Dementia can be difficult to understand, even for experts. The research that has been done so far doesn’t tell us everything we need to know about it, and there’s still a lot of work to do!
I hope this blog post will shed some light on what dementia is and how we can prevent and treat it.
Dementia is not a specific disease. Rather, it is a cluster of symptoms that are often seen together, and could be caused by a number of different things. Usually a person with dementia will experience impairments in thinking, communicating and memory.
Dementia usually affects people older than 65, but it can happen earlier.
What are the symptoms of dementia?
1. Short term memory difficulties
Often, family members will notice that a person with dementia struggles to remember events from the previous day or week.
2. Word finding difficulties
People with dementia have difficulty remembering words. They might experience the word as being ‘on the tip of their tongue’ but can’t seem to get it out. They might also say the wrong word occasionally. For example, they might say ‘Put the pot on’ instead of ‘put the kettle on’.
3. Mood or personality changes
It is common for people with dementia to show gradual changes in mood and personality. Family members often report that their loved one has become more aggressive or more depressed.
4. Difficulty with familiar tasks and routines
People with dementia might struggle with things they used to do without effort, like making a cup of tea.
5. Difficulty with complex tasks, especially problem solving
When faced with a complex task, people with dementia often struggle to make sense of what to do. For example, if the person with dementia is locked out of their house, they might not think of calling a friend or a locksmith for assistance.
6. Sense of direction and getting lost
People with dementia might find themselves unsure when navigating places they have been many times before.
7. Being repetitive
You may notice your loved one repeating stories or questions frequently.
8. Confusion
Often, especially in the later stages of dementia, patients experience confusion. They might be unclear about where they are. A common example of this is the patient thinking they are at home when they are in the hospital.
Preventing cognitive decline associated with dementia
This is a complex topic, and a lot of research is still needed about how to prevent symptoms of dementia. The World Health Organisation (WHO) recognises these methods for prevention (but bear in mind that not all of these are proven to work!):
Exercise - the WHO strongly recommends regular exercise (150 minutes per week) to maintain cognitive function into old age. 150 minutes may seem like a lot, but it doesn’t mean you need to run or lift weights. Walking is a suitable exercise to do, and 30 minutes every week day will get you to 150 minutes easily!
Healthy, balanced diet - this is also strongly recommended by WHO. The strength of the evidence depends on the diet, but WHO recommends: lots of fruit and veg, legumes, nuts, and wholegrain; reduce intake of sugar, salt and fats
Keeping the mind active - there’s not much evidence that ‘brain gym’ helps to prevent cognitive decline, but there is some low-level evidence. You can keep your mind active using specially designed apps, word games or reading.
Some studies have looked into increasing Vitamin D and Omega 3 fatty acids to help prevent cognitive decline. The evidence isn’t substantial yet, and the WHO does not offer guidelines to use supplements
Good sleep - this is recommended by many scientists and doctors. Sleep is proven to be linked to memory function. However, it is not clear how much of an effect it has on the progression of dementia.
Treatment
The most important part of treating dementia is catching it early on. Diagnosing dementia early in the progression of the disease means treatment and counselling can begin sooner.
There is no ‘cure’ for dementia, and treatment usually revolves around optimising health and supporting caregivers.
Your doctor will make sure there is a good team of therapists and other professionals working with you. This might include a speech therapist, occupational therapist, social worker or psychologist, among others.
All healthcare professionals are aiming to ensure the patient with dementia can maintain independence as long as possible and live comfortably. We are also involved in supporting caregivers and loved ones during the full progression of the condition.
Dementia can be complicated by poor nutrition and pneumonia as a result of swallowing difficulties, which is an important part of speech therapy for dementia patients.
What do speech therapists do for patients with dementia?
Speech therapists play a very important role in treating patients with dementia. Your speech therapist will be involved in:
Tracking the progression of the condition over time
Teaching caregivers and loved ones how best to communicate with patients who are experiencing difficulties with communication
Ensuring patient safety by maintaining communication of basic needs and emergency needs
Perhaps most importantly, speech therapists assist with swallowing difficulties in patients with dementia. This is essential for preservation of life, because swallowing disorders can cause pneumonia if not treated correctly. Pneumonia is known to be the leading cause of death in patients with dementia, so treatment for swallowing is very important.
I am, as always, available to answer any questions you may have about dementia (or anything else!), so please feel free to contact me.
Megan Lang
Sources
WHO
Mayo Clinic
Healthline
World Health Organization. (2019). Risk reduction of cognitive decline and dementia: WHO guidelines.
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