With three close family members affected by some form of dementia, I considered myself relatively well educated about dementia, sufficiently so that, like many over 60s, I have a mortal fear I might be next.
Kailas Roberts (pictured), who this month releases his book Mind Your Brain – The Essential Australian Guide to Dementia, quickly and simply dispels the myths – and to some extent the fear – as he explains the realities.
First of all, early diagnosis does make a difference. Secondly, memory loss is not the only symptom to watch for, and thirdly, doing crossword puzzles every day isn’t going to help as much as you might think.
Kailas’ job title is quite a mouthful – psychogeriatrician – which means that he knows much more about dementia than most. After gaining his medical degree, he specialised in psychiatry and then about 15 years ago took his specialty a step further into old age psychiatry.
“I was put into a community old age mental health team and found it was a breath of fresh air,” he says. “I really enjoyed working with the elderly and in the cognitive assessment side of things. I realised this was the subsection I wanted to do.”
These days, 70 per cent of his work is with older people and he has come to realise that many people don’t seem to know that much about dementia, hence his decision to write the book.
“People come to me with memory problems, and many don’t know the difference between dementia and Alzheimer’s,” he says. “Many think that dementia is due to normal ageing and this, with a fear of diagnosis, means they leave it too late. We can do a lot more when it is diagnosed earlier.”
Once recognised, it is easier to make clearer plans, anticipate issues, foreshadow interventions and have discussions with the person while they can, rather than relying on relatives to make decisions later.
Dr Roberts has also been surprised at how much uncertainty there is about diagnosis.
“Many think it is just a memory problem, but it could be language, behavioural changes, or planning and organisational abilities,” he says.
“If there is a change in function in any of these areas, you should see about it. The more people can understand what is causing the issue the more power they have to deal with it.”
In addition, severe depression and anxiety can look like dementia and medications can cause cognitive problems.
With his experience, an urge to write, and a gift for giving simple explanations, he set about making Mind Your Brain as user-friendly as possible.
“It was important to make it readable,” he says. “There are few dementia books around and most are too medical and heavy. I wanted to write something accessible that could be read on different levels.”
The books is in two parts. The first explores the science of dementia: how the healthy brain functions, how it changes as we age, the causes of cognitive decline and how to prevent it, and what dementia actually is.
It explains the main types of dementia: Alzheimer’s disease, vascular dementia, frontotemporal dementia, alcohol-related dementia and forms of predominantly subcortical dementia.
Part Two focuses on the lived experience of dementia, in all its aspects – being assessed and diagnosed, symptoms and treatments, the physical and psychological challenges and practical life changes that can maximise comfort and happiness.
It also discusses legal and ethical issues, residential care options, and dying and end-of-life care.
One chapter is devoted to trying to prevent or delay dementia onset, which raises the question of the daily crossword puzzle.
“If you are exercising the brain in the ways you always have it won’t be as effective as doing something you are not used to,” he says. “If you have always done a crossword puzzle, try Soduku. Complex mental activity is good for your brain.”
His other key message is to not avoid diagnosis as there are things that can be done to help.
“It’s not the end of the world and there can be some years of reasonable quality of life,” he says. “Memories are going to become increasingly impaired, but you don’t have to have a fully functioning brain to derive pleasure and happiness.”
And my final question: “Why do we hear so much about dementia now. Is it more common or are there more of us?”
In Australia, more than 400,000 people are known to have dementia and this is projected to keep increasing. It’s simply that only now are we living long enough to get it.
“Medicine has come a long way so we are no longer dying of heart disease but vascular problems are still there and can cause dementia,” Dr Roberts says.
“We live longer but we have not quite worked out what to do with our brain when it gets to those later years.”
Lifestyle factors are relevant too – poor diet, fast food, lack of exercise, and excessive alcohol may be more prevalent and not helping the situation.
If you have any concerns, the best person to see is your GP as they know you best. The GP can do some screening and basic testing and depending on the outcome, will know which specialist to send you to.
Mind your Brain – The Essential Australian Guide to Dementia is now available at all good bookstores and online. Visit yourbraininmind.com or
uqp.com.au and search Mind Your Brain.