June 21, 2022
MANILA — “Pretty soon, everyone’s gonna be a stranger.”
That was one of the pivotal lines in the movie Here Today—a comedy-drama that follows the life of fictional veteran comedy writer Charlie Burnz (played by Billy Crystal) as he comes to terms with his rapidly progressing dementia—which gave a glimpse of what it is like to suffer from the condition, a neurological disorder that robs people of their memory.
Dr. Shelley de la Vega, director of the Institute on Aging of the National Institutes of Health (NIH), said dementia is an umbrella term for loss of memory, language, problem-solving, and other thinking abilities that are severe enough to interfere with daily life.
Over 55 million people across the globe are living with dementia, according to the World Health Organization (WHO). With the aging population, it is estimated that the number of people with dementia will rise to 78 million by 2030 and 139 million by 2050.
“Dementia robs millions of people of their memories, independence, and dignity, but it also robs the rest of us of the people we know and love,” said WHO director-general Tedros Adhanom Ghebreyesus.
“The world is failing people with dementia, and that hurts all of us,” he said.
More than forgetfulness
As defined by WHO, dementia is a syndrome that is “usually of a chronic or progressive nature” and “leads to deterioration in cognitive function (i.e., the ability to process thought) beyond what might be expected from the usual consequences of biological aging.”
“It affects memory, thinking, orientation, comprehension, calculation, learning capacity, language, and judgment. Consciousness is not affected. The impairment in cognitive function is commonly accompanied, and occasionally preceded, by changes in mood, emotional control, behavior, or motivation,” it added.
Dementia generally involves memory loss. However, experiencing memory loss alone does not automatically mean a person has dementia.
“Memory loss is often one of the early signs of dementia. Having memory loss alone, however, does not automatically mean that a person has the condition,” said De la Vega in an episode of the “Stop COVID Deaths” online seminar hosted by the University of the Philippines (UP).
According to Mayo Clinic, symptoms of dementia vary depending on the cause. Some of the common signs and symptoms, however, include:
Cognitive changes, such as:
- memory loss
- difficulty communicating
- difficulty with visual and spatial abilities
- difficulty reasoning or problem-solving
- difficulty handling complex tasks
- difficulty completing familiar tasks
- problem with planning and organizing
- problem with coordination and motor functions
- confusion and disorientation
Psychological changes, including:
- personality changes
- inappropriate behavior
- apathy or loss of interest
The United States Centers for Disease Control and Prevention (US CDC) also noted that some signs which may point to dementia include:
- getting lost in a familiar neighborhood
- using unusual words to refer to everyday objects
- forgetting the names of close family members or friends
- forgetting old memories
- inability to complete tasks independently
Dementia, as explained by WHO, also progresses in three stages:
- Early Stage: Where onset of common symptoms such as mild forgetfulness, losing track of time, and becoming lost in familiar places is gradual and often overlooked.
- Middle Stage: During this stage, signs and symptoms become more evident and restricting.
- Late Stage: The person who has dementia becomes nearly dependent and inactive. They experience severe memory disturbance, and the signs and symptoms become apparent.
Dementia care during pandemic
During the COVID-19 pandemic, lockdowns and restrictions were imposed, pushing people living with dementia—which studies have shown are at a higher risk of contracting COVID-19—to stay inside their homes or facilities.
According to Dr. Michelle Anlacan, neurologist and president of the Alzheimer’s Disease Association of the Philippines (ADAP), most people with dementia initially felt happy with the lockdowns.
“Most persons with dementia were initially happy with the lockdown since they saw their whole family at home all the time,” she said.
“But as the weeks dragged into months, several issues arose, and the patients developed many [behavioral and psychological symptoms of dementia]: apathy, aggression, agitation, anxiety, irritability, hallucinations, sleep, and appetite changes.”
However, persons with dementia are also more prone to experiencing loneliness and depression during the pandemic. While dementia corrodes memory over time, Ancalan said it does not always mean those with the condition would no longer feel lonely or depressed.
The lockdowns have restricted people with dementia from enjoying some beneficial routine activities such as going out for walks.
“While there is still insight, they realize their failing memory, difficulties, and the things they can no longer do because of dementia. Over time, this insight is lost, and the patient will no longer be aware of what is happening,” she said.
“Nevertheless, it does not exempt them from loneliness and depression. In fact, it may be harder to address since they cannot express their thoughts clearly.”
In a study published in Nature Journal, Italian researchers found that 54.7 percent of people with dementia experienced worsened neuropsychiatric symptoms, with worsened agitation, apathy, and depression the most commonly observed.