Carla is proud of her 79-year-old mother, who singlehandedly managed a household of eight with little money, but with lots of love and prayer. She fondly remembers those days and wishes her mum Una could relive the good old times.
Una was diagnosed with dementia five years ago, and the condition has robbed her of her once quick wit and most of her memory. Una’s story is a common one for more and more families as the prevalence of dementia increases.
In this Senior Citizens Month, this September, the international community celebrated World Alzheimer’s Day on September 21.
Alzheimer’s is the most common form of dementia, and the Barbados Alzheimer’s Association this week held a public lecture to debunk myths about the condition. Dr Ambrose Ramsay, consultant geriatrician with the Ministry of Health, told his audience that an estimated 40 million people worldwide were suffering from dementia, and in Barbados the numbers were rising.
“In Barbados it is estimated that there are 4,000 plus people living with dementia. Dementia is having a significant impact on our health system, and that is evident in the fact that between 2004 and 2005 about 16 per cent of admissions to the Geriatric Hospital came with a diagnosis of dementia.”
Dr Ramsay further revealed the findings of a 2008 survey of patients at the Geriatric Hospital, which also showed a rise in cases, which has not stopped.
“At the time we had about 340 patients, and about 54 per cent of that population was suffering with dementia; so that is more than half.
“Between 2008 and 2011, that average increased to 32 per cent; so the demand for long-term care by persons living with dementia is increasing.”
Dr Ramsay said of note were studies that showed people of African and West Indian origin more likely to develop the condition. Dementia is not one specific disease but describes a collection of symptoms that are caused by disorders affecting the brain. It affects thinking, behaviour and the ability to perform everyday tasks, particularly in people 65 years and older.
“If you are in the 60 to 84 age range, roughly five per cent suffer from Alzheimer’s; over age 85, about 50 per cent; and over 85, most will have some form of dementia.”
According to Dr Ramsay, there are three other forms of dementia.
“Vascular dementia –– that is more common in people who have hypertension, people who have had previous strokes, and also persons who have diabetes. Dementia with Lewy bodies –– this type of dementia is characterized by visual hallucinations and the Parkinson’s-type tremor.
“Then there is frontotemporal lobar degeneration, where there are significant personality and mood changes.”
The symptoms of dementia vary, but according to Dr Ramsay, short-term memory loss which may progress to total loss is a normal feature.
“There is difficulty performing familiar tasks, so simple things like making breakfast are almost impossible. There are problems with language in that the person will have difficulty communicating, or they may use inappropriate words. There is disorientation of time and place and as a result persons tend to get lost, and they lose track of the day. Eventually, they will start to lose track of the time of day.”
Sufferers may also experience changes in moods or behaviour, and they often exercise poor judgement, sometimes putting themselves at risk.
“For example, a person may get up at two o clock in the morning turn on the lights, open the door and go for a walk, or just sit there. They may let strangers into the house, and they may also have difficulty when it comes to managing money. They may give these individuals more money than they should, or they may even pay workers twice or more when jobs are done.
“As a direct result of memory loss, there are also constantly misplacing things. This is not simply misplacing your car keys or house keys. This is like putting food in inappropriate places; they might put meat in the cupboard or put shoes in the fridge.”
The geriatrician told the audience that risk factors for dementia were wide ranging, but age was really the biggest risk factor and if there was a family history of a parent or a first degree relative suffering from dementia. The other risk factors he explained were developmental, lifestyle, cardiovascular and psychological.
“Development risk factors include poor nutrition during childhood development, low education level, low occupational status and traumatic events in early life. Among lifestyle risk factors for developing dementia are low physical activity, low mental activity, smoking and occupation.”
Cardiovascular risk factors include diabetes, high blood pressure, obesity and high cholesterol, while psychological factors range from depression, anxiety to lack of sleep. At present, there is no prevention or cure for most forms of dementia. However, some medications have been found to reduce some symptoms.
Dr Ambrose advises that exercise, proper nutrition and adequate social activity can reduce the risk of developing dementia.
“Look after your heart. Generally speaking, what is good for your heart is also good for your brain . . . . Follow a healthy diet. The diet that has been shown to be useful in reducing the risk is the Mediterranean diet –– legumes, beans, vegetables, fruits, olive oil and fish. How we eat is very important. What is not a part of the Mediterranean diet is sugary foods and refined carbohydrates.
“Challenge your brain. Keep doing things to stimulate the brain: reading new things, learning new things, having discussions, debates. Word games may also be helpful. Go to new places; take a walk; learn to play a musical instrument.”