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Dementia

The holidays are a time for family gatherings, reflection, reconnection with loved ones and for many, a time to remember those whose seat at the table will be empty this year.

After almost 91 years of a wonderful life, 75 of them spent with her spouse, after blessing the lives of 8 children and dozens of grandchildren and great-grandchildren, my beloved mother passed away this year. In her final years she suffered from dementia, which took much of her memory but none of her joy for life.

Dementia is not a specific disease but rather refers to impairment in the ability to think, remember, and make decisions in a way that adversely affects daily life. Dementia is more common among older persons but is not a normal part of the aging process.

According to the U.S. Centers for Disease Control and Prevention, common signs and symptoms of dementia include problems with memory, attention, communication, reasoning and judgment, problem solving and visual perception. Persons with dementia may forget old memories, forget the names of loved ones, use unusual words for common or familiar objects, have difficulty completing tasks independently, and get lost in familiar locations.

By far, the greatest single risk factor for dementia is increasing age, with a higher prevalence among those ages 65 years and older. A family history, poor heart health, and/or history of traumatic brain injury may also increase risk.

While there are many types of dementia including vascular dementia, Lewy-body dementia, and frontotemporal dementia, by far the leading cause of dementia is Alzheimer’s disease. Alzheimer’s disease accounts for 60-80 percent of dementia cases and results from structural changes in the brain. In its early course, it is characterized by difficulty remembering recent events.

Most causes of dementia result in a gradual and inevitable decline. However, reversible causes of dementia include certain types of vitamin deficiency, thyroid disorders, medication side effects, and increased pressure on the brain.

While there is no cure for most types of dementia, early recognition and diagnosis can be helpful and treatments are available for associated symptoms, including anxiety and behavior changes.

Healthy lifestyle choices ranging from a nutritious diet and regular exercise to social engagement can reduce the risk of developing dementia.

The time-course of dementia is measured in years. Caregivers for persons with dementia, often including a spouse, children, and other loved ones, may experience stress ranging from anxiety to exhaustion. It is important for caregivers to recognize stressors and seek support from local community groups. Caregiver self-care is important and includes regular exercise, a healthy diet, rest, and respite.

Especially in this holiday season, I’d like to give a shoutout to all of those dedicated caregivers for people with dementia, like my Dad and siblings. Your love, dedication and commitment continue to make a tremendous difference. If you need support, please reach out to the Alzheimer’s Association at www.alzconnected.org.

Dr. Matthew A. Clark, a board-certified physician in internal medicine and pediatrics, works for the Indian Health Service.