World Alzheimer’s Day, observed recently on September 21st, underscores the widespread effects of dementia across the globe. This initiative seeks to challenge the stigmas associated with these conditions, which affect over 55 million people worldwide.
Closer to home, the statistics are equally concerning. Studies suggest that roughly one in ten Singaporeans aged 60 and above are affected by dementia, a figure highlighted by a 2015 study from the Institute of Mental Health.
And as Singapore progresses towards becoming a “super-aged” society—a status projected to be achieved by 2026 when over 21% of the population will be older than 65—the need to understand the various causes of dementia becomes increasingly crucial so that we can better support our elders.
What Are the 4 Main Types of Dementia
While many people are familiar with the memory loss often associated with dementia, it’s important to remember that it manifests in various forms. Each type presents its own unique set of challenges, impacting memory, thinking, personality, and behaviour in different ways.
Here’s an overview of the main types of causes:
- Alzheimer’s Disease: Representing the majority of dementia cases, Alzheimer’s is marked by a progressive decline in cognitive function due to the deterioration of brain cells. This degeneration is linked to the accumulation of abnormal proteins that disrupt cell function. Common early signs include memory lapses, difficulty with planning and performing familiar tasks, language problems, and changes in mood and behaviour.
- Vascular Dementia: This type of dementia arises when the brain’s blood supply is compromised, often due to damaged or narrowed blood vessels. This lack of oxygen and nutrients starves brain cells, impacting cognitive function and decision-making abilities. And unlike Alzheimer’s, which generally starts with memory issues, vascular dementia may begin with problems in decision-making or planning. Symptoms can vary widely but typically include confusion, difficulty concentrating, and reduced ability to organise thoughts or actions. Physical symptoms such as unsteady gait or urgent bladder issues may also be present.
- Dementia with Lewy Bodies: Characterised by the presence of abnormal deposits of the protein in the brain, known as Lewy bodies, this type of dementia includes symptoms such as vivid visual hallucinations, fluctuating alertness, and motor issues similar to those of Parkinson’s disease. These symptoms are often accompanied by sleep disturbances and may impact daily activities.
- Frontotemporal Dementia: This particular form of dementia affects the frontal and temporal regions of the brain, which are crucial for controlling language, behaviour, and emotion. Often occurring at a younger age than other dementias, it is characterised by marked personality changes, inappropriate social behaviour, and difficulty in finding the right words during conversations. Over time, individuals may also face challenges with motor functions.
Other Less Common Types of Dementia:
- Alcohol-Related Dementia: Often linked to prolonged alcohol misuse, this form of dementia stems from a critical shortage of vitamin B1 (thiamine), which is vital for brain health. The deficiency leads to serious brain function impairments that affect memory, coordination, and emotional responses.
- Mixed Dementia: This type involves symptoms of more than one type of dementia simultaneously. Often, it includes characteristics of both Alzheimer’s disease and vascular dementia, making it a complex condition to manage. The overlapping symptoms can accelerate cognitive decline and complicate diagnosis and treatment.
Causes of Dementia from a Modern Medical Perspective
Aside from the noticeable signs of dementia in the elderly, it’s essential to delve deeper into what actually causes this condition.
At its core, dementia arises from damage to brain cells or the connections between them, which disrupts the normal communication between different parts of the brain. Depending on which area is affected, this can lead to varying symptoms.
Several factors can trigger this damage, and they are often grouped based on commonalities, such as the type of protein deposits that accumulate in the brain or which parts of the brain are impacted.
Other factors that contribute to dementia include vascular conditions like heart disease, stroke, or blood clots that reduce the brain’s supply of oxygen and essential nutrients. Beyond blood flow issues, other culprits include deficiencies in vitamins or side effects from medications.
Causes of Dementia from a Traditional Chinese Medicine (TCM) Perspective
While Western medicine focuses on the physical changes and aspects of the brain, Traditional Chinese Medicine (TCM) offers a unique and holistic perspective on dementia, emphasising harmony and balance within the body.
For instance, TCM posits that dementia arises not just from the physical changes within the brain but also from disruptions to the body’s vital energies.
Consider these causes of dementia from a TCM perspective:
- Lack of Brain Marrow and Nourishment: According to TCM, the brain relies on a substance similar to bone marrow, known as “brain marrow,” for its functioning. Ageing or chronic illnesses may deplete this essential marrow, leading to a decline in mental functions like memory and cognition.
- Qi and Blood Deficiency: In TCM, the heart and the brain are closely linked, with the heart playing a pivotal role in mental clarity and emotional stability. A deficiency in Qi (vital energy) and blood can result from prolonged illness or a weakened digestive system, impairing the flow of these essential substances to the brain. This can manifest as emotional disturbances, confusion, or other cognitive impairments.
- Kidney Essence Deficiency: The kidneys are believed to store “essence” which nourishes the brain. Over time, factors like ageing and illness can deplete this essence, which is crucial for brain health and cognitive function. A deficiency here can lead to symptoms commonly associated with dementia, such as forgetfulness and diminished mental agility.
- Blood Stasis and Phlegm Accumulation: In TCM, clear pathways are essential for the flow of Qi and blood throughout the body. Blood stasis and the accumulation of phlegm can obstruct these pathways to the brain, potentially leading to cognitive decline. Over time, this stagnation can also cause “heat” or “fire” within the body, further disrupting brain function.
How to Keep Alzheimer’s at Bay
So, naturally, the question arises: what can we do to reduce the risk of dementia?
In Singapore, where the concern for dementia treatment is growing alongside an ageing population, adopting preventative measures is crucial. Here are practical steps to help fend off dementia:
- Stay Physically Active: Engage in both aerobic and resistance exercises for around 150 minutes weekly at moderate intensity.
- Eat Healthily: Aim for at least five servings of fruits and vegetables each day, along with protein-rich foods twice a week. Moderate your intake of sugars, salts, and saturated fats, and ensure you stay hydrated with 6–8 glasses of water daily.
- Quit Smoking and Limit Alcohol: If you smoke, getting help to stop is crucial. Also, keep alcohol consumption moderate.
- Keep Your Mind Active: Challenge your brain regularly by learning new skills, engaging in puzzles, reading, writing, or maintaining an active social life.
From a TCM viewpoint, nurturing your body’s balance and vitality is paramount. TCM practitioners at Chinese medical centres may recommend herbal remedies, Chinese acupuncture, and dietary adjustments to support brain health and address any underlying imbalances that could contribute to cognitive decline. It’s also crucial to manage stress and cultivate emotional well-being, as these factors can impact overall health, including brain function.
For those in Singapore seeking to understand more about dementia treatment options or looking for support in managing signs of dementia in the elderly, consulting with healthcare providers can offer guidance tailored to individual needs.
