By Ngozi T. Akueme
The old man or woman may be grappling with dementia. He or she is neither a wizard/witch nor the source of anyone’s misfortune. This article is driven by several incidences that I have witnessed in person, and also seen on social media over the years. They all follow a similar pattern. The narrative usually begins with a bird falling from the sky, turning into a human being upon landing. The man/woman then starts to confess his/her evil deeds, and many times, saying things that they are prompted to say by the growing surrounding crowd. Some even claim to witness the point where the bird turned into a human being but nobody has ever provided a footage of such in this day and age of technology. Someone manages to start the story, and this attracts a large crowd who mock, bully and sometimes beat up the poor victims who have no memory of where they are, and never did the things they claimed they did. Families have abandoned their grandparents/parents with dementia because they do not understand this medical condition. These poor men/women are left to suffer and eventually succumb to death.
My last personal experience was at Iwo community of Ibadan some years ago. A friend who happened to be around the scene of the incident sent me a video footage of an old woman being tortured. The crowd threw things at her, driving her away and calling her a witch. I recognized this pattern and quickly alerted my colleague, a consultant Neurologist. We went to the scene to find the woman very dehydrated and hungry. She had lost her memory and had been roaming around for some days. We gave her some water and food and arranged to transport her to the hospital where she had good care. She was finally reunited with her family, who had also been searching for her.
How then do we recognize people with dementia in our society? Let us first discuss Dementia. What is dementia? Dementia is an umbrella term for a group of brain disorders that affect memory and thinking. It is a complex disorder with many causes. The most common cause is known as Alzheimer disease (AD). This type typically affects older people.
What are the risk factors for AD?
Age: AD is very common in people older than 80. Studies have shown that one in six people between 80 and 85 years old, one in three above 85 years, and almost half of people over age 90 will have AD.
Family history: AD tend to run in families. If any of your family members has AD, you are at more risk of developing it. The risk is higher if that family member developed this disorder at a younger age.
Metabolic disorders: High blood pressure, high abnormal cholesterol, obesity, and diabetes appear to be risk factors for dementia according to studies.
Lifestyle factors: Older people who are physically, socially, and mentally active and engaged, eat healthy diet, non-smokers, and those who do not abuse alcohol are less likely to develop dementia. A study done by Prof. A. Ogunniyi, a renowned Neurologist, found a greater incidence of dementia in patients living in rural residence and those with poorer economic status in Ibadan.
Other risk factors reported include traumatic brain injury and air pollution.
What are the symptoms and signs of Dementia? How do we recognize people with Dementia?
Forgetfulness: This is one of the earliest signs. People with dementia tend to lose their memory. They forget names, faces, and environments. Love ones first notice difficulty remembering recent information, often leading to a tendency to repeat stories or questions. If you have the cause to tell an older person “How many times do you want me to tell you?” or “You have told me that more than once,” you might start to suspect AD in such persons.
Confusion: Persons with AD are sometimes confused for no reason. They express difficulty with speech and writing, they have trouble concentrating and reasoning.
Getting lost: Because they lose memory, they get lost even in familiar places and start to wander around aimlessly.
Mood abnormalities: They may have episodes of anger or aggression or hostility. On the other hand, some may be depressed or exhibit apathy.
Hallucinations and delusions: They see things that aren’t there or believe things that aren’t true. For example, someone with Dementia can tell you things like “I am the cause of my daughter-in-law’s bareness” or “I casted a certain spell on my neighbor.” Do not take their words seriously.
Dependence: They may be unable to eat, bathe, dress, or perform other basic everyday tasks on their own.
Incontinence: They tend to lose bladder and bowel control, and soil themselves.
Insomnia: They find it difficult to sleep at night.
These symptoms are often mild initially, but continue to worsen as the disease progresses. The progression varies between individuals. Patients often hit the advanced stage within five to ten years of the diagnosis. Most people with Alzheimer disease do not die from the disease itself, but rather from a secondary illness such as pneumonia, urinary infection, complications of a fall, or from neglect and starvation.
What to do?
The earlier we pick up the signs, the better. There are a lot that can be done to slow down the progress of AD. Some other causes of dementia can even be reversible. Persons with these symptoms should be encouraged to see a physician or a neurologist for a complete evaluation and management approach.
Now that we understand dementia better, it is highly important that we identify people with the disorder. Next time you see an old man or woman roaming around aimlessly, having hallucinations or saying scary or irrational things, instead of joining the crowd to condemn him/her, please be his/her voice, protect, and take him/her to the hospital. That could be somebody’s beloved grandmother/grandfather/mother/father. Save the elderly today. It is Dementia. Not witchcraft!!
• Dr. Akueme, Consultant Internal Physician and Dermato-venereologist, FWACP, is currently undergoing further training in medicine at One Brooklyn Health, Brooklyn city, New York. USA. She could be reached via: [email protected]