Saturday 27 July 2013

The Dementia Diary: The Dementia Diary: I don't wanna grow up

The Dementia Diary: The Dementia Diary: I don't wanna grow up: The Dementia Diary: I don't wanna grow up : I recently read a story about the world's oldest man.  He is 116 years old and he is the...

What's in a word

I'm sure many have noticed that for nearly two months I have not posted on the blog.  The reason is simple.  My mom asked me not to.  Mom has never read the blog and until it was brought to her attention, knew nothing of the blog.  She has been led to believe that it contains nasty lies about her and of course, any one who has read it, knows that is far from the truth.  So, I will focus the blog less on mom and more on dementia and everything associated with it.

I think one of the reasons mom hates the blog is because it uses the word dementia and she has grown to hate that word.  Dementia is a Latin word from de- "without" + ment, the root of mens "mind and it means madness.  Close your eyes and say the word out loud.  What image comes to mind.  I'm sure it is similar to what comes to my mind.  I see a dishevelled person in a straight jacket banging their head against the wall of a padded room.  That image creates a stigma and a big misunderstanding of what dementia in our modern world actually means.  The word is off set when combined with others and sounds more medical.  Close your eyes again and say Frontal Lobe dementia or Lewy Body dementia and what image comes to mind.  If you are like me, than your mind stays blank because we haven't been conditioned to associate anything with those terms.  That is what needs to change.  People need to understand what dementia actually is.  I hope to do that.

More than half the world still believes that dementia is a normal part of ageing.  It isn't, far from it.  I know many people in their eighties and even nineties who are as quick and on the ball cognitively as I am, even more so.  They move a little slower and might even use a walker.  Their bones are weaker.  They might be a little incontinent and use Depends.  They might have some age on-set diabetes or a bit of a problem with high blood pressure and need some medication.  They might forget a person's  birthday occasionally or misplace the TV remote, but don't we all, at any age. They still enjoy playing bridge or crib.  They read, watch TV, gossip over coffee and complain about the state of affairs in the world.   They still engage in normal everyday life.  Normal ageing causes atrophy of the brain.  However, overall cognitive functioning can remain unaffected as people age. The brain may become less efficient, but still be able to do the job.  This is normal ageing and there in no dementia involved, their minds are essentially intact.

Dementia isn't a disease.  It's a syndrome meaning that is has a set of signs and symptoms.  The symptoms involve the cognitive functions of memory, attention, language and problem solving.   Dementia is characterized by a progressive impairment of memory and intellectual function that is severe enough to interfere with social and work skills. Memory, orientation, abstraction, ability to learn, visual-spatial perception, and higher executive functions such as planning, organizing and sequencing may also be impaired.  Dementia can be rapid progressing or slow in it's progression.  Regardless, plaque building up on portions of the brain and atrophy of the neurons and white matter of the brain eventually causes physical symptoms as organs of the body lose the ability to function properly. 

There are over 200 types and sub-types of dementia.  Some types are completely genetic like Huntington's disease.  Frontal lobe dementia and Alzheimer's can be inherited and it was just recently that the mutated gene for these types was finally identified.  There are 11 inherited diseases that will cause dementia.  Diseases like Krabbe disease and Urea cycle diseases.  There are types of dementia like Wernicke's syndrome and Dementia pugilistic and when the causes of the dementia, in these cases alcohol and repeated brain trauma stop, the progression of the disease stops too.  There are 'organic' types of dementia where secondary diseases cause the dementia.  Diseases like syphilis, hypertension and vascular diseases will cause dementia if not properly treated.  There are chemically induced types of dementia in which damage to the brain is caused by exposure to certain types of prescribed medications including anti-convulsive drugs and chemotherapy drugs.  Methamphetamine use and even a one time exposure to anaesthetics can induce dementia also.  In these cases some of the symptoms can and sometimes be reversible  but the initial damage to the brain tissue and white matter are not and often over time, dementia may develop.    

Geriatric medicine is still new in the world of medicine and only a handful of universities and medical schools in North America offer this type of specialization.  Sadly, dementia was first seen in 1907 but not studied again until 1976.  It's a shame that all those years that could have been spent on research and development were wasted.  Regardless, I have faith that things will improve for everyone.  For improvements to be seen we have to educate ourselves and become aware of this absolutely insidious illness and most importantly we need to prepare ourselves and our families.

The University of Calgary is one of the medical schools that does offer a geriatric medicine specialization program.  Recently the department held an on-line seminar on dementia.  Dr. Holroyd-Leduc was the facilitator.  Like my mom, she can't stand the word dementia.  She mentioned that prefers to use terms like 'Cognitive Disorder Not Otherwise Specified' and 'White Matter Hypodensity'.  She also noted the simple fact that people don't understand those terms but they do understand the word dementia.  I'm like mom too, I'm starting to hate the word just as much as she does.