, ranks as the third-leading cause of death in the United States.

The National Institutes of Health refer to dementia as not a specific disease but as a collection of symptoms that can be caused by disorders that affect the brain. People with dementia have significantly impaired intellectual functioning that interferes with normal activities and relationships. They also lose their ability to solve problems and maintain emotional control and they may experience personality changes and behavioral problems, such as agitation, delusions and hallucinations.

According to Alzheimer’s Disease International, as of 2013, there were an estimated 44.4 million people with dementia worldwide. This number is expected to increase to an estimated 75.6 million in 2030 and 135.5 million in 2050.

Dr. Michael Angelo is a family medicine physician and medical director of several nursing homes in the Shreveport-Bossier City area.

He said, “There are several types of dementia such as vascular dementia and Lewy body dementia, but the Alzheimer’s type remains the most common and famous. Alzheimer’s dementia is often determined as a diagnosis of exclusion so notification of your primary care physician is vital to detection and early recognition. The exact cause of dementia remains unclear, but it is suspected that it may be an autoimmune factor; i.e., where the body attacks certain cells in the brain that are responsible for memory.”

Angelo said, “The warning signs can be very subtle. The loss of short-term memory with the preservation of long-term memory is a hallmark for the disease. For example, a person may remember instances they experienced as a child but can’t remember what they ate for breakfast. Higher executive functions such as balancing checkbooks and paying bills on time are usually affected first. The family of an affected member may suspect something is wrong when the electricity or phone is disconnected because ‘grandma forgot to pay her bills on time.’ As the disease progresses, the loved one may grow suspicious and paranoid of others; they oftentimes experience personality changes with extreme and abrupt moods. They often become fearful of others and socially embarrassed resulting in withdrawing from society. As the disease progresses, the basic functions of daily living are affected – for example, daily grooming and the desire to bath or eat. Sometimes weight loss can be a subtle sign of dementia.”

Angelo said, “Drugs can improve symptoms and slow the progression of the disease. This may improve an individual’s quality of life, ease the burden on caregivers or delay admission to a nursing home. Many people with dementia, particularly those in the early stages, may benefit from practicing tasks designed to improve performance in specific aspects of cognitive functioning.”

Angelo said, “The exact cure for dementia remains unclear, but certain medications and dietary supplements have been demonstrated to slow the progression of the disease. Anticholinesterase inhibitors medications such as Aricept, Excelon, Razadyne have been proven to be effective; also combination with another drug class Namenda demonstrated improvements in patients with moderate to severe disease. Dietary supplements that offer antioxidant properties such as garlic, vitamin C and fish containing high levels of alpha omega fatty acids have been of benefit.”

The National Institutes of Health recognizes the following risk factors associated with dementia:

• Age – From age 65, the risk of developing the disease doubles every five years.

• Alcohol use – Most studies suggest drinking large amounts of alcohol increases the risk of dementia, while drinking a moderate amount may be protective.

• Atherosclerosis – It can hinder blood from getting to the brain, which can lead to stroke or another brain injury.

• Diabetes – Diabetic research has shown a small but positive correlation with dementia.

• Down syndrome – Many people with Down syndrome develop early-onset Alzheimer’s, often leading to dementia symptoms in middle age.

• Genetics – One’s likelihood of developing a genetically linked form of dementia increases when another family member has been diagnosed with it.

• Hypertension – High blood pressure has been linked to cognitive decline, stroke and types of dementia.

• Mental illness – Depression in particular can lead to mental decline.

• Smoking – Smokers are at risk from multiple diseases that slow or stop blood from getting to the brain via the cardiovascular system.

Angelo said, “Dementia can lead to the unnecessary suffering of millions of affected individuals if left undiagnosed – their loss of dignity and social acceptance, as well as their relationship with friends and family. Early detection and treatment is key.”