NORMAL AGEING AND DEMENTIA
There are many people who are confused in society, including members of the medical profession - confused about the relationship between dementia, Alzheimer’s disease, and normal ageing.
In our first podcast we summarised the changes that take place in the brain and the mind as we live longer. Some changes do take place in the brain as a result of the normal ageing process but these do not cause major problems. Secondly, there are changes in the way the brain works due to loss of what could be called ‘ brain fitness’ as we are less challenged as we live longer, for example if we retire from a challenging job and do not substitute that challenge with other challenging activities. Then, of course, there are a number of diseases that affect the brain other than Alzheimer’s disease, secondary cancers in the brain for example. These three factors – ageing, fitness and disease – are well understood. So too are the factors that affect the mind, the way we think and feel This is affected not so much by ageing as by the attitudes and behaviours of other people, particularly what could be called ‘ageism’ – consistent under-expectation of what people in their 60s, 70s, 80s and 90s can achieve based on incorrect beliefs, for example that all intellectual functions deteriorate with age, whereas the scientific evidence is that some functions such as the ability to make complex decisions improve as we live longer .
However, in this podcast we are thinking about a particular condition called dementia.
What is dementia?
Dementia is not a disease like rheumatoid arthritis that can be confirmed with a blood test. It is better described as a condition which can be observed by people, including people without a medical degree. As we emphasised before, minor memory slips are not a sign of early dementia but simply occur due to failure to organise the knowledge and limited ‘shelf space’ to hold all the data that we need for daily life. There are four changes that indicate that dementia is developing and which need to be taken seriously and these include:
- failures of self-care, for example failure to wash or get to the toilet in time with apparent disregard for the consequences;
- failure to look after one’s home properly, leaving the gas or the water on;
- problems with driving;
- problems with money.
These are signs of a condition called dementia.
This is different from normal ageing, and we also find in unhelpful to talk about pre-dementia or MCI (mild cognitive impairment) although many people, including many respected academics, do use these terms. We prefer to emphasise that dementia is different from normal ageing.
The causes of dementia
Alzheimer’s disease is a diffuse disease affecting all of the brain. The cause is unknown and it rightly remains a very high priority for research both for finding a means of treating Alzheimer’s disease and, even more important, of preventing it.
However, Alzheimer’s diseases are only one cause of dementia. The second main cause is vascular dementia, namely dementia due to impairment of the blood and oxygen supply to the brain, and there are other causes of dementia which can be influenceded so the risk of dementia can be reduced , by at least a third
What can individuals do?
Find a friend and explain to them the difference between dementia and normalageing
What can the community do?
Society needs to educate all members about the difference between dementia and normal ageing and the cause of dementia, and the fact that, in the words of The Lancet, it is never too early and never too late to reduce the risk of dementia.
Try these books
What I wish people knew about dementia
Wendy Mitchell
Bloomsbury
Increase Your Brainability and Reduce Your risk of Dementia
Larry Chambers, Charles Alessi and Muir Gray
OUP2021
