Building Healthy Communities through Medical-Religious Partnerships

9. Dementia

9 Dementia Dementia is a clinical syndrome or condition in which there is a progressive deterioration of mental faculties, usually over many years. Problems with memory are usually the first sign of dementia. Other symptoms may include difficulties with language, impaired judgment, problems in performing simple tasks such as dressing, and changes in personality and behavior. Most people with dementia also develop clinical depression, agitation , anxiety, or other “behavioral symptoms” as their disease progresses. Dementia is not an inevitable consequence of aging. Although the risk of dementia increases with age, the overwhelming majority of older adults do not have dementia. It is important to understand that most older adults who report problems with memory do not have and may never develop dementia. Minor problems with memory may be a normal part of aging and should not be viewed as evidence of dementia. Dementia can be caused by a number of brain disorders. The most common is Alzheimer’s disease, which accounts for approximately 50–60 percent of all cases of dementia. Alzheimer’s is a progressive, degenerative disease that attacks the brain. There is loss of nerve cells, especially in the regions responsible for memory and intellectual functions. Currently there is no cure for this irreversible disease, although several newer medications can result in modest improvements in mental functions for some affected people. Dementia resulting from vascular disease is the second most common type. This form of dementia occurs when there is damage to multiple small areas of the brain. This is typically thought to arise as a series of “small strokes” resulting from atherosclerosis and blockage of small arteries in the 88 suggested topics for congregational programs brain that occur over a period of months or years. For this reason, vascular dementia is now generally referred to as multi-infarct dementia. There are many risk factors for vascular dementia; the most important is hypertension . Individuals can reduce their risk of experiencing this form of dementia by controlling their blood pressure, avoiding smoking, eating a low-fat diet, exercising regularly, and controlling their weight. Another common condition that can cause the symptoms of dementia , particularly in older adults, is depression. Older depressed individuals often have problems with memory, experience periods of confusion, and can be unresponsive to other people. It is important to distinguish correctly when dementia is caused by depression because effective medical and psychological treatments for depression might reverse the dementia symptoms . Other causes of reversible dementias include overmedication, unusual drug reactions, thyroid disease, and some vitamin deficiencies. Like depression, these can be treated if they are correctly identified. The Risks of Ignoring Information on Dementia The potential harm of relying on inaccurate or incomplete information about dementia and the health care resources appropriate for managing this condition goes beyond the patient. Dementia is frequently referred to as a “caregiver’s disease” because of its tremendous impact on the family. The spouse and other members of the patient’s family face many new challenges and stresses that can seem overwhelming and endless. The decisions and pressures the family faces may produce conflict among family members . Also, it is not uncommon for family members to experience depression in reaction to this difficult situation. Family members who confront these challenges without the appropriate knowledge, skills, and resources are in danger of developing their own health problems. The belief that dementia is inevitable and that there is no effective treatment for any type of dementia can have painful consequences for patients and their families. Patients who are thought to have dementia but who actually are depressed suffer unnecessary pain and limitations, and so do their families. In addition, the belief that nothing can be done to prevent the development of dementia can have harmful consequences. This belief, frequently based on the mistaken notion that all dementias are the result of dementia 89 Alzheimer’s disease, can become a self-fulfilling prophecy. In fact, several steps can be taken to reduce the risk of experiencing vascular dementia. Furthermore, these same steps may also reduce the risk of developing the symptoms of Alzheimer’s disease. Recent studies have shown that some people with the brain abnormalities associated with Alzheimer’s disease do not show its symptoms. Researchers found that the memory loss and confusion associated with Alzheimer’s disease most likely results from the combination of the brain deterioration of Alzheimer’s disease and one or more small strokes in certain...