What is it?
Dementia, also known as major neurocognitive disorder, is characterized by a loss of mental faculties that reduce a person’s ability to self-care. There is a decrease in performance in one or more cognitive domains such as memory, complex attention, executive functions (e.g., planning, organization, and abstraction), language, visual-motor functions, or social skills. Changes can be noted by the person with dementia, but most often by the family or a doctor. Cognitive losses must be severe enough to be observable in a standardized test that can be done by a doctor in the office or, in some cases, by a neuropsychologist. Brain imaging tests that allow observation of the brain such as computed tomography or magnetic resonance imaging are not necessary in all patients. When a person has a cognitive decline, but no impact on daily functioning, the diagnosis is that of a minor neurocognitive disorder, which may be a condition precedent to dementia.
Having a good physical condition only has advantages. Evidence from the results of health study reveals that women in good cardiovascular fitness at age 50 are less likely to suffer from dementia. The study estimates that the risk of neurodegenerative diseases is thus reduced by 88%. This information is all the more important as these diseases affect around 50 million people worldwide, according to the World Health Organization (WHO).
Importance of physical activity
Only 5% of physically fit women had dementia, compared to 25% of moderately fit women and 32% of those with a low level of fitness. Worse, 45% of those who stopped all physical activity because of cardiovascular problems were diagnosed with dementia.
Negative cardiovascular processes can occur in your fifties and may increase the risk of subsequent dementia, “says Helena Hörder, lead author of the study. “Improving cardiovascular fitness in middle-aged people could delay or even prevent the development of dementia.”
A normal consequence of aging
- Normal everyday forgetfulness, such as having trouble remembering a person’s name, not remembering what was coming in a room
- A state of temporary confusion due to intoxication or acute medical problem (delirium)
- A disease exclusively of the elderly person
- A temporary problem that can be ignored
Unfortunately, there are no curative treatments for dementia, but there is a lot of research going on. Two classes of drugs can improve the cognitive symptoms of Alzheimer’s disease and certain other dementias, namely the acetyl cholinesterase inhibitors (donepezil, glutamine, rivastigmine) and meantime. Although these medications may help with the symptoms, they do not slow the progression of the disease.
Environmental interventions and medication are often needed to decrease the behavioral symptoms of dementia. An occupational therapy assessment can help secure the living environment. Antidepressants and low-dose antipsychotics are often used for psychological and behavioral symptoms.
What can I do?
- Do regular exercise, do not smoke, and maintain a healthy diet.
- Stay active intellectually at any age, especially after retirement.
- Treat diabetes and hypertension optimally.
- Seek medical attention at the first sign of cognitive loss, do not wait in shame or shock the person with dementia.
- Reflect on and prepare for the legal aspects of loss of autonomy early in the illness, which includes mandates of incapacity, appointment of a representative for health care decisions and preparation of a will.
- For the family, provide gradual support for tasks such as managing finances and shopping. Respect the autonomy of the person while ensuring his safety (eg risk of fraud online or on the phone).
- Assess driving skills on a regular basis. If you are concerned, consult your doctor who may recommend a road test or license withdrawal.
- Involve family members and friends to facilitate home support when possible.
- Plan in advance for seniors or long-term care homes to be ready when the time is right.
- Discuss end-of-life care in advance (e.g. level of intervention desired)