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Medicine & Health Education
The Story of Dementia
Creating an Understanding of the Diseases and
Lifestyle modifications for Health and True Happiness
Bala N. Aiyer, M.D.
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Understanding Dementia - Steps to Prevent
 
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Some Simple Steps to Uplift the Physical, Mental and Spiritual Health
 
 
Problems of Dementia - Prevention, Control and Management
 

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"Dementia" in the age groups of 60's and 70's are rarely due to Alzheimer's, though often gets mislabeled and it is rare in India and among Indians. Alzheimer's often occurs at an younger age and is due to a protein deposit in the brain cells. So, let us analyze the other common cause of Dementia. Some of them are often called Vascular Dementia or Multi-infarct Dementia, referring to circulation problems in small blood vessels of the Brain. Please read various causes that need to be investigated and the last paragraph of this article to see if there is a definitive cure and improvement of the condition instead of just looking for rehabilitations only. Neurological and vascular problems that occur due to aging process, metabolic syndromes like diabetes, hypertension and lipid disorders and many genetic defects can be corrected and reversed well with proper nutritional supplements and antioxidants.

Let us first analyze the causes of Dementia and loss of memory in our (Seniors) age groups. When we forget where we parked our car in a parking garage, when we came in our car that is just memory loss due to our age or our busy work. But if you are searching for your car [that you drove years back] when came by a taxi or bus [and we don't drive anymore], then that is dementia. Our brain is made up of lots of Fat and Cholesterol, and needs constant blood circulation to every area, with constant supply of Oxygen and Glucose. With low oxygen, when I lived in Ladakh at altitudes above 15,000 feet, I noted that my comprehension and memory were poor and I get tired on reading even 10 or 20 pages of any technical book or science fictions as much as we get after strenuous exercise. This will give you an idea of what I am talking about.

 

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1. If you have diabetes, taking Insulin or Sulfanylurea medicines, you need to watch out for early morning Hypoglycemia that can occur at about 4AM and then get a reactive hyperglycemia. So, sugar test in morning will be normal or high. Many are suggested to take very long acting Insulin, Glargine etc. at bed time. If, instead, NPH Insulin at bed time is taken, it peaks in action at 3 AM and you will end up in early morning hypoglycemia, followed by reactive hyperglycemia at 7 AM. This is a common mistake. Instead of this, Insulin 70/30 as split dose 2/3 before breakfast and 1/3 before supper [or taken in small doses 3 or 4 times a day after testing], is a sensible dosing schedule. If you avoid this morning hypoglycemia, dementia will improve. Too strict a diet plan, without proper medical advice is wrong. One must eat four to five small meals a day, including a good breakfast in morning and also a bedtime snack to avoid the early morning hypoglycemia. Diabetes is not just high sugar, but inability to maintain a proper glucose level and use the glucose or store the glucose as needed.

2. Second reason, most common is drug induced. Lack of good sleep is a common problem and people take Sleeping pills in the form of Tranquilizers and psych meds. This is like hitting a fly with a gun. A simple cup of Milk at bed time, Melatonin 3 mgm and occasional dose of Benadryl 25 mgm or Chlorpheniramine 2 mgm can help. [These two can affect the heart in the elderly]. Just go to bed and keep lying down, do meditation and read a book. If you feel sleepy during the day, just go to sleep whenever you get sleep. No fixed schedule is needed for this. But, good sleep is important.

3. Next is dehydration, which can cause memory problems, that needs to be corrected. At our age, we do not drink enough water and the kidney malfunction and water is not balanced well, as we pass lots of urine at night. To compensate, drink 1 cup of water or at least ½ cup every time you get up at night. Also, you must drink one full cup [8 oz or 250 ml] of water at night before going to bed and also 1 cup of water, as first thing in the morning, before your morning cup of coffee or Tea. Similarly, you must drink water during day also, as juices or watery buttermilk with sugar and salt. Water intake may be restricted due to Cardiac failure and Chronic Renal failure by your physician

 
 

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4. The fourth is the most important. This is the circulatory problems, as part of the metabolic syndrome. We all know and recognize Heart attack, Stroke and poor circulation in the legs, especially with Diabetes, Hypertension and Hyperlipidemia. But, more common is the "Little Strokes" - with small thrombus or micro-emboli from the Carotids to the frontal cortex leading to Multi-Infarct Dementia. You need to get Carotid artery Doppler test, just like doing an EKG, to see the situation even when you feel normal. One Aspirin-a-day may not help much, as this can increase bleeding also.

5. Nutritional problems are the next most important things to attend to. As we age. Our appetite gets less and we tend to eat lest calories and less varieties. Our food will be just starch and fat. Fewer proteins, fewer fresh vegetables and fruits lead to malnutrition and lack of proteins and vitamins. These need to be corrected with proper nutritional low calorie diet plans. Vitamin deficiency can lead to muscle weakness, nerve problems and general tiredness. Vitamin C, Folic Acid and B-Complex are needed as also adequate protein intake, unless restricted due to renal problems. A good multi-vitamin supplement like Centrum [in USA] or similar combination or Ultra-Mega-Green available in USA - GNC stores that contains vitamins and several antioxidants and vegetable supplements like green tea and grape-seed extracts are very useful.

6. Vitamin B12 is the most important nutrient that we, as Indians, need to consider. As vegetarians, we do not get any Vitamin B12 from any Vegetable product. We get it only from the small amount of Milk and butter we eat as also the meat-eaters from the animal products. As age advances we try to avoid milk, may be from lactose intolerance or fear of fat intake, and meat-eaters also reduce meat and eggs due to Cholesterol, leading to Vitamin B12 deficiency from food intake changes. Besides, problems in stomach and terminal ileum cause problems in absorption of Vitamin B12 which is a complicated process. This B12 deficiency may not show up as anemia as we get enough Folic acid from vegetable sources. But, we may develop B12 deficiency Neuropathies and also dementia like neurological problems. One must get their Serum B12 levels checked and also repeat the same after a course of oral Vitamin B12 supplement. If there is an absorption problem, Injection Vitamin B12 1000 Mcgm once a month will help.

 
 

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How do we prevent these or reverse these conditions?

 
 

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Normal aging process is often blamed for several of the health problems we face as we reach our age. How do we prevent these or reverse these conditions is similar to management of heart attack. Normal cells deteriorate with aging and get replaced with scar tissues. However some of these changes can be slowed or reversed by controlling Diabetes, Hypertension and Lipid problems. (See: Metabolic Syndrome and Healthy Eating Habits)

Proper control and correction of Hypertension, Diabetes, Nutritional Deficiency and Dehydration will help. Once people show early signs of loss of memory, reading lots of books, writing, - like exercise for brain is very important. Good daily physical exercise, breathing exercise and taking good care of our heart and brain with proper nutrition is very important. Mental exercise including Yoga and meditation, studying books on various subjects, trying to learn new subjects including languages as also taking proper nutritional supplements, vitamins and anti-oxidants will be of great help.

If you are retired and not going for a regular routine of work every day, sitting quiet is not advisable. Try to develop a hobby, painting, writing articles, reading technical books and journal, trying to study a new subject, writing something on computer, including computer games and solving puzzles, writing articles, reading and writing philosophy are all very good to keep the brain active. [See AARP/Games]

Of all the nutritional supplements and antioxidants, I would like to mention of some very important ones. Everyone is familiar with the advantages of Green Tea, Grape-seed extracts, Vitamin B12, Vitamin D3, Vitamin-E, and other Vitamins. There is also some advantage in taking Fish oil, Resveratrol, Omega-3 and co-enzyme Q10 as useful supplements often mentioned in preventive healthcare, but not well documented. Anti-Oxidant / Supplements like Acetyl-L-Carnitine which is a modified Amino acid and Alpha-Lipoic Acid which is a modified Fatty Acid as nutritional supplement can be useful in several conditions related to metabolic syndrome, vascular problems and neurological problems including dementia.

 
 

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-- Memory and Thinking are very important for good health--
Essential Changes -- for a healthy Heart and General Health0
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