Understanding Dementia – Is it Diet-related?

As the ageing population increases, dementia has undeniably become an uprising issue.
In 2015, there were 9.9 million dementia patients worldwide, and it doubles every 20 years. In addition, the proportion is higher in low-income countries than in high-income countries. This may be closely related to medical equipment and people’s consciousness towards health. Dementia has severe impact towards every level ranging from individuals, families and society.

Definition of Dementia:

Many may mistake it as a sign of ageing; however, the symptoms of dementia are much more recurrent. As it progresses to a later stage, the patient might even forget their own identity. Generally, patients with dementia require assistance from specialized personnel for food, clothing, housing and transportation. Patients will experience gradual declination in memory, learning ability, attention, language, thinking, planning abilities and many more. 90% of people with dementia will have mental and behavioural symptoms. It is divided into:

1. Alzheimer’s Disease

Accounting for 60-70% of all dementias, its formation is related to sustained brain inflammation. The main symptoms are forgetting recent events, hallucinations, delusions and gaffes. The symptoms are not obvious in the early stage but may be more prevalent in later stages such as Parkinson’s symptoms. The onset age is mostly after 70 years old.

2. Vascular Dementia

It refers to certain conditions that cause blockage or reduced blood flow to the brain, causing vital oxygen and nutrients that delivers to brain cells deprived and causing a decrease in thinking ability. This condition sometimes occurs suddenly after a stroke where major blood vessels in the brain are blocked. It comes after Alzheimer’s disease as the second most common cause of dementia.

3. Dementia with Lewy Bodies

Brain shrinkage is not obvious, but deposits of special proteins on the surface of the brain can be observed. In the early stages, patients will have delusions and hallucinations and rarely having language problems and Parkinson’s symptoms. They are also sleepy during the day and have sleep disorders at night (characterized by rapid eye movement)

4. Frontotemporal Dementia

It is in the frontal lobe of the brain (the area behind the forehead) or brain disease caused by degeneration (protein changes) of brain cells in the temporal lobe (the area behind the ears). It is characterized by behavioural, personality, and language disorders with focal degeneration of the frontal and/or temporal lobes. It is mainly due to genetics.

5. Wernicke-Korsakoff Dyndrome

The symptoms include confusion, dull eyes, and memory loss. It is caused by excessive consumption of alcohol which will damage the stomach lining, affecting the absorption of vitamin B1. Deficiency in vitamin B1 will have a direct effect on the brain’s efficiency in glucose absorption. It can be overcome by avoiding alcohol consumption. Consumption of vitamin B1 may also help in some cases.

Signs and Symptoms of Dementia to Look Out for:

Memory declination that affects everyday activities
Loss of ability to solve and plan things
Confusion about time and places (eg: forgot the date or way back home)
Blurred concepts of space and vision (eg: unable to distinguish colours, misidentifying people)
Difficulties in speech and writing: (eg: unable to express words they want to convey)
Belongings are being scattered all over the place and cannot be found
Withdrawing from the workplace or social circles:
Mood and personality changes

Prevention of Dementia

Maintain a healthy weight: Control your BMI in a healthy range.
Control the three highs (high blood pressure, high cholesterol, high blood sugar)
Diabetes: The risk of dementia is 1.5 times higher in people with diabetes than in people without diabetes, and twice as high in people with hypoglycemia. Simply put, elderly people with poor blood sugar control are more likely to develop cognitive impairment. It is recommended to maintain a normal blood index through diet and lifestyle habits in advance.

Dietary Recommendation

DASH or Mediterranean diet (more whole grains, vegetables, fruits, more fish, etc.)
Although ginkgo extract, fish oil, and vitamin E are well known for maintaining brain health, there is still insufficient data that show their effectiveness in delaying dementia.
Maintain a healthy lifestyle: quit smoking and drinking, and maintain aerobic exercise at least three times a week. You can also train your brain by reading and playing memory games.

The reliance on dementia drugs is not a long-term solution, hence we should start with prevention and tackle from our lifestyle instead by maintaining healthy habits.

The following are some common non-drug treatments that can be considered for improving brain health：

Reminiscence therapy
Art Therapy
Reality orientation therapy
Bio-psychosocial model

The Basic Mentality of Caring for Patients

Most forms of dementia are incurable. It can be very frustrating for family members, especially when there is a sudden change in emotions and behaviour among dementia patients which may be difficult to cope with at times.
What we can do as a family member is definitely to be more caring, empathic and understanding. For example, people with dementia may have lost functional abilities and need more time to walk, waiting patiently instead of scolding is a better solution. Another example would be adapting to their preferences, if the patient is undergoing art therapy and usually has no concept of painting but likes to sing, the patient can be encouraged to sing more.

Useful Tips for Family Members

Adjusting your mentality: Up to 95% of dementia is irreversible. However, the condition may be delayed through controlling diet and maintaining normal blood pressure, blood lipid and blood sugar. As a family member try to keep your old folks as healthy as possible and work together as a family to delay their dementia from worsening.
Understand more about dementia through official resources: Obtain more information from formal channels such as NGOs and medical books, keep in touch with other caregivers, and listen to their experiences. The ideal care team should include family members, doctors, nurses, physical therapists, smart therapists, nutritionists and other medical personnel.
Maintain a regular schedule: Try to communicate with the family member to take turns taking care of the patient, or invite professionals to take care of the patient. Make financial planning and mentality preparation in advance. If you notice any problems seek medical advice immediately.

Safety and comfort should be the main considerations for the patient’s living environment. Technology like smart appliances might also come in handy to improve the patient’s quality of life.

The Basic Mentality of Caring for Patients

Dementia cannot be cured, hence we should maintain healthy eating habits and living habits at a young age to reduce its occurrence. If an elderly person in your family has the following conditions, you may need to seek timely medical advice to ensure whether the elderly person has dementia. The sooner you detect it, the better prepared you can be to manage dementia and slow its progression. Some of the signs to look out for in an elderly person include forgetfulness, confusion, disorientation, and difficulty with daily tasks. Along with seeking medical advice, it is important to consider nutrition strategies for delaying dementia. This may include incorporating foods rich in antioxidants, omega-3 fatty acids, and vitamins such as B12 and D into the elderly person’s diet. Additionally, maintaining a healthy weight and regular physical activity can also help reduce the risk of developing dementia.