Risk factors and prevention
There is no certain way to prevent any type of dementia. However, adopting a healthy lifestyle can reduce one's risk of developing dementia. A healthy lifestyle can also prevent or reduce the risk of cardiovascular diseases such as strokes and heart attacks.
Risk factors for dementia include:
• Physical inactivity
• High blood pressure
• High blood cholesterol
• Diabetes Mellitus
• Excessive alcohol consumption
• Smoking
• Mid-life obesity
• Lack of mental stimulation
To lower your risk or delay the onset of dementia, you can:
• Keep physically active
• Keep your blood pressure at a healthy level
• Monitor blood glucose if you are a diabetic
• Eat a balanced diet
• Quit smoking
• Exercise regularly
• Go for regular health screening
• Refrain from heavy alcohol intake
• Be socially engaged
Medical treatment
Presently, there is no cure for dementia. There are, however, drugs that may help improve mental function, mood, or behaviour and slow the symptomatic progression of the disease. Although slight improvement or stabilisation of symptoms can at times be seen, these ultimately do not prevent the disease from getting worse. The following are the medications used to treat dementia:
Acetylcholinesterase inhibitors help to maintain mental function. There are 3 in this category, namely Donepezil (Aricept), Rivastigmine (Exelon) and Galantamine (Reminyl). They are primarily licensed to treat the mild to moderate stage of the disease although there is also evidence of efficacy in advanced dementia.
Generally, these medications are well tolerated but possible side effects include vomiting, nausea, diarrhoea and anorexia especially at higher doses. A transdermal patch formulation is available for Exelon.
Memantine hydrochloride is licensed to treat moderate to advanced stages of the disease. It can also be an alternative if patients cannot tolerate Acetylcholinesterase inhibitors. It has minimal side-effects generally and can be used on its own or in combination with Acetylcholinesterase inhibitors.
Antipsychotics, antidepressants, mood stabilisers and sedatives are at times used to treat various challenging and disruptive behaviours such as anxiety, aggression, agitation and sleep problems. Antipsychotics are used with caution and usually not for prolonged periods because they can:
• increase the risk of cardiovascular diseases, such as stroke or heart attack
• cause excessive drowsiness and impair alertness and communication
• cause slowness, rigidity, unsteady gait and falls
Next Chapter: BEHAVIOURS IN DEMENTIA
