A friend from school once shared with me how her grandmother has dementia, and how it has been a terrible experience. She (the grandmother) struggles to remember them sometimes, and even forgets who she is. Caring for her is a really tough challenge for the family, and when I asked if there is a cure for this illness, she told me there is none.  The only thing they can and still do for her grandmother is take care of her and give her other medications, and hope she will rest one day, as she describes the disease as a nightmare.

According to Mayo Clinic, dementia is a term used to describe a group of symptoms affecting memory, thinking, and social abilities severely enough to interfere with one’s daily life. It isn’t a specific disease, but several diseases can cause dementia. All memory losses are not caused by dementia, there are a lot of other factors that can cause memory loss, although memory loss is also an early sign of dementia. Dementia is a brain disorder that slowly destroys memory and thinking capacity and eventually, the ability to carry out even the simplest tasks.

Dr Bizoza Rutakayire, a psychiatrist and psychotherapist at Caraes Ndera Neuropsychiatric Hospital, says that Alzheimer’s is the most common cause of dementia in people 65 years old and above, however, there are no statistics are available in Rwanda for those who have dementia.

"Alzheimer’s disease is progressive, and there is currently no cure, it is generally known to be a disease of the ageing, the dementia syndrome is a disturbance of superior functions and disassociating alteration of memory, and alteration of at least one cognitive function, like language,” he says.

Causes

Mayo Clinic states that Alzheimer’s disease is the most common cause of progressive dementia in older adults, but there are a number of other causes of dementia. Depending on the cause, some dementia symptoms might be reversible.

Yvonne Uwamahoro, a psychologist at Mental Health Hub Rwanda, says that various risk factors can cause dementia.

"Damage to or loss of nerve cells and their connections in the brain can also be a cause, many factors can contribute to dementia, like:

• Age; the risk increases as we age

• Family history; family members who had dementia can put you at risk too.

• Excessive alcohol use; consumption of too much alcohol can cause brain changes and lead to early-onset dementia. 

Bizoza says that lack of exercise increases the risk of dementia and, the same happens with consuming unhealthy food. Chronic diseases such as hypertension and diabetes, or smoking, head trauma from an accident, and air pollution can all increase the risk of dementia. According to Bizoza, there are two types of dementia; degenerative dementia, and non-degenerative dementia—among the causes of degenerative dementia is Alzheimer’s disease. There is progressive dementia that isn’t reversible, these include:

• Alzheimer’s disease 

Although not all causes of Alzheimer’s disease are known, experts do know that a small percentage are related to mutations of three genes, which can be passed down from parent to child. 

• Vascular dementia 

This type of dementia is caused by damage to the vessels that supply blood to the brain. Blood vessel problems can cause strokes or affect the brain in other ways, by damaging the fibres in the white matter of the brain.

• Lewy body dementia 

Lewy bodies are abnormal balloon-like clumps of protein that have been found in the brains of people with Lewy body dementia, Alzheimer’s disease, and Parkinson’s disease. This is one of the more common types of progressive dementia.

Dementia-like conditions that can be reversed according to Mayo Clinic are:

• Infections and immune disorders. Dementia-like symptoms can result from fever or other side effects of your body’s attempt to fight off an infection.

• Metabolic problems and endocrine abnormalities. People with thyroid problems, low blood sugar (hypoglycaemia), too little or too much sodium or calcium, or problems absorbing vitamin B-12 can develop dementia-like symptoms or other personality changes.

• Nutritional deficiencies. Not drinking enough liquids (dehydration); not getting enough thiamine (vitamin B-1), which is common in people with chronic alcoholism; and not getting enough vitamins B-6 and B-12 in your diet can cause dementia-like symptoms.

Symptoms of dementia

Mental changes

• Memory loss

• Difficulty  communicating  or finding words

• Difficulty with visual and mental abilities such as getting lost while driving

• Difficulty reasoning and problem-solving

• Confusion and disorientation

Psychological changes

• Depression

• Anxiety

Personality changes

• Inappropriate behaviour

• Agitation

• Hallucinations

• Paranoia

How to help a person with dementia

‘Meals on Wheels’, a social service organisation in an article, suggest that if you or a loved one believe you may be experiencing dementia, it is important to not ignore the signs. While Alzheimer’s is the most common cause of dementia, there are other causes that may be reversible. Additionally, resources such as support groups, caregiving, and therapy may be available. 

”Seek help as soon as you notice memory problems or other symptoms of dementia; keep those who have dementia active; engage them in mentally stimulating activities and, involve them in social and physical activities,” Uwamahoro advises.