Expert: Mary Gordon - 7/23/2008

Question
Explain why dementia is not a 'normal part' of the ageing process

Answer
Jessy, you asked why dementia is not a "normal" part of aging. First off, dementia is a term like fever. It describes a symptom. Dementia means that person has symptoms that suggest impaired brain function, so their memory might be poor, their ability to reason compromised, they may have trouble recognizing people or places, finding words - there are a whole host of signs of cognitive impairment, that get lumped together as "dementia". Basically it just means very confused for an extended period.

If the doctor told you you had a fever, you would say, yes I know, but why do I have a fever? What is it from? What disease is causing me to have a fever, and how do we treat it ?

Same thing goes for dementia. The word does not tell you what the cause of the brain damage is. It might be from strokes, vitamin deficiencies, anemia, thyroid problems, low oxygen, liver or kidney problems, tumors, hydrocephalus, viral infections - or it can be from Alzheimer's, Parkinson's Disease and a host of others - even inheritable genetic diseases like Huntington's. There are literally dozens of diseases which can damage your brain, and none of them is "normal", if normal can be defined as something that happens to most people, or that is inevitable. Look at it this way - cancer and heart disease are the two most common causes of death, but no one would say either one of those was "normal".

It is true that a lot of elderly people do eventually develop dementia from some cause. However, it should never be accepted as part of normal aging.Dementia is not the same thing as being a little more forgetful than you were in your prime. My mother in law didn't just forget she had an appointment. She couldn't tell time or read a calendar, or know how to figure out how to phone a cab to get her there - or she'd get lost in the hallway of her apartment. This was happening even when she'd seem perfectly normal during a social conversation. It was pretty clear that there was something really wrong with her. Her own mother lived to be almost 90 and was as sharp as a tack until she was almost 90, so no, I wouldn't say it was normal when my mother in law got loopy at 73.

Any kind of mental impairment needs to be investigated and the cause diagnosed. Many causes can be treated. Some can even be reversed if caught early enough. Others can at least be slowed down a bit, to give the person a better quality of life for longer.

There is a lot of evidence to suggest that taking care of your general health is the best way to up your odds of surviving to a healthy old age with your mind intact. Do all the things your grandma told you. Avoid stress. Keep your weight  down. Exercise. Eat a healthy diet. Don't smoke. Don't drink too much. Stay away from drugs. Do what your doctor tells you to do, and see him or her regularly. Keep track of your cholesterol and blood pressure and keep them in the healthy range. Get enough sleep. All pretty boring, but it does give you your best odds.

Your brain is a delicate thing, and if you haven't taken care of yourself, and your health starts to fall apart, its no surprise your mind can go with it. There is lots of research going on to get to the bottom of the many causes of brain damage, and to try to find ways to prevent it, slow it down, or even reverse it.

If you have a loved one who has been told they are just old and should expect to develop dementia, its time to see a new doctor, because they deserve better. Some of the dementias are caused by incurable, progressive and fatal diseases - and if that was your fate, you might want some clear ideas about prognosis so you could get your affairs in order, and prepare your family, just as you would want to know if you had any other disease that might kill you.  If a loved one gets confused, you also would never forgive yourself if you didn't insist on a proper examination and diagnosis, and found out later they could have been helped if only they'd had a better doctor.

Hope this helps.

Mary G.