My friend’s mother died last week. She had suffered from dementia for 5 years and in these years , family life had come to a halt. She was violent and scared. On good days she was a child and talked to her long dead father. On bad days , she accused her daughter in law who looked after her devotedly of all sorts of crimes, threw things, beat off people, packed her clothes three times a day and boarded imaginary planes. She was in and out of hospital as she broke limbs, got bedsores and high blood pressure. Everyone was relieved for her when she died because it had been 5 years of enormous suffering,
My aunt has just entered the first phase of dementia. She is 84. She remembers only her teenage years and her school teachers . All of us have disappeared from her memory and so has her daughter with whom she lives. She alternates between beatific vagueness and hostile suspicion.
The older you get, the higher your risk of developing dementia. Dementia is widely recognised as a major medical, social and economic problem in developed countries where the over 65s account for an increasingly high percentage of the population. Unfortunately dementia is now becoming a major problem in developing countries where it did not exist 50 years ago. More than 50 million people have dementia and the most common cause of this dementia is Alzheimer's disease. By 2025 this figure is expected to double with 71 per cent of these likely to live in developing countries, making the need for prevention of an incurable disease crucial. Most populations are getting older . In U.K 20% of the population is 65 and older. By 2025 25% of people in Canada will be 65 years or older. 8% of all Western populations are currently affected by moderate to severe dementia
— a collection of symptoms that significantly impair thinking, normal activities and relationships — and 10-15% have mild, early and borderline demented states.
There are several forms of dementia. They include:
Alzheimer's disease is the most common cause of dementia in people 65 and older. Nearly all brain functions, including memory, movement, language, judgment, behaviour, and abstract thinking, are affected. To give you an idea of figures, one in 20 Americans have Alzheimer's. The number rises to one in four over age 85.
Binswanger's disease is dementia characterized by damage to small blood vessels in the brain as a result of hardening of the arteries to the brain. Creutzfeldt-Jakob disease — the human form of mad cow disease — is a degenerative, fatal brain disorder that is linked to an abnormal form of a protein called a prion found in contaminated meat. CJD kills an average of one person in a million every year. Dementia pugilistica is caused by head trauma. Other dementias are HIV-associated dementia, frontotemporal dementia which is characterized by degeneration of nerve cells in the frontal and temporal lobes of the brain, Huntington's disease which is a degenerative hereditary disorder , Lewy body dementia which accounts for about 20 per cent of all dementia cases and is characterized by the presence of abnormal structures called Lewy bodies in the brain and vascular dementia caused by several small unnoticed strokes in the brain.
Dementia is characterized by confusion and intellectual impairment. The symptoms include loss of memory, judgment and reasoning, changes in behaviour and communication abilities. Mood swings, depression, irritability, and trouble learning new things, making a decision or remembering facts. One in five people with dementia will become aggressive and can pose a danger to himself or herself or the people he or she lives with. There is no cure only a progression of symptoms.
Understandably, the scientists are worried and studies are being done all over the world to find a reason and thereby a way to prevent the onset of symptoms. Diet is one factor researchers are investigating for its role in reducing the risk of dementia . One of the most important studies, running into millions of dollars, has been done by the Department of Preventive Medicine, Looma Linda University, CA called the Adventist Health Study. They looked into the incidence of dementia and intake of animal products and these were their findings :
”We investigated the relationship between animal product consumption and evidence of dementia in two studies. The first enrolled 272 California residents matched for age, sex, and zip code and a wide range of dietary exposure. The second included 2,984 subjects who resided within the Loma Linda, California area. The matched subjects who ate meat (including poultry and fish) were more than twice as likely to become demented as their vegetarian counterparts and the discrepancy was further widened depending on the number of years of past meat consumption. There was a trend towards delayed onset of dementia in vegetarians in both substudies. “
According to the Physicians Group for Responsible Medicine(PCRM) in the USA statement in 2004, a number of dietary and lifestyle factors have been associated with an increased risk of developing dementia. These include the eating of high levels of cholesterol and saturated fats . Both found only in meat and hydrogenated vegetable oils. Cholesterol aids the production of beta-amyloid protein, which is one of the chemicals thought to cause damage to the brain in Alzheimer's disease. High levels of cholesterol also increase the risk of developing conditions such as heart disease and stroke that are linked to increased risk of dementia.
People with a diet of unsaturated, unhydrogenated fats and low cholesterol foods decrease their risk. of developing Alzheimer's disease as well as reducing the risk of obesity, cardiovascular disease and diabetes. PCRM advises that foods high in cholesterol should be avoided; these include meat fat, full fat dairy products, and processed foods such as cakes and biscuits.
Foods that are thought to reduce the risk of heart disease and stroke and that have been researched for their benefits to brain health are as follows:
* monounsaturated and polyunsaturated fats ,oils such as olive oil ,avocados ,olives, nuts and seeds
*Antioxidants mop up destructive chemical molecules in the body known as free radicals. Free radicals may be one of the causes of brain cell death in Alzheimer's disease. Fruits and vegetables are sources of antioxidants with the highest concentrations found in the most deeply or brightly coloured. Foods rich in antioxidants (from the richest onwards are prunes, raisins, blueberries, other berries, spinach, brussel sprouts, plums, broccoli, beetroot, avocados, oranges, red grapes red capsicums, cherries, kiwifruit, onions, corn, eggplant, tea, red wine (no more than 1-2 glasses a day, only three days a week) Green leafy vegetables such as lettuce and cauliflower may reduce the risk of dementia and promote retention of mental agility.
* Vitamin B3 (niacin) found in cereals, may have a role to play in reducing a decline in mental agility.
*Vitamin B12 is important for maximising brain function . Vitamin B12 deficiencies have been associated with dementia and low dose oral supplements may help reduce the risk of dementia. Foods rich in Vitamin B12 include nutritional yeast, soya, fermented foods, some seaweed products, and modified breakfast cereals.
*Beans, legumes and peanuts are rich in vitamins and minerals, folate, omega-3 fatty acids and antioxidants. Tomatoes contain an antioxidant called lycopene, which reduces the oxidation of 'bad' cholesterol, and could in turn reduce the risk of clogged arteries and heart disease and strokes. .
Folic acid (folate) is used in the production of energy, cell division and the formation of red blood cells. It is essential for brain function. Food sources for folic acid include oranges, bananas, melons, strawberries, avocados, spinach, corn, broccoli, cabbage, cauliflower, pumpkin, sweet potato, whole grain cereals and oats, peanuts and soya. Deficiency has been associated with dementia
At the Ninth Annual Conference on Alzheimer’s Disease and Related Disorders, Harvard researchers discussed the role that fruits and vegetables play in dementia. Jae Hee Kang, and colleagues evaluated 13,000 participants in the Nurses Health Study. They calculated the women's intake of fruits and vegetables between 1984 and 1995 and correlated these values with performance on tests of cognitive function conducted between 1995 and 2003, when the women were in their 70s. Women with the highest consumption of green leafy vegetables and cruciferous vegetables declined less than women who ate little of these vegetables.
How do you want to grow old ? At home with your grandchildren or in a home with other patients of dementia ? You make the choice with every meal you eat.
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