Updated: May 21
I just returned from presenting at the wonderful 2023 International Reflexology Conference in Ottawa where the lovely participants made me feel very welcome. It was the first time I taught reflexology therapists about dementia and how we can make a difference and improve the lives of those living with memory loss. I was truly touched by the reaction and appreciation of our work by the participants and am looking forward to working with more reflexology therapists. I’d like to share with you today the info from the first part of my presentation – an introduction to understanding what dementia is.
Our Aging Brain
There are many age-related changes that happen to us as we get older:
Our skin may become thinner and is less elastic causing wrinkles and sagging.
We may experience graying or thinning hair
We may have changes in vision.
Our hormone levels change, which leads to menopause
There is increased inflammation in our bodies known as inflamm-aging which can cause more aches and pain
👉🏽 And there are changes in the brain that can lead to a decline in cognitive function.
You may be surprised to learn that our brain cells, also known as neurons, start to deteriorate in early adulthood and may show signs of age-related decline starting in the mid-20s to early 30s!
Research has shown that some brain regions, such as the prefrontal cortex, hippocampus, and basal ganglia, are particularly susceptible to age-related decline. These regions are involved in cognitive processes such as memory, attention, and decision-making, which can be affected by aging.
There are, however, several ways to potentially slow the process of age-related decline of brain neurons, some of which we have shared in previous blog posts, that include:
Exercising regularly - Exercise for Brain Health
Getting enough sleep - Sleep Well for Briain Health
Learning coping mechanisms - The Importance of Coping
Is Memory Loss with Age Normal?
We often joke about having a “senior moment” when we have a temporary lapse in memory or mental processing that is commonly associated with aging, but when is forgetting something or being confused more than just a senior moment? What is normal memory loss with age? When should it cause concern?
Normal memory loss is:
Does not interfere with daily life.
Typically involves minor changes in memory, such as occasional forgetfulness or difficulty recalling names or words
Can be managed with lifestyle changes and memory aids such as writing things down or using a calendar.
Abnormal Memory Loss
Persistent decline in cognitive function and memory
Includes difficulty completing familiar tasks, getting lost in familiar places, or having trouble with language or communication.
What is Dementia?
Dementia is not a specific disease or condition.
Dementia is diagnosed when cognitive functioning interferes with daily life and independence.
Executive function refers to a set of cognitive skills that are involved in planning, organizing, initiating, and completing tasks. Some basic examples of daily living activities that need executive function are:
Being able to get dressed
Being able to make a cup of coffee or a meal
Being able to go shopping
When memory loss and disorientation affect executive function, then it is considered dementia.
Dementia is an umbrella term for many different types of conditions that affect cognitive function, just like Cancer is an umbrella term for many types of cancers.
Types of Dementia
There are many conditions that can cause dementia. These are the 4 most common conditions:
Alzheimer’s Type Dementia
This is the most common type of progressive dementia, accounting for 60-80% of cases. Alzheimer’s Type Dementia comes on slowly, over time. It is characterized by the presence of amyloid plaques and tau tangles in the brain, which can only be definitively diagnosed through examination of brain tissue after death. However, some people can have the same plaques and tangles in their brain, but do not show signs of having dementia while alive.
Ronald Reagan and Margaret Thatcher both had this type of dementia. Vascular Dementia
Vascular Dementia is due to damage to the blood vessels that supply blood to the brain. This type of dementia can cause strokes or mini strokes. Often mini strokes go unnoticed, but in time they can cause dementia. The onset of symptoms can be sudden or gradual, depending on the underlying cause. Vascular dementia can also affect different areas of the brain, depending on which blood vessels are affected
Just like a change in lifestyle may prevent heart disease, lifestyle changes such as lowering blood pressure and cholesterol may prevent this type of dementia, Please be aware that sleep apnea, a condition where breathing stops while sleeping, can cause vascular dementia! If you or someone you know snores, wakes up tired after a good night’s sleep or wakes up with headaches, please get checked! You can read more in this blog post: The Dementia you Can Prevent
However, it is worth noting that like other conditions, not all cases of vascular dementia are preventable, and that other factors, such as age and genetics, can also play a role in its development.
Lewy Body Dementia (LBD)
You may not have heard about Lewy Body Dementia, but LBD is the second most common cause of progressive dementia, after Alzheimer's disease. It is characterized by the presence of abnormal protein deposits in the brain called Lewy bodies.
Both Lewy Body Dementia and Parkinson's Disease are considered Lewy Body Diseases, and the location of the Lewy body deposits in the brain can determine whether an individual develops LBD or Parkinson's disease.
People with this condition tend to be more cognitively intact. Symptoms of LBD may include hallucinations, delusions, sleep disturbances, and physical symptoms like those seen in Parkinson's disease. While the onset of symptoms can be gradual, LBD can often be misdiagnosed or underdiagnosed, with some estimates suggesting that up to 80% of cases are misdiagnosed.
Robin Williams was misdiagnosed as having Parkinson's disease, and his family believes that this may have been detrimental to his health. Since his death, his family has been a strong advocate for raising awareness of LBD and supporting research efforts to better understand and treat the disease.
Frontotemporal Dementia (FTD)
Frontotemporal Dementia affects the frontal and temporal lobes of the brain. These areas control personality, language, and behavior.
People with this type of dementia may have trouble finding the word they want or may replace words with other words.
Bruce Willis who was has aphasia, a language disorder that affects a person's ability to communicate, was diagnosed with Frontotemporal Dementia.
How Does Dementia Affect Memories?
Dementia can have a significant impact on a person's memories. To understand this better, we can use the Bookcase Analogy. Imagine memories as books on a shelf, with recent memories on the top shelf and older ones on the bottom. When dementia affects the brain, it shakes the bookcase, causing the most recent memories to fall out. As a result, a person's memories become limited to those from the more distant past, which may now seem like their most recent memories.
For example, a person with dementia may only remember their children as they were 30 or more years ago, when they were young. This can make it difficult for them to recognize their adult children and lead them to expect to see them as young children or youths. This can be a challenging situation for the family member, but understanding what is happening in their parent's brain can make it easier to accept that their parent still loves them, even if they cannot comprehend that their child is now an adult. We previously covered this topic in a blog post about parents not recognizing their children, which provides more insight into this phenomenon and how to deal with it.
Dementia Strengthens Emotions
As cognitive abilities decline in someone with dementia, their emotions and feelings often become more prominent. Although they may not be able to recognize or remember you by name, they can still feel the emotional connection they have with you.
If we imagine our emotional connections in the bookcase analogy, this bookcase is sturdy and the books with our emotions don't disappear when dementia rocks the bookcase.
A person with dementia may forget who visited them, but they will always remember how they felt during the visit. These feelings remain with them even after the visit ends.
In fact, people with dementia have explained that they may not recognize someone they have met before, but they will remember how that person made them feel.
So, it's important not to give up on someone living with dementia and to continue visiting them, even if the person no longer remembers who you are. They still need you and will feel the love and comfort you bring.
As a person's cognitive abilities decline, they may develop a greater capacity to connect with others on an emotional level. This is similar to how individuals compensate for the decline of one sense by using another sense more.
When someone has dementia, they may become more sensitive to the people around them. They are better able to tell who genuinely cares about them and who is only pretending to care. This can sometimes lead to confusing or unexpected behavior. For instance, if a staff member at a care facility greets a person with dementia with a smile and says, "How are you, sweetie?", but doesn't like them, the person with dementia may sense this and become angry. This can make it appear as if the person with dementia is being aggressive, when in reality, they are reacting to the staff member's true feelings.
Always be honest so you can build a trusting relationship.
Dementia is diagnosed when it affects activities of daily living.
Dementia is an umbrella term for many types of dementia.
People with dementia's recent memories disappear first.
People with dementia's feelings and emotions don't disappear.
People with dementia often have a greater capacity to connect with others on an emotional level.
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Hands-On Dementia for Caregivers
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