Dementia and Ageing

Dementia and Ageing

Dementia and Ageing

20 million was the population of the elderly according to the Census of 1951. By 1991 this figure rose to 57 million. The decade from 1991 to 2001 saw a sharp increase in this figure. It is expected that by the year 2050 the numbers will reach 324 million. These figures were given by the Indian Journal of Community Medicine, July 2008. India is fast coming on the verge of becoming a nation of elderly.

Old age brings with a host of illness, both mental and physical. Dementia is one such common mental illness associated with old age. It has been observed that around 5% of the people above 65 years of age tend to suffer from Cognitive impairment that can potentially lead to Dementia and an additional 5% also show moderate changes.

Cause of Dementia

You might wonder at this point, what exactly is Dementia. Dementia is a chronic and progressive deterioration of mental faculty most probably occurring due to old age. The signs and symptoms should be at least present in the patient for a minimum of six months to confirm the case of Dementia. The other associated symptoms of Dementia include loss of emotional control, imbalance in social behaviour, lack of motivation and inability to perform ADLS, that is, activities of daily living. These symptoms are collectively referred to as ‘non-cognitive’ characteristics of Dementia and are called BPSD that is, Behavioural and Psychological Symptoms in Dementia. They are the most upsetting and difficult to cope with symptoms for family care givers, friends and relatives. Progressive cerebral degeneration is what is responsible for causing Dementia. This cerebral degeneration can be a result of a number of conditions like Vascular Dementia, Dementia with Lewy bodies or Alzheimer’s.

Clinical Assessment of Dementia

Though no specific diagnostic tests are available to confirm Dementia, a detailed examination of physical, basically neurological and mental state can be used to find out the underlying pathology of the patients. The diagnosis can be further supported by certain brain imaging methods like MRI Scanning or CT or functional imaging techniques like SPECT (Single Photon, Emission Computer Tomography) scanning.

It is essential that the aetiology of Dementia is established during the patient’s lifetime to:

  • To find out the course of illness and help in good prognosis
  • To determine specific treatment for each type of Dementia

The patients of Dementia generally either fail to cope or suffer from disturbed behaviour or might have both. They often deny the existence of the condition in the early stages of the disease.

Managing Dementia

These patients need:

  • Evaluation of the cause and intensity of the disease
  • Evaluation of difficulty in functioning and the requirement of care
  • Evaluation of the patient’s social condition
  • Determining treatment and care according to diagnosed needs
  • Providing emotional and physicals support to care givers
  • Constant review of the above mentioned points to determine if the treatment is effective or not

Nearly half the patients of Dementia suffer from simultaneous physical health troubles. Taking care of such patients becomes even more challenging. Dementia is also often accompanied by:

  • Emotional instability
  • Depression
  • Some psychotic characteristics
  • Behavioural trouble

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