Mr. G., 76 years old, a retired chemical engineer, started misplacing things like his keys or wallet and having difficulty remembering where these went. Relatives also noted he was frequently repeating stories or questions he already asked or said a few minutes before. He also started to become more irritable to those around him, especially when they tend to remind him of things. There was a time when he had to call from a gasoline station several miles away, asking to be brought back home since he could not remember the route back. As the months went by, he had become increasingly paranoid, blaming his maids of stealing from him. Eventually after about four years since all the problems started, he was brought to the hospital for progressive weight loss, necessitating tube feeding.
The given scenario is a common situation that goes undiagnosed among the older persons. The signs or symptoms and duration may vary but the underlying problem is memory deterioration. The latter can be a manifestation of dementia, which is defined as progressive and irreversible memory deterioration accompanied by disorders in language, action, decision-making, or other intellectual abilities, leading to functional decline and behavioral problems.
The majority of cases of dementia are caused by Alzheimer’s disease. In this disease, substances called amyloid plaques and neurofibrillary tangles appear in the brain, particularly the hippocampus in the temporal lobe of the brain (the seat of memory). As the disease progresses, the damage eventually involves other parts of the brain, like those responsible for rational thinking and mood. In the severe stages of the disease, parts of the brain involved in sleep and other vital functions are eventually affected. Other causes of dementia include damage to the brain from small or large strokes (vascular dementia), neurological diseases like Parkinson’s disease, and other less common neurodegenerative diseases. Age is the most important risk factor; the older you get, the higher the risk. This is different from saying that dementia is a normal finding in aging; many older people are still able to function properly even as they age. Other risk factors include high cholesterol levels, hypertension, previous head trauma, and diabetes.