Dementia and the Ways to Prevent and Treat It
Speaker: Dr. Lawren Hicks, MD, John Muir Health
Important Websites: Alzheimer’s Association – ALZ.org | National Institute on Aging – nia.nih.gov
Overview
Dementia is a short-term memory loss plus the impairment of cognitive functions which include complex tasks like balancing, reasoning and difficulty in new and unfamiliar situations. Visuo-spacial and language impairments are also common dementia symptoms.
Cognitive impairment can be noticed in the following areas: learning and memory, language, executive functions (assessing new situation and solving new problems), complex functions (sustained focus on a task; multitasking), perceptual motor (drawing a clock; copying a diagram), social cognition (able to appropriately socialize and to recognize people). Dementia patients will eventually lose their cognitive ability and will be unable to live on their own.
Among the several types of known dementia, Alzheimer’s Disease is the most common (60-80%), followed by Vascular Dementia, which is more common in blacks, people with diabetes and hypertension (10-20%). Lewy Body Dementia accounts for about 10-15% while dementia caused by Parkinson’s Disease accounts for about 5%.
The course of dementia is irreversible, and it shortens life expectancy. An Alzheimer’s patient will have an average of nine years remaining if diagnosed at age 65. If diagnosed at age 90, the remaining life expectancy is three years.
Preventing Dementia
Certain drugs have adverse effects on cognitive functions. These include, but are not limited to, analgesics (pain killers), any medicines that are marked as PM (e.g. Tylenol PM), psychotropics (older antidepressants; antipsychotics), sedatives (adverse effects last longer than you think), and possibly some drugs for overactive bladders.
Paying attention to our overall health would also help prevent the onset of dementia. Stay away from smoking and drinking alcohol, maintain a healthy blood pressure (135/85), keep the LDL (bad cholesterol) at 100 or lower, and keep the blood sugar level within the normal range. Maintaining a healthy weight would also help. Above all, exercise is one of the most important preventive measures.
Deficiency in Vitamin B12, Vitamin E and Thiamine are common causes of dementia.
Mediterranean diet is recommended for preventing dementia. A Mediterranean diet is rich in fruits, vegetables, whole grains, and heart-healthy fats (olive oil). It may help manage your weight, protect your heart, and prevent diabetes.
Treating Dementia
There are two drugs available to “treat” dementia. Since the course of dementia is irreversible, these drugs are only used for slowing down the progression.
A good practice of the following will help slow the progression and improve the survival of a dementia patient: a good support system (socially and physically), good personal hygiene, good nutrition, fall prevention, maintain body strength, avoid pressure sores (bed sores) and infections, etc.
Some Acronyms related to Dementia
AD – Alzheimer’s Disease
AAN – American Academy of Neurology
ADL – Activities of Daily Living (bathing, dressing, feeding, toileting, transferring, maintaining continence, etc.)
IADL – Instrumental Activities of Daily Living (using the phone, shopping, doing housework, doing laundry, preparing meals, driving, taking medications, managing money, etc.)
DLB – Dementia with Lewy Bodies
MCI – Mild Cognitive Impairment
Mini-Cog – A brief, cognitive screening test that is frequently used for early dementia detection.
MoCA – Montreal Cognitive Assessment
MMSE – Mini Mental State Examination
