Dementia

Around 70,000 New Zealanders live with dementia, and this number is rapidly growing as the population ages. Dementia is a progressive disease that affects people in different ways. It can affect anyone at any age, but is more common as you get older. There are many forms of dementia, but many of these forms can be slowed or managed with medications and lifestyle changes.

Forms of dementia

Dementia is an overarching umbrella term used to describe a group of symptoms that affect memory, cognitive ability, and communication. The most common forms of dementia include Alzheimer’s disease, vascular dementia, Lewy Body disease, and frontotemporal dementia.

Alzheimer's disease

As the most common form of dementia, Alzheimer’s affects two-thirds of people with dementia. People with Alzheimer’s may first notice symptoms of forgetfulness and mild confusion which will progress to memory loss, disorientation, personality changes, and behaviour changes. Alzheimer’s is caused by a build-up of abnormal proteins in the brain making plaques and tangles, and can cause the brain to shrink as the disease progresses. More information on Alzheimer’s disease can be found here.

Vascular dementia

The second most common form of dementia is vascular dementia. This form of dementia is caused by poor blood supply to the brain, such as from a stroke or blood clot. Because of the lack of oxygen and nutrients to the brain, the brain cells start to die. Symptoms of vascular dementia can begin suddenly, such as after a stroke, or can begin gradually. It is also possible to have both vascular dementia and Alzheimer’s disease. For more information on vascular dementia, check here.

Lewy Body disease

Lewy Body disease, also called Lewy Body dementia, is a form of dementia that is caused by abnormal clumps of protein in the brain that lead to the degeneration and death of nerve cells. Lewy Body disease shows symptoms similar to Parkinson’s disease, like tremors, shuffling, stiffness, quiet speech, loss of facial expression, and hallucinations. It leads to changes in movement, thinking, alertness, and behaviour. People with this form of dementia can fluctuate between almost normal functioning and severe confusion in a short period of time. More information on Lewy Body disease can be found here.

Frontotemporal dementia

Frontotemporal dementia (FTD) covers a group of disorders that affect the frontal and temporal lobes of the brain. Symptoms of FTD often begin your 50s and 60s, although it can begin at any age. Dementia affecting the frontal lobes often presents with difficulty being motivated, planning and organising, controlling emotions, and expressing socially appropriate behaviour. Dementia affecting the temporal lobes may affect speech and the ability to understand language. More information on Frontotemporal dementia can be read here

Symptoms and warning signs

While many forms of dementia have a slow onset, some warning signs to be aware of include:

  • Memory loss that affects your daily living
  • Frequently misplacing things
  • Difficulty performing your regular daily tasks
  • Difficulty with understanding language or communicating with others
  • Changes in mood and behaviour
  • Disorientation to time or place
  • Struggling to think abstractly
  • Decreased or poor judgement
  • Loss of initiative

If you notice any of these symptoms, see your doctor.

Delirium or dementia 

Sometimes in older people, dementia and delirium can be misdiagnosed. While the two share some similar symptoms, they are different conditions that require different treatment and management. Delirium is a sudden confusion that causes serious disturbances in thought, mood, and behaviour. It can have similar symptoms to some forms of dementia, such as mood changes, speech changes, disorientation and confusion, hallucinations, and sleep changes, but has different causes, and affects the brain in different ways. Delirium primarily affects your attention and concentration, while dementia can also affect memory.
 
Delirium can be caused by infection, dehydration, kidney and liver failure, drug interaction, head trauma, or other physical problems. Delirium often has a rapid onset and can normally be traced to another health condition. Because of this, delirium is usually reversible if the underlying cause is treated. If you notice symptoms of delirium, you should see a doctor as soon as possible to begin treatment. More information on delirium can be found here.

Managing dementia 

While dementia cannot be cured, some coping methods, lifestyle changes, and medications may slow the progression.

If you are struggling to remember things, use other resources to manage what you need to remember. Making notes and reminders can be useful, as well as using a calendar or diary to track your commitments. It may be helpful to cross the days off a calendar to keep track of the date. If you feel comfortable using technology, take advantage of the functions available to you such as phone reminders, a digital calendar, and maps.

Make a list of important phone numbers to keep near your phone or in your bag in case you need to contact anyone. Give a copy of important keys to people you trust in case you lose yours or someone needs to get to you in an emergency.

Some general advice for managing dementia includes: 

  • Staying active
  • Eating a balanced diet
  • Limiting alcohol
  • Finding time every day to relax
  • Resting when you are tired
  • Staying involved in activities and social commitments
  • Taking all medications prescribed to you

You should continue having regular health check-ups with your doctor. You can also talk to your doctor about medications that may slow the progress of your dementia or help with managing symptoms.

Prevention

While dementia cannot be completely avoided, some lifestyle choices may lower your risk of developing dementia. Alzheimer’s NZ recommends:

Physical activity: keeping active every day will help control your blood pressure and weight. It can improve your mood and can be a good way to socialise.

Healthy diet: Eating a healthy and balanced diet can help the body function properly. Avoiding foods with lots of fat, sugar, salt, or that have been processed will lower your risk of heart disease, which is beneficial for your brain.

Looking after your heart: Keeping your heart healthy will also help keep your brain healthy. Lowering your risk of high cholesterol, high blood pressure, diabetes, and obesity will lower your chance of developing dementia. It is recommended that you give up smoking and limit alcohol consumption as well.

Challenging your brain: Keep your brain active by challenging yourself to learn new things such as taking up a new hobby or learning a new skill. This will build new brain cells and strengthen the connections between them. Activities such as reading, puzzles, strategy and logic games are good for challenging your mind.

Staying social: Engaging in social activities helps to stimulate your brain while also improving your social connections. You can also combine physical and mental exercise through sports and hobbies

Living with dementia

As a person who has been diagnosed with dementia, you still have the right to be treated as a person and to live with dignity and respect. Every person in New Zealand is protected by the Human Rights Act, which gives all people equal opportunities and protects everyone from discrimination. You are also protected by the Convention on the Rights of Persons with Disabilities which protects the dignity of people living with disabilities by ensuring everyone gets equal treatment in all aspects of society. You can read more about these at Alzheimer’s NZ.

Receiving a dementia diagnosis can be confusing and make you question your identity. You may struggle to process your new diagnosis and may experience grief. You can find helpful resources at Alzheimer’s NZ on coming to terms with your diagnosis and maintaining your identity.

Planning for your future

After receiving and processing your dementia diagnosis, you may want to think about planning for your future. For people of all ages, it is important to plan for declining health in case you are not able to communicate your wishes at the time. An Enduring Power of Attorney (EPA) is a person that you trust that you have nominated to look after you and your things if you can no longer do it yourself. If your EPA is activated, your trusted person will be able to make decisions on your behalf. For more information on EPAs, you can read here.

An Advance Care Plan (ACP) is a plan created by you that sets out the terms for your future care if you can no longer make your wishes understood. You can find more information about ACPs here.

Websites of interest

  • For more information on dementia, check Alzheimer’s NZ
  • If you need support because you are caring for someone with dementia, check here
  • For more support and to see what services can be provided for you, contact your local Dementia NZ or Alzheimer’s NZ

 

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