When’s the best time to find out that you will get dementia?
“Many of the first symptoms of dementia can be difficult to distinguish from normal ageing. That’s probably one of the reasons why people are uncertain as to whether they should contact their doctor with their problems,” says one researcher.
A blood test that can be used to make a precise diagnosis of people with symptoms of dementia is just around the corner.
The test can potentially also determine whether we are at risk of developing Alzheimer's disease years before symptoms appear.
At the same time, it may take several years before a medicine for the disease is available. Needless to say, this poses an ethical dilemma.
What’s the point of knowing that we could develop dementia when there is no cure?
You can read more about this dilemma in this article on sciencenorway.no.
What’s the best timing?
Given all these uncertainties, at what point is it best to find out if you will develop dementia or not?
“When you or your next of kin first notice that your memory is worse than other people your age, or when forgetfulness causes problems in everyday life, it’s a good idea to be examined to find the cause of your problems. The same applies if other cognitive symptoms occur, such as language difficulties or problems with time or orientation in space,” said Karin Persson, a postdoctoral researcher at the National Centre for Ageing and Health.
Could be other things than dementia
Many of the first symptoms of dementia can be difficult to distinguish from symptoms of normal ageing. This is likely the reason why many people wait a little before contacting their primary care physician with their concerns, says Persson.
She points out that illnesses other than dementia can cause cognitive problems, including depression, burnout, vitamin deficiency, infection or metabolic diseases.
Some of these disorders can be easy to treat, she says.
“If the most common causes can be ruled out and there is still no good explanation for the patient’s symptoms, then the patient’s physician should proceed with tests and imaging studies of the brain,” she said.
Medicines that help
A dementia diagnosis isn’t completely hopeless, because doctors have tools to help, even if the disease itself cannot be stopped.
If you are given this diagnosis and the right treatment and follow-up, you can often function better. For example, you will likely be able to continue with many of your usual activities and stay at home longer, Persson said.
“There are also medicines that can help with the symptoms of some diseases that cause dementia. These help the brain cells that have not already been lost work better,” she said.
But drugs cannot stop the disease.
Treat poor vision or hearing
It is also important to optimize everything that helps the brain to function as well as it can, so that the person has the best conditions for living with the handicap they have, she said.
This may involve the use of glasses and a hearing aid if the patient has reduced vision or hearing, or aids that relieve the burden in the exact area that poses challenges.
Many people wonder if it is a good idea to try to learn new things to stimulate the brain.
“Roughly speaking, stimulating activities that are fun are good for the brain. But if you start pushing yourself to do cognitive tasks that you don't like, it can lead to stress. And stress is not good for the brain,” says Persson.
It's important to try to stay fit, both physically and mentally, she said.
“Isolating yourself isn’t good, because then your brain doesn’t get enough stimulation. This can also increase the risk of additional diseases, such as depression,” she said.
Plan to make your life easier
One of the most important reasons for finding out if you have an incipient dementia disease is that it gives you the opportunity to plan, the dementia researcher said.
For example, you can learn to use aids and create routines that help when your cognitive function gradually declines.
You could start using an electronic medicine dispenser, electronic calendars, simpler clocks, easier-to-use mobile phones and remote controls.
People who are employed can arrange their working situation. Those who need to move to a simpler home can do so before they become too ill. You can also create a power of attorney to make it easier for your family members.
In addition, a correct diagnosis and information are important for the next of kin.
Problematic to find out too early
Nevertheless, learning that you have a high risk of developing dementia long before you have symptoms of the disease is problematic, Persson said.
“This diagnosis could cause you to worry and reduce your quality of life, especially as long as we have no treatments to stop or slow the disease,” she said.
As of today, patients are not normally tested until they have symptoms, she said.
Must be prepared
A survey from 2021 showed that more than 100,000 people in Norway have dementia. This was 25 per cent higher than expected.
That number will increase considerably in the coming years.
In 2050, 237,000 people in Norway will have developed dementia. That will require twice as many nursing home places as today.
A lot of work is being done on how healthcare personnel in the primary healthcare service can diagnose the disease earlier and more precisely, Persson said.
Most primary care physicians don't usually have many patients with dementia. That makes it more difficult for them to gain experience in diagnosing dementia, she said.
“There are an increasing number of tools that can help in making a diagnosis, and more are on the way. The Norwegian National Centre for Ageing and Health, for example, is developing e-learning courses in basic dementia assessment for primary care physicians to further increase their knowledge about dementia assessment,” she said.
Some facts about dementia
- Dementia is not one disease, but a syndrome that can be caused by various diseases and injuries.
- A survey from 2021 showed that more than 100,000 people have dementia in Norway. This was 25 per cent higher than expected. Age is the most important risk factor. Ninety percent of all people with dementia are over 65.
- The older we get, the more likely we are to develop dementia. If all 90-year-olds in Norway had been examined, close to half would have been diagnosed with dementia.
- Alzheimer's disease is by far the most common cause of dementia among the elderly. This disease affects around 60-70 per cent of all people who develop dementia. It often starts with forgetfulness, because it first affects the part of the brain that deals with learning.
Translated by Nancy Bazilchuk