A Peek into Dementia

This week, we will be taking a peek into Dementia.

Why dementia? Because dementia is on the rise and one of the major reasons why maintaining brain health across the lifespan is being advocated globally. The rise in the number of people with dementia is not a statistic “cooked up” somewhere, we are seeing it increasingly in clinical practice. Some schools of thought suggest that if we all live long enough, we will eventually develop dementia, largely because ageing is the single most important risk factor. Others disagree, arguing that dementia is not an inevitable part of ageing.

What is clear, however, is this: dementia is becoming more common, and it affects far more than memory alone. It isn’t simply about forgetting names or misplacing items. It is much more than that. To understand this better, read the piece ''A reflection on Dementia''. Afterwards, we’ll reflect on what it teaches us about dementia.

"Dementia is becoming more common and affects far more than memory."

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Reflecting on the Fade: Why “The Person” Changes

The piece ''A Reflection on Dementia'' captures a painful reality many families face when caring for a loved one with dementia.

In the early stages, memory changes are either dismissed as normal ageing or are unnoticeable because symptoms start subtly.   Behavioural changes, however, frequently lead to frustration and anger from caregivers and family members who do not understand why someone they have always known begins to change.

This is reflected in one of the lines on "A Reflection on Dementia":

“Papa is getting so difficult… Mama was always tough, but now… she’s impossible.”

The tragedy is that dementia, not the person, is responsible for these changes.

"As dementia gradually changes an individual, families often find themselves struggling to relate to this 'new' person, and it is easy for frustration to occur. But we must remember: it is the disease, not the individual, causing these changes."

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So, What Is Dementia?

Dementia is a progressive disease of the brain that affects memory, behaviour, mood, language and thinking.  Eventually, these changes become severe enough to interfere with a person’s daily activities and their ability to live independently.

People with dementia have problems with: 

• Memory function: Forgetting recent conversations and familiar faces or misplacing objects.

• Behavioral shifts: Difficulty in social interactions or relating to others.

• Mood swings: Rapidly shifting from happiness to deep sadness without an obvious trigger.

• Physical & sensory changes: Sleep disturbances, hallucinations, and in advanced stages, they have difficulty speaking, swallowing, or moving.

It is important to note that symptoms vary depending on the type of dementia. The most common forms include Alzheimer’s disease, Vascular dementia, Lewy Body dementia, and Frontotemporal dementia, each presenting with its own distinct features.

"Dementia is far more than simple forgetfulness; it reshapes thinking, mood, and behavior."

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How does dementia occur?

It occurs when neurons (the nerve cells in the brain that act as the brain's communication network) begin to die or undergo some structural and functional changes. While some neuronal loss occurs naturally with ageing, in dementia this loss is exaggerated and accelerated, leading to changes in the brain (as seen in the image below). The changes account for the symptoms we see in individuals with dementia.  

Image of the brain in health versus dementia. 

In dementia, the brain becomes smaller, with thinner folds and wider spaces. This happens because brain cells are gradually lost, leading to problems with memory, thinking, and behaviour.

One key process involves the accumulation of abnormal proteins in the brain. In a healthy brain, these proteins are cleared away efficiently. In dementia, however, they build up and form "clumps" that trigger damaging reactions, eventually killing the neurons.

This is not an overnight process; these proteins can accumulate for over a decade before a person shows the first sign of forgetfulness. Factors such as poor brain development in childhood or prior brain injuries can make the brain more vulnerable, potentially causing symptoms to appear earlier or progress more rapidly.

"Dementia occurs when abnormal proteins accumulate in the brain over many years, forming 'clogs' that destroy neurons far more rapidly than natural aging. This decline is often accelerated in brains made vulnerable by injury or poor brain development in childhood."

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Over the next few weeks, we will explore:

• Who is at risk of developing dementia?
• Common causes and types of dementia.
• How to tell normal ageing from early dementia?
• Ways to reduce risk and protect brain health.
• Treatment options and supportive care.

Please look out for the next posts in this important series. Because understanding dementia is the first step toward compassion, prevention, and better care.

Protecting your brain, protecting who you are.

Disclaimer: This content is for informational purposes only and is not a substitute for professional medical advice.