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Forgetfulness is common but how to know if it is the early sign of dementia? In an interview with HT Lifestyle, Dr. Pramod Krishnan, HOD and consultant, neurology, epileptology and sleep medicine, Manipal Hospital Old Airport Road Bengaluru said, “It is common for the young and old to occasionally forget unimportant bits of information. This occurs much more frequently as we age and is especially true for information that is transient and without lasting relevance. This is common in our busy schedule especially when we are juggling multiple tasks simultaneously. When this occurs more frequently, it triggers a concern of something more sinister brewing in the brain, like a neurodegenerative disease called dementia.” Also read | Neurologist explains difference between normal forgetfulness and dementia memory loss: ‘If it gets worse over time…’
Dr. Pramod Krishnan shared how to distinguish between forgetfulness and dementia:
1. Memory errors
In Dementia, the memory errors are consistent. Early in the disease, the memory difficulty is limited to events that happened recently (the last few days) and the older memories remain intact. In minor forgetfulness of aging, a simple cue or sufficient time is enough to retrieve the information. This is not true in most patients with Dementia.
2. Memory tends to worsen
Memory errors tend to worsen over time. They end up repeating the same questions or statements or activities. They struggle to recollect where they have kept things of daily use like pens, keychains, or spectacles. Memory errors eventually affect day to day functioning of the individual. They have difficulty remembering the date, miss important deadlines (eg paying bills), miss errands, and forget to buy some items from a list of items they had in their mind. Learning new information or new hobbies is particularly difficult.
3. Mixed up timelines
Some of them get confused with the timelines of events and may mix up events that have happened in the past with events that happened recently. Some may fill up forgotten pieces of information with their own creation and produce entirely new and convincing narratives (confabulation).
4. Lack of insight
Many patients with dementia do not acknowledge that they have a problem and may argue if memory errors are pointed out. This lack of insight is common in dementia.
5. Other difficulties
Individual may demonstrate other difficulties along with forgetfulness, like difficulties in naming, performing multi-step activities that require some planning and sequence, calculation, managing money and navigating routes. Behavioural changes may accompany these symptoms in the form of reduced social interaction and lack of interest, aggression, restlessness and sleep disturbances. MRI brain tends to show decrease in brain volume called cerebral atrophy. Also read | Dementia risk factors you can control: Essential lifestyle changes for a healthier brain
Tips to manage dementia:
1. Regular exercise: Apart from regular exercise like brisk walking or jogging, one should attempt age-appropriate activities like swimming, cycling or working out in the gym to maintain physical fitness. A physically fit body means a sharper cognitive ability.
2. Healthy diet: A well-balanced diet rich in vegetables, fruits, nuts, berries, milk products and meat (for non-vegetarians) provide the body and brain with the essential nutrients to stay healthy.
3. Sleep: Chronic sleep deprivation, poor sleep quality and sleep disorders like obstructive sleep apnea (OSA) are proven to impact cognitive functions adversely. Addressing both the quality and quantity of sleep will enhance cognitive abilities in the long run.
4. Social bonding: Interacting with people from different walks of life, being part of various social groups, attending festivities and other functions, visiting friends and family are highly stimulating for the brain.
6. Cognitive stimulation: This may include a variety of activities like solving puzzles, creative work like painting, sketching and other hobbies, engaging in discussions and debates reading analytic articles, writing diary etc.
7. Managing chronic stress through activities like mindfulness and meditation or seeking necessary help through counselling or psychiatric improve cognitive functioning. Clinically significant depression can coexist with dementia.
8. Progression of dementia can be reduced significantly by control of vascular risk factors like hypertension, diabetes mellitus and dyslipidemia, reduction in alcohol use and cessation of smoking.
9. Medicines like Donepezil, Memantine, Galantamine and Rivastigmine provide only symptomatic improvement in memory in mild to moderate dementia and do not halt the progression of the disease.
10. It is important not to highlight or confront dementia patients about their memory problem as they lack insight and tend to get upset, angry or depressed. Memory aids like large clocks and calendars in every room, notes with instructions at important locations in the house, reminders on their phone, sufficient exposure to sunlight, safety aids for mobility and independent functioning are important. Help should be offered to dementia patients only if they are unable to perform any task. Also read | Study reveals just 5 minutes of exercise daily can cut dementia risk in old people by 41%
Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.
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