Rising to the Dementia challenge

Source: The Hitavada      Date: 29 Oct 2018 09:16:41


By Ajay Mardikar,



  Dr Shailesh Pangaonkar,Dr Sudhir Bhave, Dr Nikhil Pande, Dr Swati Dharmadhikari 

DEMENTIA is one of the top ten causes of death in the world. It involves loss of memory of the events of recent past, much more than the remote events. The condition worsens with the growing age and even results in irritating behaviour. Entire family is affected by the behaviour of persons suffering from Dementia. This is an alarming situation and the major cause appears to be increased life span, changing lifestyle full of stress, growing addictions to toxic substances, drugs, alcohol and tobacco.

It is a big danger the Indian society is looking at if the numbers tell a story. More than 3.7 million persons in India were suffering from Dementia in 2017. The number will be doubled by the year 2030. The societal cost which is Rs 14,700 crore, will also increase by three times.

“The world is estimated to be living with more than 50 million persons with Dementia. Another alert is that this number is likely to be around 75 million by the year 2030 and 131.5 million by 2050. Already 58% of the persons suffering from Dementia are living in low and middle income countries. By the year 2050, this figure will rise to 68%,” informs Dr Shailesh Pangaonkar, Consultant Psychiatrist and Director, Central Institute of Behavioural Sciences, Geriatric Memory Clinic and Research Centre.

Dementia is a primarily degenerative disease of the brain. This disrupts the production and distribution of certain chemicals called neurotransmitters that carry messages to and from the brain. Researchers have discovered several important risk factors for developing Dementia. These include age and genetics, and also medical conditions and lifestyle choices. A person’s risk of developing Dementia depends upon a combination of all of these risk factors. Some of them, such as age or the genes are beyond control. Some other factors are related to situation where pollutants like lead, mercury, arsenic etc affect the brain cells leading to developing Dementia.

Unfortunately, no cure for Dementia has been found. Non-pharmacological interventions and the use of residential and domestic resources, such as day care and nursing home care may reduce symptoms and suffering.
There is no vaccine against Dementia. But a combination of healthy habits may prevent or delay the brain cell degeneration.

“About 10 to 15% patients can be cured, if Dementia is related to hypothyroidism. Treatment is dependent upon the reasons behind developing Dementia. It may be out of trauma, a small part of patients suffering from deficiency of vitamin B-12 or is chronic alcoholic,” says Dr Sudhir Bhave, consulting psychiatrist.

Dr Nikhil Pande, Psychiatrist, says with growing cases of hypertension and diabetes and also high cholesterol, cases of Dementia are on the rise. “This is called vascular Dementia. Earlier, it was considered to be an old age problem, but in the recent past persons of 40 to 45 years have also shown symptoms due to stress and depression,” he adds.

Forgetfulness in young age may be due to lack of focus. Dr Pande also describes pseudo-dementia, which may occur in young age. It is indicated through depression, unnecessary suspicion or even hallucination. Dr Swati Dharmadhikari, consulting Psychologist, terms menopausal stage as another reason for Dementia. However, it may be temporary, she adds. “The problem may be beginning of Alzheimer’s or schizophrenia, besides diabetes, blood pressure, diseases related to kidney or hypothyroidism,” she feels.

However, there is still hope to cure this problem. Medicines to delay damage to the brain cells are available and researchers are near finding cure to the problem. Better management, however, is essential, states Dr Pande.
Dr Pande advises socialisation, engaging in soothing music, playing or listening to percussion instruments (with strings), solving puzzles as exercise for the brain.

Other major suggestions for better management are:-

A) Regular physical exercise that can reduce the risk upto 50 percent.

B) Staying socially engaged to protect against Alzheimer’s disease and Dementia.

C) Healthy eating habits to reduce inflammation and protect neuron and maintain communication between brain cells. Those who continue learning new things and challenging their brain throughout life are less likely to develop Dementia.

D) Uninterrupted sleep for flushing out brain

“Besides the prescribed clinical treatment, feedback from the patients helps in modifying the treatment. It is also suggested that the patient and family members should share their experiences with the counselor openly,” opines Dr Pangaonkar.