Dementia, simply put, is a group of symptoms associated with a progressive loss of brain functioning. The word “dementia” comes from “de” (without) and “mentia” (mind).
Dementia is a syndrome usually chronic, characterized by a progressive, global deterioration in intellect including memory, learning, orientation, language, comprehension and judgement due to disease of the brain.
Dementia occurs because of diseases that affect the patient’s brain. Because the brain controls every function of our body, dementia patients have problems doing various tasks of daily life.
Patients face memory loss, which increases as their dementia progresses. They find it difficult to balance their bank statements or plan for visitors at home. Sometimes, they forget where they are (which house, which city) or the date and time. They struggle to find the right words to explain what they want. Over time, they become unable to do the normal activities we all take for granted, and even have problems walking, talking, and swallowing food. In the final stage, they become bed-ridden and fade away.
To people around them–their family, friends, colleagues, neighbours–dementia patients look confused and forgetful and start behaving strangely, such as withdrawing or getting aggressive. These symptoms are often assumed to be part of normal ageing; but dementia is not normal ageing.
Patients may show some or most of the following symptoms (the number and intensity of the symptoms increases as dementia progresses):
- Forgetting important things, especially recent things
- Finding it difficult to plan events or solve problems
- Normal, daily activities seem more difficult to do
- Wearing wrong/ inappropriate clothes, or becoming untidy
- Getting confused about which day, month or year it is, or where the person is
- Having problems with pictures
- Having problems with numbers
- Using wrong words while speaking or writing
- Putting things at very unsuitable places (like putting a file in the fridge)
- Starting something, and then being unable to remember what they wanted to do, even after trying a lot
- Taking strange decisions about investments
- Withdrawing socially
- Getting agitated for minor things or for no apparent reason at all
- Seeming suspicious about people
A useful reference to understand the dementia symptoms is 10 signs of Alzheimer’s from Alzheimer’s Association. This document describes each symptom and also explains how to distinguish between ‘normal ageing’ and dementia for each of these symptoms.
When we talk of what dementia is, it is also important to understand what it is not. Dementia is not mental retardation. It is not delirium or amnesia. And it is not being crazy.
Unfortunately, in India, while we recognize the symptoms of dementia, the corresponding words of our languages (as shown in the depiction alongside) focus on the behaviour but do not recognize that this behaviour is the result of a medical condition. This is explained by the 10/66 Dementia Research Group on their page here.
The memory loss in dementia is different from normal memory problems we all face
A lot of people associate the word dementia with “memory loss”. They also get worried every time they forget something, scared that they have dementia. But not every misplaced key or forgotten date indicates dementia. Many of us forget things occasionally, but this is different from the “memory loss” associated with dementia.
An excellent set of comparative examples of how normal forgetting differs from the forgetting of a dementia patient is available at the site of ARDSI Hyderabad Chapter. Click here to read. Another set of examples is available at the ARDSI Delhi Chapter site, at this link. There are many such examples–example, consider your own name. Do you expect that, however old you become, you will forget your own name? Dementia patients forget their names.
Here are a couple of interesting articles that explain the memory loss problem found in Alzheimer’s: an abstract of a paper, When the zebra loses its stripes: Semantic priming in early Alzheimer’s disease and semantic dementia, that studies semantic memory and dementia, with its findings discussed here. Also, Dementia May Result from Incomplete Memories explains distortion of memory and false memories, and the paper abstract is here: Paradoxical False Memory for Objects After Brain Damage
In the early stages, patients often manage to cover up or compensate for memory loss. And even if they seem confused, people around them assume that this was a “normal” loss. To realize something is wrong, the family needs to be more alert.
As dementia progresses, however, the problem becomes more obvious.
Understanding Memory Loss , a document at ADEAR, explains memory loss, and which types of memory loss are part of dementia. It also gives tips on how to handle memory loss. The document, while reassuring us that some memory loss is normal as we age, also reiterates: If you’re worried about your forgetfulness, see your doctor.
In early stages, patients hide their confusion
Often, patients and their families ignore early symptoms of dementia, because they mistake these for old age. This confusion is worsened by language, where old age and senility are assumed as linked. To top it all, the term “senile dementia” and “pre-senile dementia” are still used by some of the older doctors, linking “senile” with “dementia”.
But dementia is not just a faster case of ageing. It is usually caused by distinct changes in the brain, such as damage to brain cells. The symptoms are not just an exaggerated case of old age, and dementia may also occur in younger persons (this is called early-onset dementia).
Another confusion is that people think dementia is inevitable with age. It is not. Not everyone who grows old gets dementia. While the probability of getting dementia increases as one ages (more old people get dementia as compared to younger people), dementia is not a part of normal ageing, and it is not inevitable.
Dementia symptoms could be caused by a number of medical conditions. Read on to know about these.
