What we can do to ensure that our mothers are positive, happy and mentally active, so dementia does not set in for as long as possible.
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Do you think you genuinely engage with your parents? Do you spend quality time with them?
It is natural for young adults to spend lesser time with their parents as they grow older. Youngsters have their own lives and families, and careers. Parents have a different worldview, and conversations with them can be laborious. Yes, we may love our parents, we may take them out for dinners or movies, and spend time with them. But as sons and daughters, do we provide them with enough mental support and the patience they need?
Take your time to think about it. If your honest answer is ‘no’, it isn’t just the guilt you will have to deal with in the near future. You will also have to deal with their dementia sooner than later, says Dr Lakshmipathy Ramesh, Senior Consultant – Geriatrics, at Kauvery Hospital in Chennai.
Dementia is not a specific disease. It is a term used to refer to a group of diseases associated with decline in memory and loss of other mental skills, and Alzheimer’s disease is the most common form of dementia. As mortality rates increase in developing countries and people live longer, health experts have warned that countries like India could face an epidemic of dementia among its elderly in the coming decades. Since the average life-expectancy in women is more and we have a general apathy towards their health, our mothers are even more vulnerable to dementia than our fathers.
In India, women are prone to social isolation and withdrawal from society. They tend to be more diffident, face a lot more stress and are more likely to be depressed, compared to men. Dementia does not happen overnight, it starts with identifiable symptoms and gets worse with age, and faster, if not treated properly, says Dr Lakshmipathy Ramesh.
Spotting it early
“Dementia is not 100% preventable, it can happen to anyone as it’s a part of ageing. It doesn’t have a single factor, it could be genetic disposition or other environmental reasons,” explains Dr Lakshmipathy Ramesh. Research and medical histories have, however, pointed us to certain definite factors.
“Use it, or lose it,” declares Dr Lakshmipathy Ramesh. The more the human brain is allowed to remain unused, the more susceptible it is to dementia. “Stress is also an important factor,” he adds.
The doctor points out that in several cases, they have seen depression preceding dementia. “It is called pseudo-dementia. The patient is in a highly depressed mode and forgets things. It is not dementia, however. If we examine them, we can correctly identify the depression, treat that alone, and bring them back to normalcy. But if it is not treated properly, it can be one of the risk factors for dementia,” the doctor warns. Pseudo-dementia is more common in women, he adds.
While the progression of most forms of dementia is irreversible, there are some reversible forms of dementia. “Thyroid problem, B12 deficiency, high or low blood sugar and certain types of brain tumour can cause dementia, too. If we treat these underlying causes, the patient will return to normal,” Dr Lakshmipathy Ramesh says.
Dementia is usually preceded by Mild Cognitive Impairment, which is defined as the stage between the expected cognitive decline of normal ageing and dementia. It involves problems with memory, language, thinking and judgment.
So, how can we identify these patterns in our parents?
Here are a few things to watch out for: They will forget names of people even if they remember faces. Their minds will be confused. They could get forgetful with everyday chores – forgetting to switch the fan off, leaving the toilet unflushed, leaving their footwear behind or forgetting to buy a few things from the grocery list.
“These are the earliest hints. If we identify it at this stage, then we can start treatment accordingly,” Dr Lakshmipathy Ramesh points out.
Use it, or lose it
“There is no curative treatment for dementia, only supportive care to prevent further deterioration,” the doctor explains.
Keeping the mind active and using the brain regularly is the central theory around any treatment for dementia. “After 60, they must use their brain properly. They should take up new activities, things they have not done before and have to learn, like using a computer. When our brain learns new things, it gets stimulated and that helps control dementia,” Dr Lakshmipathy Ramesh adds.
There are a few other tricks. “When they read a book, they should imagine in their head what has been written. They should think about what they are reading, how it impacts their worldview,” he says. Doing the crosswords and Sudoku puzzles are, of course, immensely helpful.
The importance of “successful ageing” cannot be emphasised enough, but what does it mean? Over the years, its definition has evolved from being free of diseases and disability in our old age, to a more rational model – being prepared for the eventualities of old age, like illnesses and loss. We cannot escape what is to come, but we can be prepared for it.
“Setting out expectations right is very, very important,” the doctor emphasises.
When women reach their 50s, they should start thinking practically about how life is going to turn out. “If we set high expectations from life, and it is not matched, it will lead to depression, which is a risk factor for dementia,” he warns.
It is natural for life to become less busy after retirement. Kids will get married and move further away, and they will have their own lives and careers. People close to us will start dying, and we will start feeling lonely. “Ageing people have to prepare themselves for all this,” he says. “Most people fail by being rigid in their lifestyle and mindset in their old age, and then face disappointment,” the doctor says, “although, women can take care of themselves better compared to men.”
“We must ensure that our parents have an active social life. They should not be cynical. They should appreciate others for small things and be nice to them,” he points out, “At home, if your partner brings you coffee, tell him/her it is nice and appreciate the effort, it keeps life positive.”
What can kids do?
“Spend quality time with them. Don’t just take them to movies. Sit down and talk to them, engage with them and find out what is happening in their lives. Be patient and listen,” the doctor says.
“Youngsters are superficial with their parents. They just ask them if they have had their food or something. They don’t go beyond routine conversation. We have to spend quality time with our parents, that is when we can start identifying symptoms of dementia,” the doctor explains.
It happens often that women withdraw themselves from society due to loss of hearing or vision. They feel diffident or shy, may have the impression that they are troubling others. “We must assure them that they shouldn’t feel so, and engage with them even more when they are failing in health,” the doctor says.
Husbands too have an important role to play in ensuring their wives are happy and active. “They should take them out for walks and talk about what is happening in life. They should do everything together. Travel together, listen to music – whatever makes them happy,” the doctor says, “And be nice to your wife, be of help to her.”
This series was produced by TNM Marquee in association with Kauvery Hospital.