PT Health Watch: Does dementia affect only older people?

There’s a widespread belief that dementia affects only older people, but this is not entirely true.

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While age is a major risk factor, dementia can also occur in younger individuals. Among younger people, the condition is known as young-onset or early-onset dementia.

Dementia is a term used to describe a group of symptoms that affect memory, thinking, behaviour, and the ability to perform everyday activities. It results from damage to brain cells and is most often progressive, meaning symptoms worsen over time.

Dementia is not a single disease but a syndrome caused by various underlying conditions, such as Alzheimer’s disease, vascular dementia, or frontotemporal dementia.

According to the World Health Organisation (WHO), dementia over time destroys nerve cells and damages the brain, leading to deterioration in cognitive function. That is, the ability to process thought.

The deterioration in cognitive function is often more pronounced than what might be expected from normal ageing.

However, while consciousness is not affected, this decline in mental ability is often accompanied, and sometimes preceded, by changes in mood, emotional control, behaviour, or motivation.

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Risk factors

While the condition is most commonly associated with ageing from around 65 years and above, it can also affect people in their 30s, 40s, or 50s.

Young-onset dementia affects about 119 out of every 100,000 people worldwide between the ages of 30 and 64, according to this study on the Global Prevalence of Young-Onset Dementia.

The WHO identified that dementia is currently the seventh leading cause of death globally. As of 2021, around 57 million people had dementia worldwide, and more than 60 per cent of them live in low-and middle-income countries.

In Nigeria, dementia is also a common condition and has increased astronomically in the last 20 years.

WHO also noted that there are nearly 10 million new cases yearly. According to the global health body, various factors contribute to the development of dementia, depending on the underlying type, especially among younger people.

These factors can be grouped into modifiable and non-modifiable factors. Non-modifiable risk factors are those that cannot be changed or eliminated, such as ageing, family history, genetics, and even gender.

WHO indicated that women make up a larger share of people living with dementia worldwide. Research suggests that this is partly because they tend to live longer than men.

This study also suggests that biological and hormonal factors increase women’s vulnerability to Alzheimer’s disease, the most common form of dementia.

Modifiable factors, on the other hand, can be changed. One of the most significant is cardiovascular health, according to the WHO.

The global health body highlighted conditions such as high blood pressure, high cholesterol, diabetes, obesity, and smoking as risk factors for dementia.

These conditions impair blood flow to the brain, leading to damage in the blood vessels that supply it. Over time, this damage may lead to vascular dementia, which results from a reduced oxygen and nutrient supply to brain tissue.

Maintaining healthy blood pressure, controlling sugar levels, and adopting heart-healthy habits are therefore vital preventive measures.

Some forms of Dementia

Dementia comes in different forms. According to the WHO, Alzheimer’s disease is the most common form and contributes to 60–70 per cent of dementia cases globally. It is driven by an abnormal build-up of proteins in the brain, which disrupts communication between nerve cells.

It typically begins with a gradual decline in memory and an increase in difficulty learning new information.

Frontotemporal dementia, which is basically the degeneration of the frontal lobe of the brain, is also a common form of the condition.

It most often affects younger people, usually starting in their 40s. It affects the front and side lobes of the brain, causing major changes in behaviour, personality, speech, and language before memory is significantly affected.

Vascular dementia is another common form of dementia. It occurs when damage to blood vessels reduces blood supply to the brain, often following strokes or chronic cardiovascular problems.

In this case, thinking speed, organisation, and problem-solving are usually more affected than memory in the early stages.

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Lewy body dementia is caused by abnormal deposits called Lewy bodies. People with this condition experience fluctuations in alertness, vivid visual hallucinations, and Parkinson-like movement symptoms such as stiffness or tremor.

Other less common types include Parkinson’s disease dementia, Huntington’s disease dementia, HIV-associated dementia, and Creutzfeldt-Jakob disease.

Each form progresses differently, but all involve a decline in cognitive ability that interferes with daily life.