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Published: November, 2013; Vol 10, Num 6

 

Assessing Dementia

Conventional thinking has it that Americans and Canadians on the cusp of retirement will be distinguished for being healthier and living longer than previous generations and, at the same time, for increased risk of developing dementia.

New evidence, however, indicates that this may not be so. While dementia is primarily an old-age disease, research published in The Lancet finds that the incidence of dementia is declining among today's elders, and investigators speculate that it could decline further among elder generations to come.

This should be welcome news for senior members of the Boomer cohort, who are nearing retirement, number over 41 million and include many Laborers. Many will live to age 85 and beyond, and chances are improving that they may do so with their cognitive faculties intact. 

Losing your keys does not mean you have dementia. Normal memory loss due to aging includes:

  • Taking longer to process information, especially if it is complex
  • Taking longer to remember phone numbers and names
  • Some difficulty recalling events that happened a long time ago
  • Needing to write down more reminders about errands
  • Taking more time to refocus once attention has been diverted (remembering where you put your keys)

The new evidence, from England and Denmark, finds that the rate of dementia has fallen by about 25 percent among today's elderly. Because previous research shows a diminished prevalence of dementia among better educated and heart healthy (low cholesterol and low blood pressure) individuals, health analysts believe the general decline may reflect broad improvements in education and health among today's elders relative to those in the past. The researchers conclude that fears of soaring Boomer dementia in the decades ahead may be unwarranted. 

Alzheimer's disease advocacy groups expressed caution about the new evidence, however, stressing that the observed trend might not hold up or could be different in the U.S. If that were the case, the social cost of dementia, not to mention its impact on the afflicted and their immediate families, could be huge. Already, according to a study published in The New England Journal of Medicine, the cost treatment for 3.8 million dementia victims in 2010 was approximately $200 billion of which Medicare paid $11 billion. This exceeds the financial burdens of heart disease – $102 billion – and cancer – $77 billion.

What is dementia?

Communicating with someone who has dementia can be challenging. Here are some tips:

  • Keep it simple. Call the person by name. Ask one question at a time, and give the person ample time to answer.
  • Encourage the person to point or gesture if they can’t remember what an object is called.
  • Maintain eye contact. If you start to feel tense, take a break

Dementia is an umbrella term for a series of diseases and conditions that affect memory, judgment, language and motor skills. These are cognitive abilities, and, as people age, some decline is normal. However, when daily functioning is deteriorating and ongoing, it may be a sign of dementia that should be assessed by a doctor. Dementia symptoms can sometimes be minimized with medication, changes in diet and exercise. Furthermore, early diagnosis allows the affected person to be more involved in decisions about their care.

Symptoms of dementia include:

  • Severe memory loss
  • Impaired judgment
  • Difficulties with abstract thinking
  • Faulty reasoning
  • Inappropriate behavior
  • Loss of communication skills
  • Disorientation to time and place
  • Gait, motor and balance problems
  • Neglect of personal care including bathing, eating and dressing, also safety
  • Hallucinations, paranoia and agitation

Types of dementia

Most dementias worsen over time. These include:

  • Alzheimer's disease − During the course of this most common cause of dementia, the chemistry and structure of the brain change – plaques and tangles develop – leading  to the death of brain cells. Problems with short-term memory are usually the first noticeable signs. As the disease progresses, people lose the ability to speak, no longer recognize family and friends and lose control of all bodily functions. Eventually, the body completely shuts down.
  • Dementia with Lewy bodies − This form of dementia gets its name from tiny protein deposits called Lewy bodies that develop inside nerve cells and which cause degeneration of brain tissue. Symptoms include disorientation and hallucinations, rigid muscles, slowed movement and tremors.
  • Vascular dementia − If the oxygen supply to the brain fails due to vascular disease, brain cells are likely to die, and this can cause dementia. Symptoms are similar to other dementias. They include increasing difficulty to perform everyday activities such as eating and dressing. These symptoms can occur suddenly, following a stroke or over time through a series of small strokes.
  • Frontotemporal dementia – The damage is usually focused in the front part of the brain, the frontal and temporal lobes. They shrink. Symptoms include changes in personality, behavior and language.

Less common sources of dementia include:

Dementia has no cure, but research is ongoing.  According to the Alzheimer's Society, avoiding fatty foods, reducing alcohol consumption and quitting smoking can be helpful in reducing risk for certain types.

If someone you love has dementia, consider joining a support group. The Alzheimer's and Dementia Caregiver Center has information about support groups and also a 24/7 Helpline: 1-800-272-3900.

In addition, you may have a Member Assistance Program (MAP) through your LIUNA health and welfare fund.  A MAP can provide emotional support and assist in locating resources for your loved one.

[Janet Lubman Rathner]