Aspects of dementia might be reversible, says specialist

IOL News

26-04-2025

With growing research on brain health, there are ways to protect your grey matter, boost cognitive function and de-stress.
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Dementia is widely feared as a terminal condition which robs people of their memories and identity, even turning loved ones into strangers. But medical experts say that certain forms of dementia may stem from underlying, treatable causes such as vitamin deficiencies, infections or metabolic disorders - opening the door to reversal in some patients and renewed hope for families.
Dr Kalpesh Narsi, a specialist psychiatrist from the KZN Department of Health said that dementia is not just a memory problem but a multi-organ condition.
Narsi was one of the guest speakers on 'demystifying dementia', a webinar hosted by the Arya Samaj Women's Forum (ASWF). At least 100 people attended the webinar in which Narsi said that there were about 60 types of dementia including Alzheimer's, and often memory loss is just one aspect of it which could manifest much later in the illness, while other warning signs could be missed.
Narsi said dementia was caused by damage to brain cells and it was significant that an organ which weighed around a kilo and a half and which could fit into the palm of your hand was so powerful. 'These brain cells communicate with each other through connections called synapses and in a healthy brain we have close to a hundred trillion synapses so that's really a lot that's going on in this precious little organ, and what happens in dementia is that these neurons or these nerve cells start to degenerate.'
This degeneration, he told the audience, disrupted the thinking or cognitive processes. 'They can have problems about what they're thinking. They have problems with piecing different thoughts together, analyzing their own thoughts, making sense of those thoughts, comprehending. And therefore, their ability to function in daily life is quite impaired.'
Narsi said while memory or attention issues are common symptoms of dementia, only functional decline, the loss of a person's ability to manage daily activities independently can lead to a clear diagnosis. This could include reduced mobility, incontinence, loss of the ability to chew or swallow, and an inability to manage other chronic illnesses such as diabetes or high blood pressure, leading to further health complications. Therefore, the cost associated with dementia could be 'tremendous' because apart from medication, eventually those affected would need nutritional supplements, adult nappies as well as transport to hospitals and clinics, said Narsi.
He highlighted the importance of treating the biological, psychosocial, as well as the lifestyle aspects of the disease. He said in a group of 60-year-old people, about two or three percent of them would suffer from dementia. However, this number increased exponentially as they grew older. 'If I have to look at a cohort of elderly people that are 80 years old, we're looking at about 10% that have dementia. And if you were to reach the age of 95 years, then your chances of having dementia are around 45%, almost 50%. So as you get older, your risk of getting dementia exponentially gets higher and higher.'
Another feature of dementia was that people often displayed exaggerated versions of their preexisting personalities so that someone who was frugal would become extremely stingy or a shy person completely withdrawn. Psychiatric problems like delusions where they begin imagining or believing things that are not true were also a symptom.
'So, they might become paranoid, they might start feeling that people are against them, or people are trying to kill them, or poison them, or people are out to get them, or target them, or maybe even steal things from them. They could hallucinate, which is when people start to hear voices, and typically, they tend to hear voices of the deceased, or voices from, you know, far back in the past,' Narsi said.
But it's not all doom and gloom as some forms of dementia caused by vitamin deficiencies (like B12 or thiamine), infections (HIV or syphilis), or thyroid disorders can be reversed with proper treatment.
'So, therefore, a lot of time needs to be spent by the medical practitioner, the team of doctors, to try and pick out the reversible causes of dementia. 'We have secondary dementia, which is a whole host of conditions, which causes the blood supply to the brain to be compromised. So, diseases such as high blood pressure, diabetes, high cholesterol, or blockage of your arteries, all of these would cause a reduction in oxygen supply to one's brain, and this reduction to oxygen supply will then cause dementia,' he said.
Speaking multiple languages, a high level of education, yoga and meditation are just some ways to protect brain health, Narsi said.
The World Health Organization (WHO) says while age is the strongest known risk factor for dementia, it is not a normal part of ageing. It says dementia is the seventh leading cause of death globally and 65% of dementia-related deaths are in women. In 2021, 57 million people worldwide lived with dementia, with over 60% in low- and middle-income countries and every year there are almost 10 million new cases, according to the WHO.
Spiritual leader Swami Aryavesh, the President of the World Council of Arya Samaj told the audience that lifestyle habits as well as stress could be a major contributor to the disease. As a scholar with qualifications in law and linguistics, Swami Aryavesh said that regular social interaction as well as yoga, meditation, healthy eating and exercise played a key role in brain health.
'We must try to teach ourselves that nothing is permanent, whether it's good or bad. So if there's stress today, it is not permanent, it will go away, you just need to have patience. You just need to give some time to that issue and find a solution and move on.'
Femada Shamam, CEO at The Association for The Aged (TAFTA) said that the whole family was affected when people suffered with dementia.
'The critical thing is building up our social networks because dementia can be a very lonely disease, and not just for the person living with dementia, but for the caregivers. I found that lots of people who care for older people with dementia isolate themselves because they are embarrassed. They're overwhelmed. So building up your social networks becomes absolutely essential.'