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Dr Sacrifice Chirisa Mental Health Matters
Dementia has many causes as discussed last week. However, the major risk factors are:

• Age: The risk increases as you age, especially after age 65. However, dementia is not a normal part of ageing, and dementia can occur in younger people.
• Family history: Having a family history of dementia puts you at greater risk of developing the condition. However, many people with a family history never develop symptoms, and many people without a family history do. Tests to determine whether you have certain genetic mutations are available.
• Down’s syndrome: By middle age, many people with Down’s syndrome develop early-onset Alzheimer’s disease.
• Mild cognitive impairment: This involves difficulties with memory but without loss of daily function. It puts people at higher risk of dementia.

No single test can diagnose dementia, so psychiatrists have to run a number of tests that can help pinpoint the problem.

Cognitive and neuropsychological tests: Doctors will evaluate your thinking (cognitive) function. A number of tests measure thinking skills such as memory, orientation, reasoning and judgment, language skills and attention.

Neurological evaluation: Doctors evaluate your memory, language, visual perception, attention, problem-solving, movement, senses, balance, reflexes and other areas.

Brain scans: CT or MRI, These scans can check for evidence of stroke or bleeding or tumor or hydrocephalus.

Laboratory tests: Simple blood tests can detect physical problems that can affect brain function, such as vitamin B-12 deficiency or an underactive thyroid gland. Sometimes the spinal fluid is examined for infection, inflammation or markers of some degenerative dis- eases.

Psychiatric evaluation: A mental health professional can determine whether depression or another mental health condition is contributing to your symptoms

Most types of dementia cannot be cured, but there are ways to manage and treat these symptoms.

Medications

The following are used to temporarily improve dementia symptoms.

• Cholinesterase inhibitors: These medications like donepezil (Aricept), work by boosting levels of a chemical messenger involved in memory and judgment.
• Memantine: Works by regulating the activity of glutamate, another chemical messenger involved in brain functions, such as learning and memory.
• Other medications: Psychiatrist canprescribe medications to treat other symptoms or conditions, such as depression, sleep disturbances or agitation.

Several dementia symptoms and behaviour problems might be treated initially using non-drug approaches, such as:

• Occupational therapy: An occupational therapist can show you how to make your home safer and teach coping behaviors. The purpose is to prevent accidents, such as falls; manage behaviour; and prepare you for the dementia prog- ression.
• Modifying the environment: Reducing clutter and noise can make it easier for someone with dementia to focus and function. You might need to hide objects that can threaten safety, such as knives and car keys. Monitoring systems can alert you if the person with dementia wan- ders.
• Modifying tasks: Break tasks into easier steps and focus on success, not failure. Structure and routine also help reduce confusion in people with dementia.

I hope this compressed information will help as we are seeing an increase of dementia in people as more and more people are living longer than before.

Let us not ill-treat our elderly suffering from dementia and other patients but we ensure to seek psychiatric help for them.

DISCLAIMER:

This column contains information about mental health related issues. However, the information is not advice, and should not be treated as such. The writer accepts no responsibility for misuse and misrepresentation caused by the use or misunderstanding of this article. No warranties or assurances are made in relation to the safety and content of this article and attachments. Columnist accepts no liability for any damage caused by or contained in any attachments. No liability is accepted for any consequences arising from this article.

• Dr S. M. Chirisa is a passionate mental health specialist who holds an undergraduate medical degree and post graduate Master’s degree in psychiatry both from the University of Zimbabwe. He is currently working as a Senior Registrar in the Department of Psychiatry at Parirenyatwa Group of Hospitals and is also the current national treasurer of the Zimbabwe Medical association (ZiMA). He can be reached at [email protected]