James was a loving husband and a devoted family man, but a couple of years ago, his wife Annie noticed that his behaviour had started to change. The 59-year-old would misplace small items around the house and accuse Annie of stealing them. Her attempts to reason with him often resulted in a torrent of verbal abuse.
The drastic change in his temperament had a dramatic impact on their lives. Annie’s father, who used to be very close to James, hardly talks to him; and during a dinner with Annie’s family, James accused her of behaving inappropriately when she hugged her brother-in-law.
The once loving husband had morphed into an argumentative, suspicious and occasionally violent man. About a year ago, James went to see a consultant doctor from the department of neurology in his local hospital.
After a comprehensive neurological and cognitive evaluation along with a brain scan, James was diagnosed with mild Alzheimer’s Disease, a form of dementia.
Young onset of dementia
Dementia refers to a group of symptoms affecting memory and other intellectual abilities severely enough to interfere with daily occupational and social functioning. Mild Cognitive Impairment (MCI), an early symptom of dementia, is even more prevalent and can begin in the 50 to 60 year old age group.
The burden of illness in those younger than 65 years of age is different, both in terms of the cognitive domains involved and the subsequent effects on the patient, caregiver and family. Dementia affecting someone in their 50s or 60s has a profound effect on employment, finances and family.
Patients with early onset of dementia are more likely to have difficulties with language, judgment and behaviour as opposed to memory difficulties in conventional dementia. Behavioural changes include loss of inhibition and depression; language difficulties include difficulty in finding words, use of wrong words or loss of meaning of words.
Patients may also experience problems with executive functions including judgment errors, difficulty with planning and sequencing, and associated motor problems such as gait difficulty and the inability to coordinate their limbs.
Managing the disease Dementia is a neuro-degenerative disease that leads to a progressive decline in memory, language and executive functions. Early diagnosis and intervention is key to managing early onset of dementia because as the disease progresses, the patient will have difficulties at home, at work and even at social functions.
Current treatments involve the use of drugs to slow the progression of the disease and to maintain functional capability. Caregiver support and counselling are also extremely important for the patient.
For patients like James, his symptoms are kept under control with medication and most importantly, love and support from his wife and family. Annie stands by him through his good and bad days, helping him with mental exercises to keep his mind active. The couple bond over word puzzles and mental arithmetic to help delay the progression of his condition.
Mental stimulation improves the interneuronal connections in the brain and delays the progression of dementia. Future treatments, currently in advanced stages of research, include compounds that halt pathological changes in the brain.