– Tell us about dementia.
– Dementia is a severe disorder of cognitive functions, usually memory is impaired. The ability to read, write, speak, perceive, reason, social functions, and the ability to communicate are also impaired – but here it is already in advanced stages. Dementia is a syndrome, its origin can be diverse. Alzheimer’s disease is one of the causes of dementia; there may also be dementia of vascular origin, for example, after a stroke. And oncological diseases, metabolic diseases can cause dementia. In a word, there are many reasons, but the most well-known is Alzheimer’s disease.
– Is it a disease of older people?
– Yes, it is fixed after the age of 60, and it is already in an advanced stage. When a 60-year-old person is diagnosed with dementia, it means that its onset could have been 10-15 years ago. In the population, there may be hundreds of thousands of people with dementia. For example, we have 23 places in the department, so we diagnose 20 patients with Alzheimer’s.
– Dementia cases are increasing due to an aging population and better diagnostics or are there other reasons?
– People’s life expectancy is increasing, medical services are improving, which also support life expectancy. As life expectancy increases, other systemic inflammatory processes appear, such as heart, kidney, and liver failure. Diabetes. This also affects the onset of dementia.
Another important point is the excessive use of drugs, it also negatively affects our health. When there are many medications that interact with each other, it is very difficult to track those interactions. An important question is whether it is appropriate to prescribe many drugs? That question always comes up, because the administration of some drugs also promotes and accelerates the onset of dementia.
There is no holistic approach to human health. Usually, only the symptom is treated, regardless of the actual causes that cause one or the other symptom. The issue of nutrition is very important. Food is contaminated with various pesticides, antibiotics and other impurities, and they enter our body with food. It is clearly proven that this negatively affects not only our cognitive functions, but also our general health – again, chronic diseases appear.
A person needs certain substances that ensure the proper transmission of nerve impulses and the balance of the body. These are vitamins, food supplements. Their use in Lithuania is so far met with great skepticism both by family doctors and other specialists. And supplements are still very important. Of course, they must be balanced, measured. It is necessary to carry out research, only then to prescribe doses and decide on the duration of use. Of course, psycho-emotional things – stress, tension – cannot be ruled out. It is important to recognize and correct these conditions in time.
As I mentioned, there are many causes of dementia. Genetics, age, gender are more formal causes. Good epigenetics, i.e. a balanced lifestyle, must be ensured and preventive measures applied when necessary. All over the world they are recommended after 45 years. Then there would not be so many cases of dementia diagnosed.
– Family doctors pay more attention to the prevention of the patient’s health, apparently, they simply do not have time.
– I think that little time and so-called weight is given to prevention. Because doctors basically treat the symptom, that is, it is important to recognize the symptom, diagnose the disease and eliminate it. Most doctors are focused on this. And why does that symptom appear, in what context, and what can provoke it, these things are usually not touched by the family doctor, nor perhaps by other specialists. It also costs time… After all, you can’t find out quickly, the time for visiting a doctor is limited. Doctors are really busy, that’s one thing. And the other is the lack of information. I don’t know how much GPs are aware of the latest research and effective results.
Our Gerontopsychiatry Department is now more focused not only on the diagnosis and the further decision of “where to put that person”, i.e. to provide social, nursing services, but also on broader support. Of course, those results may not be as clinically significant, but still we are watching improvement when you restore a person’s vitamin and fluid balance, reduce, if necessary, the use of chemical drugs.
– Elderly patients not getting enough attention?
– There is minimal attention to patients of older age groups. There is even a discriminatory approach here. If you are older, you are no longer useful to your country and attention is not given as much as it could be to improve a person’s lifestyle, health and sociality. Let’s understand, it is still a big burden for the state when “a person needs to be placed somewhere”.
It goes without saying that we will all get old. Prevention needs to be more focused and targeted. It seems that you live while you are young and involved in your own affairs, but a critical approach is necessary, that as you age you lose certain functions, that you need to replenish yourself with materials, pay attention to forgetfulness. Don’t attribute it to your age alone. If the forgetfulness is repeated, it is necessary to worry and investigate.
Of course, people are still afraid of the diagnosis. The fear is that Alzheimer’s and dementia are incurable, which is in principle true when the stages are advanced. But there is treatment, we have two drugs, their effectiveness is debatable, because we do not see much of an effect. However, improving diet and lifestyle – when it is followed very strictly – in mild cognitive impairment or mild to moderate dementia, really has good therapeutic effects.
– How should older people eat?
– The need for food decreases with age. Children, especially elderly parents, carry food that often increases insulin resistance. What is needed is the realization that there is no need for excess nutrition. With age, the number of meals and the size of portions should be reduced. To move. People complain that their joints and back hurt. Chronic diseases of bones, joints, and muscles occur due to too little physical exertion. In order for the body to function well, it must be “used”. If a person is immobile and receives excess food, it is, of course, wrong.
– The person himself or his relatives notice possible signs of dementia, what to do?
– We invite you to come to us in Vilnius (Vasaros st.) and take psychometric tests, of course, they take time. Especially since not every specialist can perform them. For now, inpatient monitoring is being carried out at us, but the plans include an outpatient examination. Of course, you can also try to contact a family doctor, they will refer you to specialists. The most important thing in general is to ask for help, solutions will be found.
Asking for mental health is still embarrassing for people. If you have a toothache, you go to a doctor, if the problem is related to mental, emotional health, memory, then going to a psychiatrist is a shame. There is still a lack of awareness that this is a medical problem. Treatment is normal, a person cannot handle everything by himself. A person is not only made of bones and muscles, he also has a psyche. When the body begins to break down, a holistic approach is needed.
– The doctor is sometimes a god who will give you a pill and everything will be fine. Changing your lifestyle is not easy.
– When it comes to dementia, there is no pill that will help. These are lifestyle diseases. You have to be interested in what suits you, be interested in a healthy lifestyle, monitor your cognitive functions. We often come across cases where a person comes to prescribe pills and thinks that everything will be solved. Unfortunately not. In our field, when working with older patients, in many cases the drugs don’t even work, because the receptors in the brain and the whole body decrease, the proteins decrease, the fluid balance changes, and those drugs often cause more side effects than they have an effect. And then what? Another drug, and another drug… Then you take 15 drugs, and you feel worse. It’s not uncommon for us to take the medication and see what’s going on with the person and what they need. There is no algorithm that will make the situation easier, each patient’s case is individual, it depends on age, gender, state of the neuroendocrine system and so on.
– What kind of help is there for the relatives of a person with dementia?
– The whole team works here: psychologist, psychiatrist, therapist, neurologist, social worker, occupational therapist. Everything is explained, what is happening with the patient, how he should be treated, how to communicate, how to adapt the patient’s home to make it as safe as possible. What is the course of the disease and the prognosis. It’s a team effort. Here is a lot of information that our department provides.
I will repeat, it would be very good if it were understood at the state and political level that old age awaits everyone. As we prepare for it, so it will be. So far, the state’s approach to old age is really nonexistent. He is like this – you are no longer useful. In old age, a person can be useful! And it would be better for the state if such a person were healthier, more conscious, more independent as long as possible. You’re not going to introduce old people’s homes everywhere and crowd those people in to end their days there. This is a much higher cost. Education and access to help should be as high as possible. So that people feel that the state helps them and will help them.
– And what we see in society – be young and beautiful. Here’s the aspiration…
– Exactly. In our country, a person after 60 years is almost equal to a disabled person. It feels like old age doesn’t exist… Everyone wants to be young and healthy, beautiful, without wrinkles. It’s not real. What is happening now is a denial of reality. The most important thing is experience, often employers do not value experience. Abroad, everyone is preparing for old age, no matter how Spanish, they are happy, they travel. Because they are preparing for old age and do not accept that stage as something crippling. They live a full life. And the children of older people are happier and live full lives because of it. After all, when a person gets dementia, the whole family suffers. After all, you will not leave such patients alone, there is always anxiety and tension. Relatives themselves experience stress, their health deteriorates.
There can be healthy aging, there can be pathological aging. A question for politicians, which way do we want to go? Maybe we won’t save everyone, but it won’t be as bad. It is sad when two questions are now being decided – to a nursing home or to a nursing home? Everything. All help. In the end, there will be those old people’s homes, but there will be fewer of them, maybe they will be more dignified, instead of 10 people in 20 square meters. m area will be tucked away. “Pampers” yes, they cost a lot (ironic). But those things can be avoided. Old age should be dignified.
Tags: Lets deceive age Respublika .lt
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