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Dementia: Causes and Prevention

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Dementia: Causes and Prevention
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Worldwide, over 47 million people have dementia, and each year an additional 7.7 million succumb to the condition. It is one of the major causes of disability and dependency in elderly people with far reaching impacts—not only on the person themselves, but on their family, caregivers, and society. Because of this, the World Health Organization calls dementia a “public health priority”. To learn more about this condition, we spoke with Dr. Maryam Al Obaidli, Consultant at the Elderly Services Department at Rumaila Hospital in Qatar.

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What is Dementia?

Dementia is a syndrome in which the deterioration of cognitive function goes beyond what is expected from normal aging. Memory, orientation, learning capacity, judgment and thinking are all affected, while consciousness is not.

Dementia impairs psychological behaviors, mobility, and the ability to perform everyday tasks. A person with this condition becomes more likely to forget things—times and dates, loved ones’ names, habitual events, familiar places. This can lead to them not knowing where they are or how they got there. Actions we consider mundane, like dealing with money, dressing, basic self-care, going out to the shop, are impeded by the disease. What remains is long term memory, but it can be selective. The decline in cognitive function can spark a deterioration in emotional control, bursts of anger, lack of motivation or socially inappropriate behaviors.

This puts a huge strain on family members, who often feel overwhelmed. The additional financial, physical and emotional pressure can lead to a great deal of stress, as relatives have to overhaul their routines, work fewer hours, and learn to deal with a loved one who no longer recognizes them.

The Three Stages of Dementia

Dementia is a progressive disease. It begins with mild symptoms that are barely noticeable, but if it isn’t diagnosed and treated quickly, the symptoms worsen.

Dementia has 3 stages:
  • Early—This stage can be overlooked, because symptoms are mild, like becoming forgetful or losing track of time.
  • Middle—In the middle stages, symptoms become more apparent and include increased difficulty with communication, becoming lost at home, and behavioral changes like repeated questioning.
  • Late—This is the stage of near total dependence. Symptoms are obvious and include difficulty recognizing friends and loved ones, trouble walking, and escalated behavior changes like aggression.

The Causes of Dementia

Dementia affects people after the age of 65. But not everyone will suffer from this condition. Despite numerous studies on the subject, no one cause has been found for dementia—rather, several factors come into play and increase the risk. These include diabetes, hypertension, obesity, high cholesterol and depression. Alzheimer’s disease is the leading cause, contributing to between 60-70% of cases. Unhealthy lifestyles, a poor diet, smoking and lack of exercise are all linked to chronic diseases which can in turn lead to dementia.

Dementia in Qatar

A study carried out by Hamad Medical Center and published in the Qatar Medical Journal examined the prevalence of dementia in elderly home care patients in Qatar between 1996 and 2003. It found that 14% suffered with dementia. Researchers identified several risk factors, the main one being high blood pressure—60% of the patients had hypertension—whereas family history plays only a minor role.

Statistics in Qatar

According to the latest WHO statistics in year 2015, deaths from dementia in Qatar account for 0.91% of total deaths. This ranks Qatar 41st globally. To put this in context, the country with the highest death rate from dementia is Finland, with 15.75%. The lowest is Singapore, with 0.06%.

Tips for a Healthy Old Age

We all want a healthy old age, one where we can enjoy watching our children and grandchildren grow up and evolve into mature adults. To keep your body and brain in tip top shape as long as possible, all you need to do is follow some simple lifestyle rules:

Healthy diet: Ditch the processed foods, refined sugars and fizzy drinks—these are linked to diabetes, obesity and cardiovascular disease. Instead focus on fresh fruits and vegetables, gluten-free grains, lean protein and plenty of brain-friendly omega 3’s (which you can find in oily fish).
Brain teasers: Keep your mind quick and sharp by doing cross word puzzles, Sudoku, learning a new language, reading a book on a topic that you find challenging but interesting, or playing memory games.
Move your body: There’s an old saying: “Use it, or lose it”. This applies to your mind and your body. As we get older, we lose range of motion and muscle mass, so exercising regularly, even in the form of gentle daily walks, is important to maintain a fit, healthy body, well into old age.

We spoke to Dr. Maryam Al Obaidli, Consultant at the Elderly Services Department at Rumaila Hospital, to find out about possible treatments for dementia and the hospital’s new Memory Clinic.

What are the treatment options for dementia?

There are two avenues open to people who have been diagnosed with dementia.

  1. If the disease is in its early stages, the advice is to move away from unhealthy habits, like smoking, and improve lifestyle with a healthy diet and exercise. Practicing mental exercises, like crosswords or mathematical equations, can improve memory. Using strategies like having a daily agenda, writing lists and setting reminders on a phone can also help.
  2. The other option involves medication. Patients are advised to attend the weekly Memory Clinic at the Out-Patient Department at Rumaila Hospital, which specializes in Alzheimer’s and dementia diagnosis. The clinic performs memory tests to ascertain the percentage of memory loss; blood tests and CAT scans are used to determine the possible causes. While there is no cure, some medications can delay the effect of dementia on the brain. Small doses are prescribed to begin with, and regular follow up appointments help monitor the progress and adjust the dosage if needed.

Can you tell us more about the Memory Clinic?

Rumaila Hospital have developed “Enaya,” or “Memory Clinic,” which works with patients with severe dementia. Families can, understandably, find it extremely challenging to deal with the condition—the clinic provides assistance by offering emotional support, and teaching the best ways to interact with the patient and how to give medication.

How do you raise awareness of dementia?

Rumaila Hospital often hold awareness campaigns to spread information about how best to look after a person with dementia and how to avoid the disease. These events provide support and information for both patients and families. In collaboration with Dr. Hanadi, Head of the Elderly Services Department, the hospital has created workshops and lectures to share new research about possible cures and treatments with other medical professionals.

Can you offer any advice to our readers?

Rumaila Hospital advise people who notice signs or symptoms to visit the Memory Clinic. A referral can be obtained from any health center.

“Chronic diseases like diabetes, high blood pressure and strokes affect brain cells and memory, so we always advise patients to manage these diseases if they have them.” Dr. Al Obaidli