With the growth in population and advancement in medical science, new diseases have emerged alongside humankind's progress. These ailments encompass single-gene disorders, comorbidities, or multimorbidities. Dementia is one such affliction, representing a group of diseases involving the loss of language, memory, cognitive abilities, problem-solving, and other thinking functions. These impairments are severe enough to significantly disrupt daily life.
Prevalence in Jammu & Kashmir
A pan-India study conducted in February 2023 on dementia reveals that its prevalence is higher in Jammu & Kashmir compared to other regions in the country. According to the study titled "Deep Phenotyping and Genomic Data from a Naturally Representative Study on Dementia in India," the prevalence of dementia among the elderly population in J & K is the highest at 11 percent, in contrast to the national average of 7.4 percent. Delhi reports the lowest rate at 4.5 percent, followed by Odisha at 9.9 percent and West Bengal at 9.2 percent.
Dementia and Age
Dementia risk escalates with age, particularly after 65 years. While some dispute its connection to aging, cases have been observed in younger individuals in their 30s, 40s, or 50s.
According to Dr. Zubair Saleem, a Senior Geriatric Consultant and Gerontologist, who has treated over 30,000 senior citizen patients in the last five years, approximately 10 to 11 percent displayed symptoms of mild cognitive impairment and mild dementia. Dr. Saleem adds that in Kashmir, a significant number of senior citizens are affected by dementia, and many individuals have family members or close friends grappling with the disease.
Stages of Dementia
Dementia progresses through seven stages, including normal behavior, forgetfulness, mild dementia, moderate dementia, moderate-severe dementia, severe dementia, and very severe dementia. Alzheimer's disease stands as the primary cause of dementia, followed by factors such as alcohol consumption, high blood pressure, smoking, excess weight, and an unhealthy diet.
Treatment and Outlook
Early diagnosis, accompanied by appropriate and comprehensive treatment, can curb the rising trend and slow down the progression of dementia, enabling patients to maintain cognitive abilities for extended periods and lead near-normal lives. Treatment strategies may encompass therapy, cognitive training, and medication. Typically, individuals live for approximately eight years after initial symptom manifestation. Dementia results from the degeneration and premature death of brain cells and their connections, impacting regions responsible for memory, language, and thought processes.
Mind and Brain
The condition is partially treatable but remains incurable. It originates in the brain and manifests through the mind. Although "brain" and "mind" are often used interchangeably, they denote distinct concepts. The mind is a continuous product of the brain, body, and surrounding environment, governing emotions, thoughts, and physical engagement. In contrast, the brain serves as the physical organ supporting these functions, while the mind is described as a mental entity.
Dr. Kamran, a researcher at the University of Kashmir, who focused on genetic risk factors associated with dementia in the Kashmiri population, highlighted stress, a sedentary lifestyle, family history, dietary habits, genetics, and socio-economic status as the primary contributors to dementia in the region. Stress, particularly stemming from traumatic experiences like loss, separation, livelihood challenges, shelter insecurity, and exposure to distressing visual and auditory stimuli, profoundly impacts brain function and behavior, as behavior adjusts to circumstances.
Role of Visual Stimuli
The human body houses approximately 11 million sensory receptors, with around 10 million devoted to vision. Some experts suggest that half of the brain's resources are dedicated to processing visual stimuli. Both the brain and heart, serving as round-the-clock guardians, are more susceptible to external events' repercussions compared to other organs. The brain remains active even during sleep, contrary to mere rest. Stress can also result from visual stimuli. Notably, visuals hold significant influence over human behavior, often leading to substantial shifts in actions or feelings following brief scenes. Stressed individuals face a heightened risk of dementia, which can subsequently be passed on through genetics, manifesting as family history in medical records.
This renders subsequent occurrences more challenging to manage or escape than the initial instance. The human being, a uniquely complex organism, demonstrates the interplay of emotions, beliefs, thoughts, moods, external stimuli, internal intuition, and urges, all shaping distinct behaviors and personalities. Fear-induced psychological stress may also contribute to dementia, mirroring instances where children or students, subjected to high-pressure educational environments at school, home, or during exams, experience memory lapses more frequently than those in more pleasant and playful settings.
1. Behavioral: Wandering, personality changes, irritability.
2. Cognitive: Memory loss, speech difficulties, confusion.
3. Mood: Sadness, anxiety, mood swings.
4. Psychological: Depression, hallucinations.
Prevention and Treatment
When considering factors that exacerbate dementia, such as lack of education, economic stress, property loss, social status shifts, job-related stress, sedentary lifestyles, and unbalanced or unhealthy diets, interventions at governmental and non-governmental levels could significantly mitigate these risks. However, inherent conditions necessitate appropriate medical treatment, which may range from short-term to lifelong solutions. The loss of loved ones remains irreparable, with little recourse aside from offering consolation, support, or assistance to help the bereaved cope with their separation.
A Holistic Approach
In essence, the structure of public and private life should be designed to minimize the risk of disease outbreak. If preventive measures fall short due to human error, timely and affordable treatment, including speech therapy, becomes essential. Moreover, meditation offers a calming role in alleviating the suffering caused by disappointment, discontent, dismay, and dysfunction resulting from dementia. Combining these strategies forms a sensible approach, as advocated by conventional wisdom, rather than succumbing to despondency and retreating in isolation before actual defeat.
[The author is a former Senior Audit Officer and Consultant in the A.G.'s Office Srinagar.]