boom generation reaches it retirement peak, it would not be surprising if incidences of agerelated dysfunctions are more frequent than ever before.

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1 1 Dementia The brain is the most complex system in the universe. Everything that makes up our personality, our wants, our fears, our behaviors, our thoughts are handled by this incredible organ. Hundreds of neurons fire every minute to keep us functioning and when the connections between these neurons are broken or damaged, the person might develop dementia. But what really is dementia? Dementia, in today s day and age, a word so often heard it s sets forth in our minds a set of scenarios of aged people lost in crowds unable to find their way back home. It is an umbrella term used to describe a group of symptoms characterized by behavioral changes and the loss of cognitive and social functioning. It is the result of physical diseases that damage the brain. Sure there s always a little joke here and there about forgetting your keys but as one gets older, it has different implications. Dementia is not a consequence of growing old but the risk of having dementia increases with age. As per WHO reports, it is estimated that by the year 2020, approximately 70% of the world s population aged 60 and above will be living in developing countries, with 14.2% in India, and hence India will be cradling an aging population. As the baby

2 2 boom generation reaches it retirement peak, it would not be surprising if incidences of agerelated dysfunctions are more frequent than ever before. There are four main diseases that can cause dementia, Alzheimer's disease, Frontotemporal dementia, dementia with Lewy bodies and Parkinson s Disease. It is often so that their symptoms overlap making it difficult to differentiate among them. It ranges in severity from the mildest stage, when it is just beginning to affect a person's functioning, to the most severe stage, when the person must depend completely on others even for basic day to day activities. Alzheimer's disease is the most common cause of dementia. Buildup of proteins Amyloid and Tau damage brain cells ultimately affecting memory. Sometimes strokes also cause dementia. This may be one type of vascular dementia which is caused when there is a reduced flow of blood to the brain. Mixed dementia is when Alzheimer s and vascular dementia occurs simultaneously. Dementia with Lewy bodies often causes hallucinations and poor motor coordination leading to a loss of balance of the body. Dementia affects not only the person living with dementia, but also those around them and in the wider community. From my experience that I gathered by working here in the Dementia Day

3 3 Care Centre for ARDSI, Guwahati chapter, loneliness, retirement, death of a spouse is one of the many triggers that lead to the onset of dementia. Heaps of studies have suggested time and again how loneliness increases the risk of such cognitive impairments. Based on a study conducted by the Journal of Gerontology: Psychological Sciences, participants who reported greater feelings of loneliness were more likely to develop dementia over the preceding 10 years. People who have never married or whose spouse has died are at increased risk of developing dementia compared to married people, according to a new review in the Journal of Neurology Neurosurgery & Psychiatry. It is a reoccurring theme for most of the patients I interacted with to mention how they live all by themselves and are often lonely. The death of a spouse is another theme that is often revisited. To roughly paraphrase the words of one such patient, she says that she began forgetting things after her husband had passed away and then went on to explain how she now lacked a constant support, someone to care for and someone who would care for her. Several researches presented to the American Association for Geriatric Psychiatry, found that widowhood nearly doubled the risk of dementia.

4 4 Another such issue that may be a trigger is boredom and the feelings of unproductivity that follows retirement. A major British study tracking 3,400 retired civil servants found that Once employees become pensioners and begin enjoying a leisurely time at home, short-term memory declines nearly 40 per cent faster. The interactions, both social and otherwise that a job entails causes stimulation to the brain. This stimulation in turn makes sure that cognitive processes are at work and functioning. Retirement causes a sudden dip in brain stimulation. The idea is that there is no regular exercise for the brain in the form of cognitive stimulation after one retires. This may accelerate cognitive decline and may even trigger the onset of dementia. The day in Dementia Day Care Centre starts with warm good-mornings and light conversations as the patients start filling in. The warm winter sun fills in the activity room making it all the more comforting as people start to settle in. Word puzzles, simple math sums; additions, subtractions and multiplications are usually what starts the activity period. Word puzzles generally include a set of jumbled letters, from which the task is to find a given word. Different activity worksheets are distributed, and they are asked to begin working on it. There is an attempt to maintain a delicate balance between helping them but also allowing them the space to work through the given problems. The atmosphere is encouraging, and patient and conversations are entertained. Then gradually, there is a shift towards slightly more difficult tasks such as simple combination sums, writing down words from memory and then forming sentences, sometimes even essays. There is a little bit of exercise after this but not everyone participates. Exercise mostly includes minimal movement of the limbs and simple stretching. Some patients are given much simpler tasks such as coloring.

5 5 After spending a few hours being busy with various activities, conversations, sometimes even singing songs, the patients are picked up by their caregivers or family members. Recently, during the time I worked there, a finger painting competition was held. There was food and music and it was a lovely change for the people. Such events are to be organized every month or so. The Dementia Day Care Centre also conducts memory tests with patients who are referred from other doctors. The tests consist a list of tasks and questions based on which the test takers are scored. This score helps the help givers understand the extent of dysfunction as well as the detection of newer dysfunctions. Since dementia is not a single disease but is in fact a symptom of many diseases, it is difficult to find a unified cure for it. Until now there is no cure for dementia. However, there is tremendous research going on. Some areas of research focus on immunotherapy, stem cell research, identifying who is at risk and then working on cues for its prevention, etc. Although a definite solution for this maladjustment is difficult to fathom, research in this area provides a promising hope. Dementia affects not only the patients, but their family members, social life circle and the quality of their lives. And with an ageing country like India, attention needs to be given to maximize the comforts and ease of life for the majority of the population, which constitutes the older generation. The Alzheimer s and Related Disorders Society of India (ARDSI) has taken one such initiative.