Dementia and Alzheimer’s: Early Signs, Treatment and Caring for a Loved One

Grandmother keeps asking the same question every few minutes. Grandfather, who walked to the mosque for fifty years, got lost on the way home. The family says, “She is old, it is normal to forget.” But forgetting where you put your glasses is different from forgetting what glasses are for. Dementia is not a normal part of ageing. It is a disease of the brain, and recognising it early gives families time to plan, treat what can be treated, and support the person better.

What is dementia?

Dementia is an umbrella term for a decline in memory, thinking and daily abilities that is serious enough to interfere with everyday life. The commonest cause is Alzheimer’s disease, which accounts for about 6 or 7 in 10 cases. Others include vascular dementia, which follows strokes or damage to small blood vessels, Lewy body dementia and frontotemporal dementia.

Early warning signs

• Forgetting recent conversations, events or appointments, and asking the same question again and again
• Misplacing things in odd places, such as keys in the fridge
• Getting lost in familiar places, even near home
• Trouble finding words, or following a conversation or a television programme
• Difficulty with familiar tasks, such as managing money, cooking a usual dish, or using the phone
• Confusion about the day, season or place
• Poor judgement, such as giving money to strangers or dressing wrongly for the weather
• Changes in mood or personality, such as becoming suspicious, irritable, withdrawn or anxious

Normal forgetfulness or dementia?

Forgetting a name and remembering it later is normal. In dementia, the forgetting happens more often, gets worse over months, and affects daily life. Another difference is awareness: people with normal forgetfulness know they are forgetting, while those with dementia often do not, and it is usually the family who notices first.

Conditions that can mimic dementia, and may be treatable

Before concluding that it is dementia, doctors look for causes that can be corrected:

• Vitamin B12 deficiency
• An underactive thyroid
• Depression, which can look like memory loss in older people
• Infections such as a urine infection, which can cause sudden confusion in the elderly
• Side effects of medicines, including some sleeping tablets and sedatives
• Poor hearing or eyesight, and poor sleep
• Low sodium or sugar levels, alcohol, or a head injury with bleeding

How is dementia diagnosed?

A doctor takes a history, ideally with a family member, and does memory and thinking tests. Blood tests check for treatable causes, and a brain scan, CT or MRI, looks for strokes, tumours or shrinkage. A neurologist, psychiatrist or physician who works with older people can help.

Treatment

There is no cure yet, but treatment can help symptoms and quality of life.

• Cholinesterase inhibitors such as donepezil and rivastigmine are used in mild to moderate Alzheimer’s. They can modestly slow the decline in memory and function for a time. Possible side effects include nausea, diarrhoea, poor appetite and a slow heartbeat.
• Memantine is used in moderate to severe disease.
• Control of blood pressure, diabetes and cholesterol, which helps vascular dementia and may slow other types.
• Treating depression, poor sleep and pain, which make confusion worse.
• Many supplements and “memory boosters” are sold for dementia, but evidence is weak. Ask your doctor before buying any.
• Tranquillisers and strong sedatives should be avoided unless a specialist advises, since they increase confusion and falls.

Can dementia be prevented?

What is good for the heart is good for the brain. You can lower your risk by:

• Keeping blood pressure, sugar and cholesterol under control
• Staying physically active every day
• Not smoking and limiting alcohol
• Staying mentally and socially active: reading, prayer, learning, conversation and visiting friends and family
• Treating hearing loss and wearing glasses
• Eating a balanced diet with vegetables, fruit, daal, fish and nuts
• Getting enough sleep and protecting the head from injury

Caring for a person with dementia

• Keep a regular daily routine and a calm, familiar home.
• Speak slowly and simply, and do not argue or correct harshly. Repeating the answer patiently is kinder than saying “I already told you”.
• Use labels, clocks and notes, and keep reading glasses and hearing aids in use.
• Make the home safe: turn off the gas when not in use, lock away medicines and sharp objects, and prevent falls with good lighting and no loose rugs.
• Prevent wandering with an ID bracelet or a card with the address and phone number, and secure outer doors.
• Keep them active, and involved in family and prayer.
• Look after yourself. Caring is exhausting, so share the load with other family members and ask for help.

When to see a doctor

• Memory problems that are getting worse or affecting daily life
• Getting lost, or confusion about familiar people or places
• Sudden confusion, which can be an emergency
• Big changes in mood, behaviour or personality

Key takeaways

• Dementia is a disease and not normal ageing, and early diagnosis helps.
• Some causes of memory loss, such as B12 deficiency and thyroid problems, are treatable.
• Medicines can help symptoms for a time, but not cure it, and good care matters as much.
• Heart-healthy habits, exercise and an active social life lower the risk.

Related medicines on Medimart

These are commonly prescribed by doctors for Alzheimer’s disease and other dementias:

• Donepezil: a cholinesterase inhibitor for mild to moderate Alzheimer’s
• Rivastigmine: another cholinesterase inhibitor
• Memantine: used in moderate to severe disease
• Mecobalamin (methylcobalamin): used when vitamin B12 is low

Prescription medicines are supplied only against a valid prescription. Please take them only as advised by your doctor.

Browse dementia and memory care medicines on Medimart with delivery across Pakistan. Prescription medicines are supplied only against a valid prescription.

This guide is for general information and does not replace advice from a doctor. If you are worried about a loved one’s memory, please arrange a medical check.