Dementia has “hidden” symptoms and here’s how to tell if you have them – eat this, not that
dementia is a brain disorder that can dramatically impair cognitive functions such as language, memory and decision-making to the extent that it can interfere with daily life. In addition, someone with dementia may experience personality changes, and some people with the condition may. to control their emotions. Dementia is an umbrella term for a set of neurological symptoms that affect the brain and that progressively worsen over time Alzheimer’s Disease International“There are over 100 forms of dementia, and the best-known form of dementia is Alzheimer’s disease.”
The Alzheimer’s Association states: “Alzheimer’s disease accounts for 60-80% of cases. Vascular dementia, which is caused by microscopic bleeding and blockage of blood vessels in the brain, is the second most common cause of dementia. Dementia also has mixed dementia. There are many other conditions that can cause dementia symptoms, including some that are reversible, such as thyroid problems and vitamin deficiencies.”
Dementia is a common condition that mostly affects people over the age of 65, but it is not a normal part of aging, and younger people can also have dementia. There are many well-known signs of dementia, such as memory loss, better navigation in familiar areas or settings, and difficulty with common tasks. But there are other signs to be aware of and Eat This, Not That! Health spoke with Paul E. Schulz, MD, a neurologist at UTHealth Houston and Memorial Hermann-Texas Medical Center which explains what you need to know about dementia and the hidden symptoms to look out for.
Read on—and to ensure your health and the health of others, don’t miss this Sure signs you’ve already had COVID.
dr. Schulz explains: “Normal aging definitely causes changes in cognition. We say that from the age of 20 to 85 our concentration drops by about 40%. And concentration is the first step in memory and word retrieval. So everyone over the age of 50-60 notices , because we are already about 20% down, that our memory and word retrieval are not what they used to be. Not to personalize it too much, but if I hadn’t studied dementia, I would worry that I have early onset dementia myself because I see changes in memory and word retrieval in myself.
We ask people if they:
Their memory is worse than their spouses and friends, who are often the same age; Their spouse, co-workers and friends have told them anything about forgetfulness, etc. If none of these people notice a difference between the patient and people of a similar age, then often their testing shows that they only have age-related memory impairment. It means that the person is on the same slope as all of us. When testing shows that someone is falling below the “normal rate of decline,” we get concerned and investigate further. Less common changes with age are in wisdom (eg, reasoning, abstract reasoning, insight) and visuospatial function (finding home, restaurant, barber, store, etc.). So if someone has a change in behavior (poor judgment, spends money irrationally, becomes a victim of fraud, etc.) or gets lost going to the store, etc., then we think less about aging and more about brain changes. It’s a lot like running for me. I train a lot, but the younger runners still beat me all the time.”
Dr. Schultz says, “Dementia is very, very common. Only 6 million Americans with Alzheimer’s. Several million have other dementias. And we may only be diagnosing a percentage of those with dementia because of problems accessing health care. It doesn’t respect gender, ethnicity, intelligence, etc. .We have people from all walks of life at the clinic.This even includes fellow doctors.It can occur at any age.It is most common as we get older.
We say that 1% at the age of 60 have dementia, which doubles every 5 years to 32% at the age of 85. But we also see patients who are in their 40s and 50s. Obviously, when we see younger clients, we look more thoroughly for causes of dementia other than neurodegenerative disorders. For example, we want to rule out autoimmune diseases, infections, vitamin deficiencies, thyroid, etc.”
dr. Schulz emphasizes: “Dementia sneaks up insidiously. For several years it can involve episodes of forgetting some things and remembering others. So it often doesn’t reach the level of recognition until it’s very obvious. Given that all our treatments work best when we start very early, very we are upset when we see new patients who are well advanced before they see us. Patients with early dementia often do not recognize this. They seem to forget to forget. In fact, when a spouse says that a person is forgetful, the more vehemently the patient denies it, then we become suspicious that it is real. Non-recognition is, therefore, a very common phenomenon in a person with dementia.
Because of this, it can be very difficult to get people to see us. We had a patient this morning who is halfway through Alzheimer’s disease, and she wasn’t brought in sooner, when we could have been, because she was embarrassed that someone had tested her a few years ago. That’s a huge lost opportunity. No one is to blame. It’s just that we’re human and we don’t always want to know about something like dementia, especially when we can’t see it. After an hour with her, the patient told me she was sure it was just normal aging and wasn’t sure if she needed to be evaluated.”
According to dr. Schulz, “Depression that is long-term and untreated appears to be a risk. So we suggest that a person with depression be treated as much as possible (I say this because not everyone with depression responds to current medications and procedures). It is less easy to show that treating depression prevents dementia, but we all believe it’s probably true.
Hearing loss often results in a person not hearing or misunderstanding conversations. At the very least, hearing loss contributes to cognitive impairment in dementia. It is unclear whether hearing loss is a risk factor for dementia, as opposed to just appearing to have it.
Cardiovascular risk factors. We and others have many studies showing that traditional cardiovascular risk factors (those for stroke, heart disease, and peripheral vascular disease) also accelerate the progression of dementia. So we measure many of them in our Center for Neurocognitive Disorders every day. We check cholesterol, blood sugar, blood pressure, blood fats (triglycerides), weight (BMI) and others.
Concussions have been in the news for the past few years and appear to genuinely increase the risk of dementia. So, wear a helmet when skiing or cycling, fasten your seat belt in the car, etc.
Physical and mental exercise, in the other direction, are thought to protect against dementia.
Genetics is currently an immutable risk factor, but it can be significant. The good news is that the risk of even familial dementia can still be reduced by controlling risk factors. But it will be some time before we can change the risk factor genes.”
dr. Schulz says, “Determining whether dementia is more common now than in the past is challenging because: People often hid loved ones with dementia because it was thought to reflect badly on the family. Some ethnic groups in Texas still do. Through no one’s fault, many cultures believe that dementia is a shame. So we don’t see these patients at all. Or, if we do, we see them very late when the families are desperate.
Just a few years ago, we knew very little about dementia. In the 1960s, we talked about hardening of the arteries. In the 1970s, we started talking about normal aging for people over 65, and we defined dementia only when it was present in younger people. Then in the 80’s we discovered that dementia is not “normal aging”. And over the past 30 years, we’ve discovered that not all dementia is due to Alzheimer’s disease. We have now identified many other species.
So looking at records from more than 10-20 years ago is usually fraught with not being sure what someone had. Also, we are now much more likely to identify dementia (with the caveat that some people with signs of dementia still do not come to the clinic). For those who come to the clinic, we’ve gotten much better at being able to diagnose them and give a solid answer about what’s going on. This starts with people visiting their primary care doctor, many of whom are now aware of dementia-related issues and working towards screening. So more people were captured earlier.
On the other hand, the Framingham Heart Study, which followed people for decades, reported that the risk of dementia declines with each age. However, as more people are living longer, thank God, that means many more people are at risk of dementia. A simple way to think about it is that when people didn’t live very long, then people weren’t old enough to be at significant risk of dementia. So the bottom line is that we’re certainly seeing more patients with dementia now, but it’s very hard to say whether that means it’s more common, or that we’re living longer, or that we’re seeing our doctors more often and that they’re sensitive to the big dementia problem.”
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