An estimated 20,000 people in Saskatchewan live with some form of dementia. This number is more than the population of Yorkton and is roughly the population of Warman.
A Jan. 17 presentation by Dr. Megan Surkan with the Alzheimer Society of Saskatchewan and in partnership with the Conexus Credit Union gave the highly accredited Saskatoon-based geriatrician an opportunity to explain the condition.
Dementia is not a specific disease, but an umbrella term for the impaired ability to remember, think normally, or make decisions in daily life.
Dementia is quite common, and its likelihood increases with age. By age 65, an estimated one in 12 people will live with dementia, and by age 85, one in three live with some form of dementia, according to Statistics Canada.
Every 24 hours, an additional 10 individuals will be diagnosed with dementia in Saskatchewan.
The cause of dementia remains uncertain and complex. One certainty is that dementia isn’t a normal part of aging.
“Some people do kind of normalize certain parts of cognitive decline with age,” Dr. Surkan said. “That would be a pathology, rather than a normal part of aging.”
Dementia can be acute and sometimes reversible, or chronic and irreversible, depending on the cause.
Acute causes of dementia include the side effects of medication, symptoms of fever or infection, chronic depression, dehydration, stress, tumours, and a deficiency in Vitamin B12.
Chronic and irreversible causes of dementia include Alzheimer's disease, vascular dementia, frontotemporal dementia, dementia with Lewy bodies, Parkinson’s Disease, alcohol-related dementia, or an acquired brain injury.
Dr. Surkan said there isn’t typically a strong genetic link to dementia.
“If people have these genes, they are more likely to develop Alzheimer’s disease. However, it’s not a… guarantee by any means. A gene is not what we call deterministic – it doesn’t guarantee someone will get the illness.”
Studies indicate that up to 40 per cent of dementias are preventable through modifiable risk factors including exercise, treating high blood pressure, quitting smoking, and managing diabetes.
“In general, what’s good for your heart is good for your brain.”
Alzheimer’s disease: is the most common type of dementia, with an estimated 65 per cent prevalence. It is progressive, degenerative, and irreversible. Symptoms usually begin with issues in short-term memory. Alzheimer’s progresses in three increasingly severe stages, and the prognosis from onset is eight to 10 years on average.
Vascular dementia: is the second most common form of dementia. It’s caused by a decrease in blood flow to the brain which results in damaged brain tissue. This may be caused by high cholesterol, hyperlipidemia or atherosclerosis, or a blood clot.
Frontotemporal dementia: comes as the result of damage to neurons in the frontal and temporal lobes of the brain. This commonly affects people under the age of 65, and symptoms include unusual behaviours, emotional problems, trouble communicating, and difficulty walking.
Lewy body dementia: is associated with abnormal deposits of a protein called alpha-synuclein – or Lewy bodies – in the brain. These deposits affect brain chemistry that in turn affects thinking, movement, behaviour, and mood. Symptoms may also include visual hallucinations, REM sleep disorders, and symptoms resembling Parkinson’s disease such as a loss of smell.
An individual with Lewy body dementia may seem almost normal one day, and then hours or a day later they might become drowsy, altered, and confused.
Mixed dementia: involves symptoms from at least two forms of dementia, the most common of which is Alzheimer’s mixed with vascular dementia. Pathologists have revealed mixed pathologies in over half of all dementia cases.
Dementia commonly affects the frontal, parietal, and temporal lobes of the brain, and symptoms will match the function of the affected region.
The frontal lobe is responsible for higher level executive functioning, such as complex planning, problem solving, and step-by-step organizing. This includes the ability to self-monitor, plan, and control impulses.
The parietal lobe is responsible for perception and making sense of the world. If you see an image, the brain tells you what you’re witnessing.
The temporal lobe plays a role in manage emotions, processing information from your senses, storing and retrieving memories, and understanding language.
There are 10 warning signs of dementia endorsed by the College of Family Physicians of Canada that fall under three categories.
Abilities: include memory loss affecting day-to-day abilities, difficulty performing familiar tasks, disorientation in time and space, and frequently misplacing things.
Behaviour: includes impaired judgment, changes in mood and behaviour, changes in personality, and a loss of initiative.
Communication: includes problems with language and abstract thinking.
Before visiting your doctor, take note of any changes in your behaviour such as memory, language skills, attention, coordination, mood, or personality. Take note of medications, a family and psychiatric history, and any tasks that have become difficult.
It’s wise to bring your primary caregiver to the appointment, as some individuals with dementia may not realize all their symptoms.
Planning for a life with dementia includes determining a power of attorney, selecting a healthcare proxy to act on your behalf, and managing your medication. Individuals with dementia should stop driving and find alternative transportation.
If you have been diagnosed with dementia in any form, the Alzheimer Society provides valuable resources and a referral isn't required. The Alzheimer Society of Saskatchewan is based out of Regina and can be reached at 1-306-949-4141 or online at Alzheimer.ca/sk.
If you experience symptoms of dementia, the first step is to promptly contact your family doctor.
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