DEAR readers, how many of you have had lapses of memory lately? Or in more real terms, have you experienced going back and forth into your room looking for something and yet find nothing? For those who drive, how many times have you gone to a locksmith to help retrieve the car key you left inside. Worse situation would be someone who has inserted already the ATM card and yet cannot punch in the PIN number. Or probably, the kettle has run dry because you forgot you had been boiling water to drink.
Benign forgetfulness - a normal part of the ageing process or is it dementia? The medical community of Baguio and Benguet were treated to an update on dementia last Thursday at the South Manor Hotel by Dr. Socorro Martinez. The lady neurologist, who graduated from UST is the founding president of the Alzheimer's society of the Philippines, consultant-faculty of the UERMMMC and head of the Memory Clinic at the St. Luke's hospital. Statistics show that dementia is the fourth cause of disability in the developed countries. She emphasized that dementia is typically an adult disease- meaning common among those 65 years old and above. In the Philippines, 5.8 percent of the population belonged to the old adult category in 1995. By 2015, it is estimated that nine percent or one in 10 Filipinos would be old adult, thus the message is clear - that we are getting more and more old people and therefore society and government should be aware of its implications in terms of health care and ancillary support.
Dementia is an acquired impairment of the intellectual function with compromised multiple spheres of mental activity. It is a chronic-longstanding - progressive deterioration enough to interfere routine daily activity. In contrast, delirium is an acute or abrupt, probably temporary loss or deficit of mental function, for example, drug-induced, high fever, chemical intoxication. Dementia could be suspected by watching or observing how a person goes about his life - ADL or activity of daily living like personal grooming - taking a bath, eating, drinking, in short the basic vegetative functions.
Instrumental activity is more complicated however - watch how the person receives phone calls and relaying the message, keeping track of his medication intake, fulfilling promised appointments or even mere counting his money.
Dr. Martinez then proceeded to enumerate the many forms of dementia, emphasizing that there reversible dementia, saying that hypothyroidism (low thyroid hormone T3 and T4 in the blood) is most common, also Vitamin B12 or cobalamin deficiency, alcoholism and depression. However, the core of her discussion vascular dementias resulting from cerebrovascular accidents (CVA) and zeroed in on Alzheimer’s disease.
Alzheimer is a disease of the brain that causes problems with memory, thinking and behavior. It is not a normal part of aging as some people think, with Dr. Martinez telling her enthralled audience, she has a 100 year old patient who is lucid and excellent memory function. The brains of Alzheimer patients have an abundance of plaques and tangles. These plaques are deposits of a protein fragment called beta amyloid that builds up in the spaces between the nerve cells.
Tangles are twisted fibers of another protein called tau that builds up inside the nerve cell therefore interfering with the normal functions of its different parts. These plaques and tangles tend to develop in a predictable pattern, that is, in parts of the brain concerned with memory storage and recall. Although symptoms can vary widely, the first problem is forgetfulness severe enough to affect their ability to function at home, at work and in the community. Other symptoms include confusion, getting lost in familair places, misplacing things and trouble with language. Alzheimers could dramatically change the patient's life and the lives of people around him or her.
Next week. Management of Dementia and Memory Loss