It is usual for anyone sometimes to forget their keys at home, need help remembering minor details, or do basic things. These are part of the daily realities of living that become increasingly common as a person ages. When such realities become so significant as to affect our ability to survive on our own, it is often a sign of something worse… like dementia, for instance.
Dementia is a progressive condition that affects a person's ability to think, reason, and remember. It is a leading cause of disability and dependency among older adults, and the number of people affected is expected to rise significantly in the coming years.
More than 50 million people are estimated to have dementia worldwide in 2019. The number is set to almost triple by 2030. Although dementia is seen as a disease of people in Western countries, 60% of people with dementia are in poor countries in Africa and Asia.
Despite the youthful African population, more elderly people are expected to develop dementia, with Nigeria being one of the most affected countries on the continent. Knowing about the disease can encourage you to tackle the common risk factors of the disease.
Modifiable and non-modifiable risk factors of dementia
Your risk of having dementia depends on the factors you can control and the ones you cannot control. Some factors, like old age and the genes you inherit, are beyond your control, so they are ‘non-modifiable.’
On the other hand, there are factors you can control as an individual or with government policies that can help reduce your risk of developing dementia. These factors are ‘modifiable,’ and a 2024 global report shows that controlling these factors can prevent 45% of dementia cases.
The modifiable risk factors include:
- Social isolation
- Poor education
- Air pollution
- Unresolved hearing loss
- Depression
- Brain injury
- Hypertension
- Diabetes
- Obesity
- Low level of physical activity
- Excessive alcohol intake
- Smoking
- Uncontrolled vision loss
- High serum cholesterol
Controlling these factors requires personal effort combined with government policies and intervention.
Reversible and irreversible causes of dementia
Dementia is often a consequence of advanced age. However, it may also be caused by some reversible and irreversible factors.
Reversible causes of dementia produce short-lived impairment in memory and thinking, which resolve as soon as the cause is treated or removed. Such reversible causes include:
- Severe head injury
- Multiple strokes
- HIV
- Neurosyphilis
- Meningitis
- Alcohol
- Heavy metal poisoning
- Brain tumors
- Multiple sclerosis
- Liver and kidney failure
- Low or high thyroid function
Irreversible causes of dementia are neurodegenerative disorders or diseases that occur as the brain loses its neurons. They include:
- Alzheimer’s disease
- Parkinson’s disease
- Prion’s disease
Dementia may not be inheritable
Some scholars suggest a link between genetic factors and dementia because people who have dementia often have family members with a history of dementia. However, the current understanding is that you cannot inherit or transmit the disease.
What are the early signs of dementia?
Dementia develops slowly but progressively. The earliest signs are subtle and easy to pass off as regular forgetfulness. However, these are some common signs and symptoms:
- Progressive short-term memory loss
- Disorientation
- Difficulty in performing regular tasks
- Changes in mood or personality
- Language difficulty
- Difficulties with abstract thinking
- Difficulty in remembering names and faces
- Increased suspicion
- Getting lost and misplacing items
How is dementia diagnosed?
The diagnosis of dementia is based on five criteria, as outlined in the International Classification of Diseases, Tenth Revision (ICD-10). These criteria include:
- A decline in memory and thinking must be evident and sufficient enough to impair personal activities of daily living
- Memory impairment must affect the individual’s activity to register, store, and retrieve new information, while previously stored information may be lost
- Thinking impairment must reduce the flow of ideas and reasoning capacity
- The person must have clear consciousness
- The signs and symptoms must last at least six months
A person suspected of having dementia must meet these five criteria for their diagnosis to be confirmed.
Other investigations include:
- Lumbar puncture for cerebrospinal fluid (CSF) analysis
- Electrolyte, urea, and creatinine
- Urinalysis
- Thyroid function test
- Liver function tests
- Brain imaging
- Serum vitamin B12 and folate levels
- Electroencephalography
Unfortunately, the diagnosis of dementia in developing nations can be challenging because many people do not know about the disease. Signs and symptoms of dementia are often misinterpreted as spiritual problems or downplayed as natural rites of old age.
Besides, very few brain specialists are available to manage dementia, and facilities may need to be more readily available across the country.
Prevention of dementia
While there is no known cure for dementia, it is very preventable. Preventing dementia means managing the modifiable risk factors we mentioned earlier. You can
- Maintain a healthy lifestyle
This involves adequate sleep, eating high-quality fruits and vegetables, and quitting smoking and alcohol.
- Challenge your brain
Mental exercises such as solving puzzles, building new projects, reading, or painting engage different parts of the brain, thus strengthening them. This can prevent or delay the onset of dementia.
- Manage underlying conditions
Chronic diseases such diabetes, hypertension, and diabetes increases your risk of developing dementia. Managing them–with drugs and lifestyle and dietary adjustments–may protect your brain against dementia.
- Maintain social connections
Social isolation is the new epidemic, and it is not helped by the Covid-19 pandemic which forced everyone indoors, and social media which seems to mask the need for physical need for physical interactions.
Still, venturing outdoors and engaging people physically could benefit brain health. The richness of our social experience provides emotional support, excites our minds, and improves our mental health.
Treatment
There is currently no known cure for dementia, but many treatment options are available to:
- preserve any remaining ability to think and perform daily tasks
- relieve distressing symptoms
- accommodate the immediate needs of the patient
- treat any complications
Treatment may also involve psychological treatment such as music therapy, art therapy, memory training, and medications.
Conclusion
The number of people with dementia is rising, and our aging population is at risk of adding to the number. While some of the factors are not modifiable, managing the modifiable ones can help improve our brain function and prevent dementia. Still, this is not a job for one person. Government intervention is needed, too.
