Dementia is not a specific disease. It’s an overall term that describes a group of symptoms associated with a decline in memory or other thinking skills severe enough to reduce a person’s ability to perform everyday activities. Dementia is not a normal part of ageing, it is as a result of physical disease processes that damage the brain and triggers a loss of brain function. Dementia affects approximately one in six people over the age of 80.
Alzheimer’s disease accounts for 60 to 80 percent of cases and is a chronic neurodegenerative disease that usually starts slowly and gradually worsens over time. It is the cause of 60–70% of cases of dementia. The most common early symptom is difficulty in remembering recent events whereas long term memory is relatively spared.
Dementia is a progressive disease and so by definition gets worse over time. Dementia doesn’t just cause memory loss but damages many areas of the brain responsible for controlling different organs and systems. Since this can have detrimental effects on the whole body, physical decline is also a feature of dementia. Although dementia is a terminal the gradual nature of the disease means its subsequent effects on life expectancy will depend on various factors including the type of dementia, overall health and lifestyle.
There are 7 stages that are described depending on symptoms and signs, from no impairment to very severe decline and eventual death.
Stage 1: No Impairment
During this stage, Alzheimer’s is not detectable, and no memory problems or other symptoms of dementia are evident.
Stage 2: Very Mild Decline
The senior may notice minor memory problems or lose things around the house, although not to the point where the memory loss can easily be distinguished from normal age-related memory loss. The person will still do well on memory tests and the disease is unlikely to be detected by loved ones or physicians.
Stage 3: Mild Decline
At this stage, the family members and friends of the senior may begin to notice cognitive problems. Performance on memory tests are affected and physicians will be able to detect impaired cognitive function.
People in stage 3 will have difficulty in many areas including:
- Finding the right word during conversations
- Organising and planning
- Remembering names of new acquaintances
People with stage three Alzheimer’s may also frequently lose personal possessions, including valuables.
Stage 4: Moderate Decline
In stage four of Alzheimer’s, clear-cut symptoms of the disease are apparent. People with stage four of Alzheimer’s:
- Have difficulty with simple arithmetic
- Have poor short-term memory (may not recall what they ate for breakfast, for example)
- Inability to manage finance and pay bills
- May forget details about their life histories
Stage 5: Moderately Severe Decline
During the fifth stage of Alzheimer’s, people begin to need help with many day-to-day activities. People in stage five of the disease may experience:
- Difficulty dressing appropriately
- Inability to recall simple details about themselves such as their own phone number
- Significant confusion
On the other hand, people in stage five maintain functionality. They typically can still bathe and toilet independently. They also usually still know their family members and some detail about their personal histories, especially their childhood and youth.
Stage 6: Severe Decline
People with the sixth stage of Alzheimer’s need constant supervision and frequently require professional care. Symptoms include:
- Confusion or unawareness of environment and surroundings
- Inability to recognise faces except for the closest friends and relatives
- Inability to remember most details of personal history
- Loss of bladder and bowel control
- Major personality changes and potential behaviour problems
- The need for assistance with activities of daily living such as toileting and bathing
Stages 7: Very Severe Decline
Stage seven is the final stage of Alzheimer’s. Because the disease is a terminal illness, people in stage seven are nearing death. In stage seven of the disease, people lose the ability to communicate or respond to their environment. While they may still be able to utter words and phrases, they have no insight into their condition and need assistance with all activities of daily living. In the final stages of Alzheimer’s, people may lose their ability to swallow.
Alzheimer’s: Six pillars of prevention
Pillar 1: Regular exercise.
Aerobic exercise can reduce the risk of developing Alzheimer’s dementia by 50% – see evidence on running. (…coming soon!)
Pillar 2: Social engagement.
The weight of evidence suggests that social engagement helps maintain thinking skills and slows cognitive decline in later life. Studies show that people who are socially engaged may well have a lower risk of cognitive decline and dementia. So, pursue an active social life, volunteer, attend classes, play music, get involved with your neighbours and community and stay close to family and friends.
Pillar 3: Eat a healthy diet.
Alzheimer’s has sometimes been described as ‘diabetes of the brain’ with insulin resistance and inflammation damaging neurons in the brain as they do in the body in diabetes.
One program showing positive results is the MIND Diet.
- Green leafy vegetables: At least six servings per week
- Other vegetables: At least one serving per day
- Berries: At least two servings per week
- Nuts: At least five servings per week
- Olive oil as the primary cooking oil
- Whole grains: At least three servings per day
- Beans: More than three meals per week
- Fish (not fried): At least once per week
- Chicken or turkey (not fried): At least two meals per week
- Wine: One glass per day
Of course, sticking rigidly will benefit most but small changes will also help! Fewer than four servings of red meat per week, less than one serving of cheese per week, less than a tablespoon of butter each day, and less than five servings of pastries and sweets per week might be a start!
Regarding beverages epidemiological evidence shows tea consumption around the world possibly associated with either a decreased risk of Alzheimer’s or an improvement in cognitive function in older populations. Research has also shown that Green tea counteracts three chemicals in the brain associated with the development of Alzheimer’s whereas black tea curbed only two. Also, green tea continued to have its inhibition effect for a week, whereas black tea’s enzyme-inhibiting properties lasted for only one day.
The CAIDE study, coffee drinking of 3-5 cups per day at midlife was associated with a decreased risk of Alzheimer’s by up to 65% in later life. This is thought to be mediated by caffeine’s anti-inflammatory effects.
Pillar 4: Mental stimulation.
No studies have shown that brain training prevents dementia. However, a report from the Global Council on Brain Health recommended that people should take part in stimulating activities such as learning a musical instrument, learning a language or gardening rather than brain training to help their brain function in later life and that the younger one started the better the brain function as they aged. However, doing Sudoku, Crossword puzzles or other brain games isn’t necessarily a waste of time as there may still be some truth in ‘use it or lose it’ when it comes to cognitive function. So be curious, get organised, be open to new experiences – learn something new, a language or an instrument and get those cogs whirring!
Pillar 5: Quality sleep.
Disrupted sleep not just a symptom but a risk factor for Alzheimer’s.
See My Sleep blog on Insomnia
Pillar 6: Stress management.
Research suggests that stress and anxiety can cause inflammation in the brain, making the brain more susceptible to health problems like dementia. Stress can also lead to depression, a known risk factor for Alzheimer’s and related forms of the disease.
Meditation and mindfulness encourage a mental state where one is fully present, aware of where we are and what we’re doing, and not overly reactive or overwhelmed by what’s going on around us. It is achieved by focusing one’s awareness on the present moment, while calmly acknowledging and accepting one’s feelings, thoughts, and bodily sensations. Meditation and Mindfulness could reduce the risk of developing Alzheimer’s as studies show those who practice the techniques show a reduction of cognitive decline, reduction in perceived stress, increase in quality of life, as well as increases in functional connectivity, percent volume brain change and cerebral blood flow in areas of the brain cortex.
Keeping generally healthy is also important as obesity, smoking, diabetes, alcohol consumption (above a modest level) high blood pressure and raised cholesterol are all linked to an increase in dementia risk, especially Vascular dementia, also known as multi-infarct dementia (MID) and vascular cognitive impairment (VCI) caused by problems in the supply of blood to the brain caused typically by a series of minor strokes destroying small areas of brain tissue which leads step by step to a progressive cognitive decline.
Q. What will I do to reduce my risk?
Q. What can I suggest to my loved ones so as to reduce their risk?
Q. Research is needed to help solve this terrible affliction – will you help? Donate here.