Dementia: When Self Loses Touch with Self

By Henry O. - 2008-07-09 Find more articles like this in our Seniors and Elderly Health category.

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Introduction

Mr. James (a synonym) was a great teacher who perfectly appreciated that to impact knowledge one has to migrate emotionally to the side of the student and partake in her difficulties, rather than vilify her efforts. But too often he goes home in a cab, leaving his car behind. "It is old age!" he frequently reminds us with a stem prophetic mien that tells you simply that one day, you probably would be leaving more than your car behind. But the early stages of memory failure and dementia are serious prospects. If there was ever a voyage to get to the true heart of the human, the place where memory resides would be an excellent place to search.

For the mind to keep pace with an ever changing world as we age, memory must preserve the tiny strands of links between yesteryears, yesterday, today and project reasonably into the future, even if it is shrinking. It must situate us within a time and personality frame that must correlate with the moment, at least not too far away.

With aging comes cognitive decline which is often termed innocently "cognitive aging", a subtle attempt to bundle it with the aging process. When memory fails substantially, the various reproducible trait and behavior that define who we are dissolves into a widening well of emptiness. While over 50% of elderly people say their memory is worse than when they were younger, on the average only 8% (1% at 60 years to 35% at 90 years will development dementia. Alzheimer's dementia will account for about 60%. This age is deceptive because new techniques for brain imaging has shown that the physical features dementia commences long before the first symptoms are noticed; a signal that preventive measures may be more useful long before the disease becomes evident.

Etiology

While the elderly are particularly at risk, medical knowledge regarding the precise cause is still in infancy, an important reason why effective therapy is also unavailable, because "you can't catch what you can't find".

Decades ago, the prevailing hypothesis was that there was a deficiency in a chemical (Acetylcholine) utilized by nervous tissues to transmit impulses and communicate between each other. Many of the symptoms, notably the learning difficulties were explained by the lack of Acetylcholine. While drugs that prevent degradation of Acetylcholine (Anti-cholinesterase) compress the majority of available treatment options, their inability to offer effective respite to many patients, meant other crucial mechanisms were at play.

A more recent additional explanation is based on the deposition of a protein called Beta-amyloid which progressively induces nervous tissue destruction and the subsequent cognitive and memory decline. Other important factors that may contribute include the excessive amounts of the by-product of calorie combustion (Reactive Oxygen species) that can damage biological tissues and episodes of poor blood supply to the brain seen during Stroke (Cerebro-Vascular Accidents).

Early Diagnosis

It is true that there is there a general lack of information about dementia which significantly contributes to the delay in diagnosis. Early assessment in cases of suspected dementia is vital because it may help establish the presence of a medical condition, create an avenue to access treatment and help care-givers prepare for their role. Also early diagnosis of dementia is critical for legal and financial planning. The most common reasons for delays were lack of information about dementia, belief that symptoms were normal aging, not knowing which physician to ask, and being overwhelmed with the situation.

Prevention

Primary prevention essentially entails interventions that are carried out to prevent the occurrence of a disorder. A lot of preventive measures have been evaluated. On top is the need for to modify the risk of chronic medical disorders e.g. Hypertension, Diabetes Mellitus and Stroke with prompt medical treatment which includes; Anti-hypertensive medication, Aspirin (Acetylsalicylate) and anticoagulants such as Warfarin. Other medication includes vitamin C (500 mg) and Vitamin E (400 units) daily for at least three years was were associated with a risk of Alzheimer's Diseases.

Lifestyle practices which involves;

adequate exercise

weight control

abstinence from cigarette smoking

moderate alcohol consumption (250 - 500 ml of wine per day)

And a healthy balance diet that encourages a more efficient metabolism. Increased total fat intake and deficiency of omega 3 fatty acid rich in marine protein, have been linked to dementia).

The relationship between education and subsequent development of dementia have been explored and there is a positive correlation which might be explained by innate ability i.e. those possessing more innate intelligence might progress further in formal education and might be less likely to develop dementia. Occupational exposure to pesticides and fumigants are also associated with dementia.

Further reading:

Sarah B. Wackerbarth, Mitzi M. S. Johnson (2002). The Carrot and the Stick: Benefits and Barriers in Getting a Diagnosis. Alzheimer Disease and Associated Disorders.

Robert J. van Marum (2008). Current and future therapy in Alzheimer's disease. Fundamental & Clinical Pharmacology.

Schneider LN(2008). Prevention therapeutics of dementia. Alzeimer's and Dementia.