The Spectre of Dementia and Memory Loss

Dementia, defined as the loss of one’s mental capacity, has been shown by recent surveys to be the disease most feared by people over 65.

This may well be a rational fear as the idea of losing independence, cognition, and personal memories as we age is something that takes away our very sense of self. A person who develops Dementia in effect would cease to exist mentally but still be alive physically – so in some respects the condition is even worse than death itself. As our population in this country ages and we become more aware of loved ones and people we know losing their mental faculty as they get older, it is important that we understand what the early signs of Dementia are and have an idea of what it means to suffer from this terrible and soul-destroying condition.

Dementia is not confined to any specific ethnic or cultural group; what we do know is that it predominantly affects the elderly. As 21^st century societies – in Sri Lanka as well as the rest of the world – face an ageing population, the socio-economic burden of dementia becomes more obvious and with it, the impact on friends and family. However, while the portrayal in the media of forms of Dementia like Alzheimer’s Disease has helped to increase recognition of the condition, it has also heavily distorted the picture of what it means to actually have Dementia – resulting in many misconceptions and myths.

The first signs of dementia can begin years before a diagnosis is made. The earliest signs to be aware of in someone developing Dementia are unusual changes in character and personality – and making simple mistakes with formerly familiar things. Affected individuals may also show signs of increasing confusion in new and unfamiliar situations.

It is the person’s family and friends who are best placed to notice these subtle changes first. Other signs include increased impulsivity, lack of motivation, behaving inappropriately, becoming emotional labile, lapses in short term memory – and sometimes even a lack of insight into there being any problem at all. As many of these signs are often attributed to general ageing, it is important to put them into context. Is how this person is acting now different to how he or she was acting a year ago? If so then it’s important to consult your doctor for assessment.

Broadly speaking there are four main types of dementia; Alzheimer’s Disease (AD), Vascular Dementia (VD), Lewy Body Dementia (LBD), and Fronto-Temporal Dementia (FTD). Each of these four types can present differently but usually over time converge to a similar end state. Because considerable overlap exists between these conditions, even a straightforward diagnosis can be extremely difficult.

Traditionally dementia is regarded as a progressive decline in memory and cognition. Over the years a number of psychological tests have been developed to aid in its detection. One of the best known is the Mini Mental State Examination (MMSE) which has been in use for nearly 40 years. Originally designed as a tool for research into dementia, it has evolved into a standardised 30 question diagnostic test used to confirm an abnormal decline in memory and cognition.

For more information on dementia and what to do if you suspect that someone you know may be showing early signs, you can visit the following websites: http://www.fightdementia.org.au and www.dementiacareaustralia.com.