The
habit of viewing memory loss in elderly persons as part of the normal
aging process, as well as ignoring forgetfulness in younger
individuals, is wrecking many lives and worsening cases of dementia.
Dementia is a disease characterized
with a progressive deterioration in the cognitive (thinking, reasoning,
knowledge), personality and intellectual functions of an individual, and
is associated with decline in activities of normal daily living of
conscious patients.
“Most people don’t come to us until the
situation is bad ,” said Dr. Aishatu Yusaha’u Armiya’u a Consultant
Psychiatrist with the Jos University Teaching Hospital (JUTH). “By the
time patients get to the hospital, they have started hallucinating and
behaving aggressively. At the end of the day, they are left for the
psychiatrists, and a lot of them have either high blood pressure or
diabetes. ”
According to Dr Salisu Abullahi
Balarabe , a consultant neurologist, at the Usmanu Danfodiyo University
Teaching Hospital, UDUTH , Sokoto , the most serious misconception
people have about the disease is that there is no point doing anything
about it since it is an aging process or that the person is just
misbehaving.
| How ignorance about dementia wrecks lives |
He noted that this increases the rate at which the person progresses from mild to severe form of the disease.
Dr Balarabe said that if an old man
begins to abuse people, the usual thinking is that he is just becoming
unnecessarily difficult. He added that it is always good for the
community and especially family members to know that dementia is a
disease just as malaria, and typhoid to mention a few.
“Whatever you do in the hospital
setting may not really be compared with when a care giver really
understands what it takes to care for a patient with dementia. For
instance, if you are caring for someone and he is always crying, and
depression sets in, it would even be much more disastrous to his life
than the dementia the person has,” he added.
Mrs Susana Jurbe , 50, said when
her 76-year-old mother started exhibiting forgetfulness, and lost track
of time in 2015 , the family mistook it for the normal aging process.
Jurbe explained that her mother
started wandering about, and would realize after sometime and return
home. “She also developed high blood pressure and diabetes so when we
took her to JUTH, she was given drugs but they also referred us to the
Psychiatrist unit and they told us that the symptoms of forgetfulness
and hallucinations was an illness.”
Jurbe who takes her mother to the
hospital for routine checks once in two months said the medical experts
usually asked her a bunch of questions including if she knew who she
(Jurbe) was, who her sister is, and what period of the day it was.
Hajara said her sister, Hauwa might
have been a lot better today if her family knew it was dementia when
the problem started in 2011. Then Hauwa was 19 and got involved in
accident where a fuel tanker consumed several lives on her way from
school. Months after, she became highly forgetful. But her family kept
her at home since there was no obvious injury. By the time medical
assistance was sought, it was late.
Signs of dementia
A consultant psychiatrist at the
Federal Neuro Psychiatric Hospital, Yaba, Lagos, Dr Taiwo Oduguwa said
old age comes with forgetfulness and that if someone is forgetful but
still behaves and functions normally, that can be regarded as normal.
But, if it is persistent, such that the person doesn’t remember the area
or streets close to their residential address that is a sign.
Aside forgetfulness, the individual
may have change of behavior, says Dr Salisu Abullahi Balarabe, of the
Usmanu Danfodiyo University Teaching Hospital, UDUTH , Sokoto, “like
if someone who is known to be very calm , starts becoming aggressive ,
he may be losing control and that is a sign of early stage dementia.”
He said others signs a person may
be developing dementia, includes when a person begins to forget words,
instead of mentioning the name of a thing, he or she begins to describe
it.
In advanced stages, he stated that a
person has problem recognizing familiar faces and remembering the names
of their children, close friends, and relatives.
In addition, Dr Balarabe said by
the time a person is not taking subconsciously landmarks that would help
him have an idea of how he should go to a place, that is also a sign
of dementia, noting that when it reaches the severe stage ,the person
does not know where the toilet or bathroom is located in his or her
own house.
The medical expert said other signs
involves someone repeatedly asking you of something that you just
informed him of during discussion.
Prevalence
Out of all psychiatric cases,
dementia accounts for 22.4 percent , said Dr Taiwo Oduguwa, a consultant
psychiatrist at the Federal Neuro Psychiatric Hospital, Yaba, Lagos.
Also a four-year (2007-2011) review
of the mental health services rendered to 938 clients aged 60 years and
above at a Lagos based mental health treatment facility , carried out
by some psychiatrists showed that 216 of them representing 36.7% were
diagnosed of dementia while 5.5% (that is 56 persons) had Alzheimer’s
dementia , (a type of dementia).
Also, a clinical psychologist, and
head of Department of Clinical Psychology Department at the Neuro
Psychiatric Hospital , Kaduna, Oguizu J. Okechukwu, said about three out
of every 100 mentally ill patients that come to the hospital were
dementia cases from their observations.
The most common type of dementia is
Alzheimer disease.Dr Agbir Terkura Michael a consultant psychiatrist,
with the Benue State University Teaching Hospital (BSUTH) explained that
it is a neuro- degeneration in the brain, that is the brain
deteriorates with age, and it usually happens after the age of 65 or
during old age .Those who have parents or siblings with Alzheimer
disease are predisposed to having the disorder.
Borno State Commissioner of Health ,
Dr. Haruna Mshelia, said the exact prevalence rate of dementia in the
state was not known because it requires an extensive research, and that
has not been conducted yet, “In advanced countries where many people
live for as long as 100 years in considerable comfort, the chances of
people getting dementia are less than what obtains in the developing
countries like ours,” he said.
Causes, and those at risk of the disease
Dr Musbahu Rabi’u, a consultant
neurologist at the Murtala Mohammed Specialist Hospital, Kano said some
of the common diseases that could lead to dementia include severe
malaria, chronic meningitis, HIV, diabetes, hypertension, stroke, renal
failure, brain injury as well as aging.
Dr Adebimpe Alder, a psychiatrist
with the Melville Healthcare Resources, a mental health facility in
Abuja said brain injuries sustained during bomb blasts, communal attacks
and by military personnel predisposes to the disease.
Excessive use of tobacco, unhealthy
diet as well as illnesses like depression and social isolation could
also pose a risk, Dr. Aishatu Yusaha’u Armiya’u a Consultant
Psychiatrist with the Jos University Teaching Hospital (JUTH) said.
Clinical psychologist and head of
Clinical Psychology Department at the Neuro-Psychiatric Hospital,
Kaduna,Oguizu J. Okechukwu , added that dementia could also be caused by
deficiencies of vitamins like folic acid, B-Complex in the brain, and
by substance abuse like cocaine, marijuana, and cigarettes, among
others.
The Medical experts said most people
with dementia were not born with it, and that it could also be as a
result of traumatic causes such as an injury to the head, a gunshot,
accident or even rigorous exercises such as punch syndrome associated
with boxing.
“If the head is being punched severally as it is with boxers, they are predisposed,” Dr. Agbir Terkura Michael said.
According to Dr Taiwo Oduguwa, HIV
in a person which has led to AIDs can also cause dementia . In addition
he said chronic alcoholic use, and lots of losses like money , or family
members can cause depression which later leads to dementia.
Can dementia be prevented?
People have to modify their lifestyle as a preventive measure against dementia.
“It is important to reduce intake
of alcohol or any psycho-active substances, and engage in regular
exercise,” says Dr. Agbir Terkura Michael.
He said persons who are diabetic and
hypertensive should control their blood sugar and pressure and also
engage in social activities such as supportive clubs, Ludo games. “It
helps people keep their brain functioning well. Chess, dancing and
reading throughout people’s life span is also very important in keeping a
mental balance. Regular writing too prevents dementia to certain levels
as it tasks the brain to think while writing.”
Another preventive measure is
through the use of non-steroidal inflammatory drugs and studies have
shown that they are quite effective ,” Dr Balarabe of UDUTH explained.
Link between dementia and HIV
Medical experts said HIV infection
is associated with dementia and that is why part of the clinical
presentation of HIV, is AIDS dementia complex.
Dr Adebimpe Alder, a psychiatrist
with the Melville Healthcare Resources, a mental health facility in
Abuja said as HIV progresses, at the end stages one gets a bit
degenerated and starts to forget things, “it affects your communication
and overall daily life activities,” she added.
Daily Trust reports that in Kano,
HIV infected persons who are not receiving anti-retroviral therapy
constitute 23% of recorded cases of dementia.
Dr Musbahu Rabi’u, attributed the
prevalence to the depletion in their immune system which predisposes
them to various chronic infections that eventually metamorphose into
progressive loss of memory.
Treatment
There is no absolute cure for
dementia but that there are drugs to manage it, according Oguizu J.
Okechukwu, a clinical psychologist adding, “We also use cognitive
training, as there is always a deficiency in cognitive functions like
thinking, reasoning, retrieving information and a lot more.”
Dr Taiwo Oduguwa , a consultant
psychiatrist said treatment involves giving drugs that delay or slow
down the progression of the disease. So that instead of it progressing
like three years, it prolongs the period to five or 15 years. “The
person can live long after being diagnosed with dementia but the sad
part is, such a person will be a shadow of his or her former self.”
Does dementia lead to death?
The clinical psychologist, Oguizu
Okechukwu said when the brain shrinks to a level that it can no longer
function, the person will die, though this can take some time . “The
patient usually dies in dementia,” he said.
What families of sufferers should know and how to cope
Dr Balarabe of the UDUTH said
understanding is what a person suffering from dementia requires the most
from family members, saying they could be demoralized or
psychologically unhappy, when they don’t get it.
He said it is quite challenging
taking care of a person with dementia especially at the advanced stage
and that there is need for the family member or care giver to make
sacrifices not just on medical bills but on time given to the affected
individual.
Oguizu J. Okechukwu, clinical
psychologist, advised family of sufferers to take patients to a
psychiatric hospital where there are mental health professionals
comprising psychiatrists, clinical psychologists, medical social
workers, among others.
People staying with a dementia
patient for a period of time can develop anxiety, become irritable and
even get high BP, said Dr. Aishatu Yusaha’u Armiya’u , so they need to
be psycho-educated and monitored closely. There should be two or three
persons caring for a dementia patient so that there can be shifts, she
advised. Dr Taiwo Oduguwa said when two old couples are living together
and one has dementia, they need the assistance of two caregivers. “Mama
cannot take care of papa, the house, go to the market to buy things,
cook and do all sorts of things.”
The mental health experts said that
caregivers should always engage sufferers in physical and social
activities, in order to slow the progressive deterioration in their
health.
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