Dementia Isn't Inevitable: Take Charge of Your Brain Health

Dementia affects more people than we know. Studies show a dementia burden of over 55 million worldwide; about 8.8 million Indians over 60 years of age battle dementia in India. Dementia has left an everlasting impression on others who witnessed Joe Biden's latest debate performance, where he consistently lost his train of thought and struggled to create coherent sentences. Thus, it is critical that we understand the nuances of dementia, particularly the risk factors.

Dementia isn’t a single disease. It is a term describing a collection of symptoms that can be caused by neurological diseases. It leads to a loss of cognition that is severe enough to impair social or professional function. It affects memory and the ability to think, judge, and perform daily activities.

Dementia has become increasingly common, with approximately 10 million new cases emerging worldwide each year. Research indicates that dementia affects Indian men and women at similar rates. By 2050, India is projected to bear one of the largest economic burdens related to Alzheimer's disease and related dementias, estimated to reach $578.2 billion.

Dementia has many risk factors, age being one of the primary ones. However, dementia isn’t an inevitable consequence of ageing; it can happen in younger people.  Unhealthy ways, a sedentary lifestyle, poor diet, smoking, alcohol consumption, being overweight, and other health comorbidities can precipitate dementia. 

Dementia affects both men and women in older ages, usually above 60. People are at risk of developing dementia in case of these comorbidities:

• Older age, 65 years and above
• High blood pressure (hypertension)
• High blood sugar (diabetes)
• Obesity or other weight issues
• Excessive smoking
• Alcohol addiction
• Lack of physical activity
• Isolation and loneliness
• Depression and mental issues

Dementia is caused by different neurological diseases, brain injuries, or indirect damage to the brain. According to the World Health Organization (WHO), Alzheimer's disease is a leading cause of dementia, responsible for approximately 60% to 70% of all dementia cases as of 2023. Other causes of dementia include: 

• Blood-related disorders 
• Some infections — like HIV
• Alcohol abuse
• Brain trauma that occurs repeatedly, such as chronic traumatic encephalopathy (CTE)
• Lewy bodies, which are abnormal protein deposits inside nerve cells
• Degeneration of the brain's frontal lobe, or frontotemporal dementia, is brought on by several illnesses
• Stroke
• Deficiencies

Dementia can be divided into different types based on its cause. This includes:

• Alzheimer’s disease-related dementia: Alzheimer's disease-related dementia occurs when abnormal proteins, such as amyloid plaques and tau tangles, accumulate in the brain. Amyloid plaques are clusters of protein fragments that form between nerve cells, while tau tangles are twisted strands of a protein that build up inside nerve cells. Both of these proteins disrupt communication between nerve cells and contribute to cell damage.

• Dementia caused by Parkinson’s disease: Parkinson's disease-related dementia develops as the brain's nerve cells degrade, particularly in areas that control movement and cognition. 
• Vascular dementia: This type of dementia is caused by reduced blood flow to the brain.

• Lewy body dementia: This arises when aberrant protein deposits, known as Lewy bodies, accumulate within brain nerve cells. These deposits affect normal brain function, resulting in issues with thinking, memory, movement, and behaviour.
• Frontotemporal dementia: Damage to the frontal and temporal lobes of the brain causes this type of dementia. 

Dementia is a progressive disease. It occurs in stages.

• Early: Patients with mild dementia may still be able to function on their own, but they may also exhibit personality changes, forgetfulness, short-term memory loss, difficulty with complex tasks, and difficulty expressing feelings or ideas.
• Middle: In middle stages due to impaired judgment, confusion, and memory loss, as well as significant personality changes, assistance from loved ones or care professionals may become necessary.
• Late: Late-stage dementia worsens mental and physical symptoms, including inability to maintain bodily functions, communication difficulties, requiring full-time assistance, and increased infection risk.

Dementia has a few telltale signs, irrespective of the cause. Symptoms during the early stages of dementia include:

• Forgetting recent incidents or things in the recent past
• Easily losing belongings
• Feeling lost
• Being confused
• Losing punctuality
• Trouble finding familiar places
• Problem-solving hurdles
• Finding it difficult to find the right words when forming sentences. 
• Difficulty in decision-making
• Inability to complete daily chores
• Visual misjudgement
• Sudden mood changes

Eventually, these lead to changes in behaviour, personality, mood swings, etc. 

Dementia, though prevalent, often has risk factors that can predispose you to the condition and expedite the progress of the disease. A recent review in 2023 summarises the potential neuroprotective pathways activated by several diets (Mediterranean, MIND, and DASH diets) that result in promoting brain health and preventing dementia.

The DASH, Mediterranean, and MIND diets focus on whole grains, fruits, vegetables, nuts, and healthy fats. They emphasise foods like leafy greens, berries, olive oil, and fish, which may help lower the risk of dementia and support cognitive function as we age.
Alongside a healthy diet, factors like physical activity, quality sleep, and social interaction are vital in reducing dementia risk. While the exact mechanisms remain unclear, understanding the interplay of these factors can empower individuals to make healthier choices, promoting active and healthy ageing.

Dementia is an umbrella term that describes the loss of memory, lack of cognition, and incoherence in language and speech. Alzheimer’s disease is a specific neurological condition that presents with dementia as one of the signs and symptoms.

Dementia was once thought to be unavoidable with age. However, recent advancements in medical research have shed significant light on dementia and the potential to avoid it. With lifestyle changes and a disciplined diet and habits, dementia can be prevented or rather delayed.

The main causes of dementia are neurological conditions like Alzheimer’s disease, Lewy body, and other neurological conditions, poor lifestyle conditions, comorbidities like hypertension, smoking and alcoholism.

Poor blood supply to the brain can lead to vascular condition-related dementia.

Patients with stage 1 dementia may still be able to care for themselves, but they may experience personality changes, an increasing tendency to forget, particularly recent or short-term information, which begins to affect daily life, difficulty with complex tasks, and difficulty expressing emotions or ideas.

There is no definitive cure for dementia, however, lifestyle changes and closely following the instructions of the doctor can help people battling the condition.

To avoid dementia, it is vital to avoid the biggest risk factors, namely poor lifestyle conditions, weight gain, poor diet, comorbidities like hypertension, smoking and alcoholism.

Dementia is not a mental illness. It is the umbrella term given to the consequences of several other neurological brain conditions.

Excessive stress that leads to a sedentary life, bad diet, smoking and drinking of alcohol may precipitate dementia eventually.