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Coping with dementia

Thursday, October 10, 2013

Audrey Karim and her mother used to quarrel a lot. They were two strong personalities who believed their way was the right way. Their disagreements were regular events, to the point it got Audrey distressed. 


Until during one of their tiffs, Audrey told her mother, “Enough!” and let her have it. Although she felt this time she had the final word, there was no satisfaction in it.


It was only after that last incident she realised something was wrong. 


Her mother regressed from aggressive, to belligerent, to docile. 


She was diagnosed with Alzheimer’s disease, a progressive, degenerative disease that attacks the brain.


In its progressive state, Audrey says her mother now has very little language skills. “She would laugh. At most she would say is yes or no. How you ask the question, is how she responds,” she said of her mother, who was once a self-assertive woman who ran her own business.


Audrey’s experience accounts for seven per cent of the T&T population that may be diagnosed with dementia. Alzheimer’s is just one type of disease associated with dementia, a non-specific syndrome which affects cognitive areas such as memory, attention, language and problem-solving.


According to the Medical News Today Web site, other diseases associated with dementia are vascular dementia (caused by problems in supply of blood to the brain ie a stroke), frontotemporal dementia (progressive deterioration of the frontal lobe of the brain), semantic dementia (language) and dementia with Lewy bodies (spherical structures in the brain that damage brain tissue). Audrey’s testimony as caregiver for her mother was part of the discussion on dementia: Awareness of Disease and Impact as part of the University of the West Indies’ Research Expo last week.


The Faculty of Medical Sciences hosted the swift hour-long presentation at UWI’s Engineering Building.


“Seventy per cent of dementia is Alzheimer’s,” said Dr Gershwin Davis, a senior lecturer in chemical pathology of UWI’s Medical Science faculty, as he explained the disease. 


Globally, Alzheimer’s affects 16 per cent women and 11 per cent of men who are over the age of 65. 


Statistics also reveal that this degenerative disease affects one in ten people in that age group.


He said the challenge is measuring dementia since it moves from no impairment to very mild, to mild cognitive to moderate stages of debilitation. Diagnostic criteria involve memory, language, motor activities, failure to recognise and executive functioning.


Thus the question raised by Human Anatomy Prof Amanda McRae in her presentation, “Are we prepared for the impact of the Dementia Tsunami in T&T?”


In a prevalence dementia study conducted at geriatric homes and senior activity centres in north Trinidad and the social welfare office in Tunapuna, Prof McRae said age was the strongest predictor among the 2,000 who were randomly selected for the survey.


Prof McRae also suggested that risk prevention is possible. She listed aerobic exercise, an active social life, intellectual activities and a healthy diet as ways to delay or prevent an element of the disease.


That human interaction as someone gets older should be maintained, said Dr Nelleen Baboolal, a senior lecture in psychiatry. It helps delay the course of dementia. She also noted that 15 per cent of dementia is reversible, once there is early diagnosis. 


However, she noted that 50 per cent of patients who suffer from mental destabilisation are not properly diagnosed.


Although there is no cure for Alzheimer’s or dementia, Dr Baboolal said there are several treatments that can prolong memory, providing three to five extra years of working memory. 


Some of the risk factors for dementia are age, family history, genetics, high cholesterol, high blood pressure or head trauma.


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