Dementia and Normal Ageing
How Are They Different?
Over the next three decades, India will have an increasing proportion of ageing population. With demographic ageing, comes the problem of dementia and India is expected to have one of the largest number of elders with dementia (1). In 2015, an estimated 4.1 million persons aged over 60 years had dementia in India. This is estimated to rise to 6.35 million by 2025 and to 13.33 million by 2050. This indicates that the burden of dementia in India is already signif¬icant and is expected to rise rapidly over the next two to three decades. A study in 2010 found the prevalence of dementia in Pune city to be 4.1% in those aged above 65 years. This indicates a very significant burden of the illness in the local region (2).
It is therefore important to raise awareness about dementia and how it is different from forgetfulness that comes with normal ageing.
What is dementia?
Dementia is the term for a group of symptoms that occur when the brain is damaged by diseases. Dementia can cause a significant decline in a person's mental abilities - our capacity for things like memory, thinking and reasoning. The most common type of dementia is Alzheimer’s dementia.
What is ageing?
Ageing is a natural process in everyone’s life. As one ages, one experiences gradual changes to their brains and bodies. Some of these changes affect physical and mental abilities, and may increase the risk of disease. Almost 40% of the people over 65 years of age will experience some form of memory loss. But chances are still unlikely that they will have dementia. For the most part, the memory loss is mild enough that they can still live their day-to-day lives without interruption.
Comparing the signs of normal ageing and dementia
| Ability | Possible changes due to normal ageing | Possible changes due to dementia |
|---|---|---|
| 'Short-term' memory and learning new information | Sometimes forgetting people's names or appointments, but remembering them later | Forgetting the names of close friends or family, or forgetting recent events - for example, visitors you had that day |
| Occasionally forgetting something you were told | Asking for the same information over and over - for example, 'where are my keys?' | |
| Misplacing things from time to time - for example, your mobile phone, glasses or the TV remote - but retracing steps to find them | Putting objects in unusual places - for example, putting your house keys in the bathroom | |
| Planning, problem-solving and decision-making | Being a bit slower to react or think things through | Getting very confused when planning or thinking things through |
| Getting less able to juggle multiple tasks, especially when distracted | Having a lot of difficulty concentrating | |
| Making a bad decision once in a while | Frequently poor judgement when dealing with money or when assessing risks | |
| Occasionally making a mistake when doing family finances | Having trouble keeping track of monthly bills | |
| Language | Having a bit of trouble finding the right word sometimes | Having frequent problems finding the right word or frequently referring to objects as 'that thing' |
| Needing to concentrate harder to keep up with a conversation | Having trouble following or joining a conversation | |
| Losing the thread if distracted or many people speaking at once | Regularly losing the thread of what someone is sayin | |
| Orientation | Getting confused about the day or the week but figuring it out later | Losing track of the date, season and the passage of time |
| Going into a room and forgetting why you went there, but remembering again quite quickly | Getting lost or not knowing where you are in a familiar place | |
| Visual perceptual skills | Vision changes related to cataracts or other changes in the eyes, such as misty or cloudy vision | Problems interpreting visual information. For example, having difficulty judging distances on stairs, or misinterpreting patterns, such as a carpet, or reflections |
| Mood and behaviour | Sometimes being weary of work, family and social obligations | Becoming withdrawn and losing interest in work, socialising or hobbies |
| Sometimes feeling a bit low or anxious | Getting unusually sad, anxious, frightened or low in self-confidence | |
| Developing specific ways of doing things and becoming irritable when a routine is disrupted | Becoming irritable or easily upset at home, at work, with friends or in places comfortable or familiar places |
Top 5 ‘healthy brain’ tips to reduce risk of dementia (4)
1. Be physically and socially active
2. Eat healthy food
3. Manage stress
4. Keep on learning- challenge your brain
5. Avoid alcohol and smoking
Top 10 warning signs of dementia (5)
6. Memory loss that disrupts daily life
7. Challenges in planning or solving problems
8. Difficulty completing familiar tasks
9. Confusion with time or place
10. Trouble understanding visual images and spatial relationships
11. New problems with words in speaking or writing
12. Misplacing things and losing the ability to retrace steps
13. Decreased or poor judgment
14. Withdrawal from work or social activities
15. Changes in mood and personality
If you think you or anyone you know may have dementia, please contact
KEM Hospital, Psychiatry OPD for an assessment.
Time: Monday to Saturday 9-11:30am
Contact number: +91 20 6603 7300
References
16. Kishore S. Dementia in India, 2015 Available: http://dementiacarenotes.in/dementia/demen¬tiaindia-2015-info
17. Nulkar A, Paralikar V, Juvekar S. Dementia in India – A call for action. J Glob Health Rep 2019; 3:e2019078.
18. https://www.alzheimers.org.uk/about-dementia/symptoms-and-diagnosis/how-dementia-progresses/ normal- ageing-vs-dementia
19. https://alzheimer.ca/en/about-dementia/how-cani-prevent-dementia/brain-healthy-tips-reduce-yourrisk-dementia
20. https://www.alz.org/national/documents/aa_brochure_10warnsigns.pdf