Dementia and Normal Ageing
Old age comes with quite a number of complications and change of behavior as well as physical changes. On the other hand, dementia also comes in with several symptoms that are closely related or similar to those displayed by people in old age. This makes it quite tricky for the family members of an ageing individual to tell whether the person is undergoing normal ageing or has been affected by dementia. This is made even harder to tell apart by the fact that dementia is more frequent among people of old age than the young people. The research paper looks at the two aspects and strives to contrast the two taking into account the biological, psychological, physiological as well as the sociological perspectives towards the two concepts.
Normal ageing
As we advance in years, the body gives way to several other signs that we did not have previously and these come at different rates for each person. It is indicated that the rate of ageing and the rate of the symptoms depends on genetics as well as the lifestyle that an individual used to live and/or lives in.
There are several symptoms that are expected to set in as an individual slides into the old age bracket as depicted below by Alistair B & Michael Z, (2002:2):
There are physiological signs that can be seen on looking at the person like the less elastic skin, slowing of fingernails growth and dryness of the skin. The hair turns grey and they develop scalp, there could also be change of height by losing as much as 5 cm through compression of joints and change in posture. There could develop hearing difficulties as well as change in tone and fluency in speech. Most of the ageing people will also develop presbyopia which is the need for reading lenses that sets in mainly at the age of 40s and above. Night vision may also set in accompanied by decline in visual sharpness and fear of glare (Rawan T & David M., 2012:2).
It is also noted that there could be change in sleeping patterns where the person will most likely sleep less during the night and not as deeply as the previous younger years. They are also prone to waking up early in the morning and also waking up haphazardly at night.
Old age also comes with natural bone loss where the bones get less dense and lose strength. This is due to the fact that in the course of adulthood, people lose some of the minerals in the bones consequently leading to weaker bones in old age. It is said that this condition known as osteoporosis can be slowed by regular weight bearing activities for instance walking, avoiding foods and drinks/smoking that will weaken bones and taking enough calcium and vitamin D
There are as well some internal changes in the body mechanism like slowing in the metabolism, the heart becomes generally less efficient with age hence slowing circulation particularly during heavy activities, the lung may also become less active hence depriving the body of oxygen particularly among inactive people. The kidneys are also noted to decline in size and function as the person ages. The ageing person can also display urinary incontinence as well as lesser sexual drive particularly among women after menopause.
However, despite the above, the most crucial in this case is the nervous system as the person ages. It is noted that in the third decade of an individual, there is a general decrease in the weight of the brain as well as the size of the nervous network on the brain. This is occasioned by lesser flow of blood within the brain. The best part is that as the person ages, the brain adapts to these changes within the brain and develops new patterns in the nerve endings. The memory changes are deemed part of normal ageing hence very much expected and at this stage, these people are expected to have less recall power of the very recent memories to a wider extent be slower in remembering details and names that it was during the younger years.
Such loss of brain activities can however be revived and revitalized regularly by constantly engaging in social activities, the person can also challenge oneself to do and learn new things. Being physically active is also part of the revival process as it helps increase the flow of blood within the brain.
At old age, the information processing generally slackens and they cannot multitask and it is noted that they develop a lot of variability in cognitive functions, it is quite normal to fins the older people beating the younger generation in their knowledge of the world in general.
Dementia and old age
It is true that each person will lose memory as noted above once the old age catches up with them. There is need therefore to have differences between normal loss of memory and the problem of dementia or Alzheimer among the aging people.
Of significance from the onset is to realize that dementia is not normal aging. Dementia comes with complications such as Alzheimer where the aging person develops cognitive problems due to the change in the brain functions. It is excusable for many to take it that old age and dementia are the same thing since it is one of the most predominant and conspicuous conditions that old people generate more than any other. In a research conducted by Barry W. Roney et.al (2005) they found out that of the 454 old people they observed in nursing homes, 67.4% of them had dementia as the psychiatric condition disturbing them.
There is a general agreement Alzheimer is caused by accumulation of toxic protein known as apolipoprotein E (ApoE)-4 allele within the brain (National Institute of Health, 2012). Heijer T. et al. (2012) further indicate that people with this type of protein are commonly associated with lower hippocampal volumes, which is a predisposing factor to early signs of dementia as well as Alzheimer’s disease. A research to solidify this stand was conducted on 80 persons of old age and it was discovered that over 32.6 months duration, 27 of the 80 old persons who suffered mild cognitive impairment (MCI) due to hippocampal atrophy, progressed to the Alzheimer’s Disease type of Dementia as reported by Pieter J. Visser et.al, (1999:478).
There is further indication that the onset of the condition can be of early onset (at the age between 30 and 60) but most commonly is the late onset coming at the age of 60 years and after (Sonia M. Rosso, et.al, 2003). Old age is not caused by this toxic protein and cannot have an early onset hence the clear deference between the two aspects.
The most significant way of telling the difference between normal aging and the onset of dementia is through looking at the symptoms and the daily social manifestations of both. According to Kevin R. & Anna M., (2007), there are varied symptoms that are distinct to dementia as noted below interchangeably with Alzheimer:
One of the most common symptoms noted among people with dementia is difficulty in remembering details and particularly new information that they have just come across for instance and appointment they have just made. This is different among the ageing people since in as much as they may forget some details, they will remember later on that actually they had forgotten which is not the case with dementia patients. These people will forget some piece of information and the piece of information does not come back at all, even if someone reminded them of the information, it will sound new to them.
It is also significant to note that the dementia cases will cause the person to suffer cognitive impairment as opposed to normal ageing which may be occasioned by loss of memory (Toshioki M. et.al, 2012:11). In the case of cognitive impairment, the person may for instance forget how to do some things like he may forget how to pay his bills, yet the old age case the person will forget to pay buy will still know how to pay and the entire process if reminded that they had not paid their bills.
The other symptom is developing sudden difficulty in completing tasks which hitherto they could easily accomplish such as driving to the grocery store that they had been driving to for the last 20 years. This is a different scenario from normal ageing where the person will still recall which way to follow only that they may need help in driving there due to traffic or strain of driving.
People with dementia will also portray difficulty with words where they will be seen to stop in the middle of a conversation or repeating the same thing over and over as well as calling an object by a wrong name, this is different from the normal aging where the person will occasionally have a problem in recalling what they want to say but will not be as frequent as dementia patient and they will not switch words.
In dementia cases, the person may misplace an item and not be able to trace it later on and not even be able to know that the object that they misplaced was theirs or that they need it. A good example is one losing the reading glasses and not even recalling that they need lenses to read, this does not happen with normal aging where the person can lose the glasses but will recall that they need them and retrace their steps to where they misplaced the glasses.
People with dementia will display inability to judge distance or to estimate heights. They may perceive a rung of a ladder or step of a stair to be much higher than it actually is. They also have a tendency of imagining that someone else is in the room if they happen to pass by a mirror. On the other hand, someone aging normally may just have challenges in seeing due to presence of cataracts. The people with dementia can also display various disorientations including the loss of sense of time as well as place. He may not know the time of the day and even not recognize a place they have been for a good number of years before the onset of the condition. There is possibility of the persons changing their personality with the onset of the condition or regularly acting out of character. They can be too careful, suspicious and confused at times.
Sadly there is no known cure for this condition and once it sets in at the old age, there is likelihood that the person will live with it till death as noted by Guo S. (2012) in the International Journal of Alzheimer’s Disease. The best that can be done is so be aware of the condition through regular diagnosis then to get the right handling of the person and help that is appropriate to the individual.
References
Barry W. Roney et.al (2005). The Prevalence and Management of Dementia and Other
Psychiatric Disorders in Nursing Homes. International Psychogeriatrics-Cambridge Journals. Vol.2 Issue 1. Retrieved October 14, 2012 from http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=271878
Pieter J. Visser et.al, (1999:2). Medial temporal lobe atrophy and memory dysfunction as predictors for dementia in subjects with mild cognitive impairment. J Neurol. Vol.245. Pp478
Guo S. At al., (2012). Florbetaben PET in the Early Diagnosis of Alzheimer’s Disease: A
Discrete Event Simulation to Explore Its Potential Value and Key Data Gaps. International Journal of Alzheimer’s Disease. Pp4. Retrieved October 14, 2012 from http://www.hindawi.com/journals/ijad/aip/548157/
Heijer T. et al., (2012). Vascular risk factors, apolipoprotein E, and hippocampal decline on magnetic resonance imaging over a 10-year follow-up. Retrieved October 14, 2012 from http://www.alzheimersanddementia.com/article/S1552-5260%2811%2902716-6/abstract
Kevin R. & Anna M., (2007). Dementia syndromes: evaluation and treatment. National Institute of Health: Expert Rev Neurother. Vol.7 Issue 4. Pp 407-422
National Institute of Health, (2012). Alzheimer’s Disease Genetics fact Sheet. National Institutes of Health: National institute of aging. Retrieved October 13, 2012 from http://www.nia.nih.gov/alzheimers/publication/alzheimers-disease-genetics-fact-sheet
Rawan T & David M., (2012). The Clinical Problem of Symptomatic Alzheimer Disease and Mild Cognitive Impairment. Cold Spring Harbor Laboratory Press. Pp2.
Alistair B & Michael Z, (2002). Mild Cognitive Impairment in Older People. The Lancet.
Vol.360.Pp2
Sonia M. Rosso, et.al, (2003). Frontotemporal dementia in The Netherlands: patient characteristics and prevalence estimates from a population-based study. Oxford Journals: A Journal of Neurology. Vol.126, Issue 9. Retrieved October 14, 2012 from http://brain.oxfordjournals.org/content/126/9/2016.short
Toshioki M. et.al, (2012). A Warning Index Used in Prescreening for Alzheimer’s Disease,
Based on Self-reported Cognitive Deficits and Vascular Risk Factors for Dementia in Elderly Patients with Type 2 Diabetes. International Journal of Alzheimer’s Disease.Pp11. Retrieved October 14, 2012 from http://www.hindawi.com/journals/ijad/aip/124215/
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