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Treating dementia, supporting caregivers - Trinidad and Tobago Newsday

Imagine having to watch someone you love forget themselves and the people they love and slowly become someone else.

That is what many families have to deal with as their older loved ones are affected by dementia.

Dr Kristal Dillon, a family physician for the past 12 years and board member of the Alzheimer's Association of Trinidad and Tobago (AzATT) said there are many types of dementia but Alzheimer's disease and vascular dementia are the two most common types in TT.

“Dementia is a disorder of the brain that affects thought, memory and language. So the symptoms will be in keeping with all these areas of the brain that are affected.”

She stressed that dementia presents differently in each person but, in general, the symptoms start with memory loss. As the disease advances, they begin to get difficulties in performing familiar tasks like brushing their teeth or getting dressed.

It may also affect speech as they forget certain words or how to pronounce them, or become disoriented to time, place and people with a few lucid moments. Some may have behavioural issues such as aggression, irritability and insomnia.

And in the late stage of dementia, there is an escalation of the symptoms including them becoming non-verbal or bedridden.

According to a study done by Dementia Awareness and Research of TT in 2015, in TT, 13 per cent of people over age 60 have some type of dementia. That number is expected to increase to 17.7 per cent by 2025. Also, 23.5 per cent of people over 70 years old have dementia, and of that 23.5, 65 per cent have Alzheimer's.

But the problem is not only in TT. Dillon said the global numbers of people with dementia are expected to triple by 2050. She said AzATT is in the process of designing a national dementia plan with the Health Ministry to prepare for that eventually.

“There are also growing incidents of patients in the younger age groups with dementia. And because of that, next year we plan to launch our (AzATT) youth arm to sensitise young people about the disease. And of course, they are the ones who care for their older relatives so we can also equip them with the tools to do so.”

Dillon said when she sees Alzheimer's patients in her practice, they usually present in the mid-stage of the disease.

She first gets a thorough medical history of the patient and then makes a diagnosis, as not everyone who presents with the symptoms have Alzheimer's.

“There is no test that can diagnose Alzheimer's per se but there are screening tools that could rule out anything more sinister or another condition. Once we are certain it’s Alzheimer's disease, most times the treatment will focus on symptom alleviation.”

She also tries to educate the caregivers and take on a supportive role as there is no cure for dementia and the current treatments do not alter the underlying course of the disease but temporarily improves symptoms.

However, on July 6, the American Food and Drug Administration approved a new drug called Lecanemab. It is the first and only drug that significantly slows the r

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