Dementia is a condition characterised by progressive, usually irreversible decline in cognitive functioning i.e. memory, thinking, communication, and reasoning that in turn affects the day to day functioning of the individual.
Globally, it affected about fifty million people in 2018. There are nearly 10 million new cases every year. 10% of people develop dementia at some point and it is more common with increasing age. It is one of the most common disabilities among the old.
There are different types of dementia. The most common type is Alzheimer’s disease which accounts for about half of the cases. Others are Vascular dementia, Lewy Body dementia and fronto-temporal dementia. Most of the above are irreversible causes of dementia.
There are some reversible causes which include Vitamin B 2 deficiency, Hypothyroidism, Neurosyphilis and Lyme disease. For these, oce the cause is identified and treated, the patient does well.
Symptoms of dementia usually start insidiously and include : failing memory, reduced concentration, increasing difficulty in engaging in meaningful conversation, difficulty in carrying out activities of daily living like dressing , cooking, bathing etc., wandering and restlessness, irritability. At a later stage, patient may be disoriented, aphasic (inability to talk), incontinent of urine or/and faeces, visual and auditory hallucinations, depression, personality change etc.
What to do when dementia is suspected is to present the patient at the hospital. Detailed history will be taken followed by mental, cognitive and physical examinations. Investigations will be carried out to further confirm the diagnosis and treatment will be instituted.
Patients with dementia are best treated by specialist and as such they should be referred as soon as dementia is suspected.