Their personality changes, they no longer remember an event they have just experienced, feel increasingly overwhelmed and lose interest in previously enjoyable experiences. These and other signs can be harbingers of dementia, which is one of the most common disease syndromes in old age.
The list of celebrities affected is long, and how they deal with the diagnosis varies: Ronald Reagan no longer recognised his wife Nancy after 40 years of marriage, the former actor and head of the Ethiopia charity Karlheinz Böhm concealed his severe dementia until shortly before his death, and Gunter Sachs, who was infamous as a playboy, chose suicide at the age of 78 so as not to have to experience the progression of the disease.
In 2012, people were particularly moved by the fate of the once macho and extroverted football manager Rudi Assauer. Assauer went public and thus reignited the debate about how to deal with dementia in the future.
What do we know today about this mysterious disease and how can we understand, prevent and treat it ayurvedically?
Interesting facts about dementia from today's perspective
The word „dementia“ is derived from the Latin en = decreasing and mens = mind and describes a group of about 50 degenerative diseases of the brain that lead to a long-term loss of mental capacity.
Around 1.4 million people in Germany live with dementia. The World Alzheimer Report 2013 takes an alarming look into the future: in 2050, the number of people suffering from dementia is expected to triple from the current 35 million to 115 million people worldwide.
This development represents one of the greatest challenges for the healthcare systems of all countries, and Germany is still a long way from overcoming it. There is a lack of long-term strategies to ensure that those affected receive the care they need.
The most common form of dementia is Alzheimer's disease, named after the psychiatrist and brain researcher Alois Alzheimer, who first gave a lecture in Tübingen in 1906 „on a peculiar, severe disease process of the cerebral cortex“.
Short-term memory, thinking, language and motor skills are primarily affected.
Classification of dementia diseases
The ICD-10 (International Classification of Diseases) distinguishes between four groups of dementia:
- Dementia with Alzheimer's diseaseAffects about two thirds of all dementia patients
- Vascular dementiaThe cause lies in circulatory disorders (occurring in approx. 1/5 of all dementia patients)
- Dementia in diseases classified elsewheree.g. dementia in Parkinson's disease
- Other dementias
Causes of dementia
The causes of dementia depend on the specific clinical picture. While the mechanisms of the circulatory forms are largely understood, scientists have not yet been able to decipher the causes of Alzheimer's disease in detail.
It is known that protein fragments, known as amyloid plaques, are deposited in the brain years before the onset of Alzheimer's disease. These prevent the exchange of information between nerve cells. As a result of the progressive loss of nerve cells, the brain shrinks by up to 20%.
The main risk factor is old age, and women are more frequently affected. Other risk factors include depression, circulatory disorders, high blood pressure, elevated homocysteine levels (an amino acid), diabetes mellitus, alcohol addiction and obesity. Alzheimer's tends to run in families and genetic factors play a role. The risk for siblings or children of sufferers increases, especially if the disease breaks out early.
All neurodegenerative dementia diseases are progressive and can progress over several years. They lead to an extensive need for care and a shortened life expectancy.
Appearance and progression of Alzheimer's disease
It can take up to three decades before the first signs of Alzheimer's disease appear; the brain can compensate for the loss of nerve cells for a long time.
Those affected suffer in Early stage suffer from increasing memory loss, names and terms are harder to remember, their ability to concentrate and make judgements deteriorates. They misplace objects more frequently and are less able to absorb new information from the newspaper or television. The ability to orientate oneself decreases, for example not being able to find the way back from the toilet to the table in a restaurant or getting lost in the woods. This decline in performance lasts 5-10 years and causes shame, frustration and anxiety in those affected. This often leads to social isolation in order to avoid being noticed in public.
In the middle stage those affected gradually lose awareness of their illness, forgetfulness and disorientation continue to increase and speech is also increasingly impaired. Appointments and dates get mixed up and memories of important experiences and companions in life fade. The change in personality is difficult for relatives to bear.
The late stage is accompanied by a loss of verbal communication and physical deterioration. It leads to urinary and faecal incontinence, susceptibility to infections, stiffness and bedriddenness requiring nursing care. Those affected lose their sense of time, can no longer orientate themselves and no longer recognise their relatives. Despite all these sad characteristics, they can be temporarily emotionalised by familiar sounds, scents and prayers.
Diagnosis and treatment of dementia
To date, there is no medication that can cure irreversible dementia such as Alzheimer's. Existing drugs are aimed at alleviating symptoms and at best slowing the progression of the disease.
For this reason, early detection is of great importance. The earlier the disease is recognised and treated, the slower it progresses. The diagnosis is made on the basis of the patient's medical history, physical examination, laboratory tests, neuropsychological tests and imaging procedures such as CT or MRI.
Therapeutically, the focus is on maintaining everyday skills for as long as possible. Behavioural therapy, memory and brain performance training as well as physiotherapy and occupational therapy are used for this purpose. Relatives often receive psychotherapeutic support to help them cope with the demands of caring for and accompanying those affected.
Medication Anti-dementia drugs to improve mental performance, Antidepressants and Neuroleptics to alleviate behavioural disorders and, if necessary, medication to treat other causes such as circulatory disorders. Drug therapy can alleviate symptoms, but has significant side effects and is therefore not a happy solution.
Dementia from an Ayurvedic perspective
The cause of dementia lies in the mind, its effects are also felt in the body and the senses. In Ayurveda, the loss of memory is called Smriti Bhramsha, the gradual breakdown of brain matter Majjakshaya and refers to the sixth of seven body tissues (Majja Dhatu = bone marrow and nervous tissue). The predominant dosha is Vata, which can secondarily disrupt Pitta and Kapha.
In Ayurveda, we distinguish between three central „faculties“, i.e. abilities, of the mind:
- Buddhi = the ability to discern
- Dhriti = the determination and willpower
- Smrtit = the ability to remember
Our spirit is characterised by the three qualities Sattva, Rajas and Tamas characterised:
- Under the influence of Sattva, The principle of mental balance means that all three faculties function perfectly in an age-appropriate manner.
- Rajas, The principle of tension and energy selectively promotes our mental abilities to achieve personal goals and avoid unwanted experiences.
- Under the influence of Tamas, the principle of mental inertia and dullness, all three faculties are weakened.
Dementia leads to a decline in all three mental faculties with deficits in the cognitive, emotional and social areas. People with dementia are often no longer able to distinguish between dreams, the past and reality (Buddhi Bhramsha) and hallucinate. The loss of memory prevents them from making decisions based on past experiences.
Dementia prophylaxis - it's all about prevention
A conscious and healthy Ayurvedic lifestyle can significantly reduce the likelihood of developing dementia.
In her book „Prevention of dementia“, the well-known neurobiologist and Ayurveda doctor Vinod Verma describes 12 risk factors that need to be controlled:
- Excessive and incorrect use of the sensory organs
- Incorrect shoulder and neck posture
- Incorrect breathing
- Blockage of nasal breathing
- Chronic recurrent colds with mucus accumulation, sinusitis
- Chronic Vata imbalance
- General weakness, deep exhaustion
- High blood pressure
- Frequent mental tension and feeling of helplessness
- Shock experiences and trauma
- Living in the past, fears of the future
- Erratic thoughts
The aim of Verma is to preserve and protect nerve cells, brain matter and sensory organs and to ensure their healthy interaction.
Complementary methods of dementia prevention include a balanced diet, regular exercise, professional and private realisation, an active social life and maintaining contacts, as well as daily mental training.
The performance of the brain depends on how it is used. That's why you should always look for new challenges without overtaxing yourself. Learning new languages, setting up and operating a computer and continuing to educate yourself even in old age can be valuable „training“ against dementia.
Meditation is the best training for the mind that is recommended in Ayurveda. It can regulate tension, centre the mind, control the body, regenerate the senses and release emotions.
Ahara - Ayurvedic nutritional medicine for dementia
From a Western perspective, a Mediterranean diet is a good prophylactic against dementia: lots of vegetables, fruit, olive oil, fish and wholemeal bread are recommended. The highly concentrated omega-3 fatty acids contained in oily fish are also recommended as a dietary supplement, while seaweed products are an alternative for vegetarians and vegans.
From an Ayurvedic point of view, ghee is recommended daily as the best fat for our nervous system. This should be supplemented with olive oil and a nut/seed oil (e.g. walnut oil).
In Ayurveda, the meal system, the choice of food groups and their proportions are always individualised according to the person and not just according to their clinical picture. It is therefore not possible to make a generalised recommendation for dementia.
To reduce the increased Vata and air element, warm, oily and nourishing food should be consumed regularly.
Vihara - the ayurvedic order therapy for dementia
People with dementia need regular daily routines with regular mealtimes and active and passive elements.
The effect of music and art has been known for some time and can have a soothing effect at every stage of dementia. Singing and making music together has a strong emotionalising effect and reinforces positive feelings.
Vastu Shastra, the Vedic teachings on healthy living, can be used as „Ayurvedic milieu therapy“. This is primarily aimed at the design of living spaces to increase the well-being of those affected. Colours, fabrics and furniture can have a strong influence and evoke positive memories.
Aushadha - Ayurvedic herbal medicine for dementia
Therapy with medicinal plants aims to improve the metabolism in the nerve tissue, prevent cerebral degeneration and optimise the performance of all nerve cells.
The following medicinal plants with anti-dementia effects are used for this purpose:
- WITHANIA SOMNIFERA = ASHWAGANDHA (winter cherry)
- CURCUMA LONGA = HARIDRA (turmeric)
- BACOPA MONNIERI = BRAHMI (small fat leaf)
- CONVOLVULUS PLURICAULIS = SHANKHAPUSHPI (field bindweed)
- CENTELLA ASIATICA = MANDUKAPARNI (Indian Pennywort)
- CELASTRUS PANICULATUS = JYOTISHMATI (Tree Shrike)
- NARDOSTACHYS JATAMANSI = JATAMANSI (Indian nard)
- ACORUS CALAMUS = VACHA (calamus)
- GLYCYRRHIZA GLABRA = YASHTIMADHU (liquorice)
- TINOSPORA CORDIFOLIA = GUDUCHI
Many of the mechanisms of action of these plants have been proven in scientific studies, here are three examples:
- Ashwagandha has a cognitive and memory-enhancing, adaptogenic effect and improves adaptation to internal and external stressors. Its withanamides inhibit free radicals, prevent amyloid formation and block the death of nerve cells favoured by amyloid deposits.
- Curcuma counteracts the accumulation of amyloid plaques and reduces existing ones. It is also one of the most effective means of inhibiting inflammation and reducing free radicals.
- Brahmi improves cognitive functions, strengthens memory and protects neurones from amlyoid-induced cell death by inhibiting cellular acetylcholinesterase activity.
An experienced Ayurveda diagnostician and therapist must be consulted to determine the exact composition of the medicinal plants in question. I strongly advise against self-medication, which can also have detrimental consequences.
It is now undisputed that the plants mentioned have a positive effect on the central nervous system (CNS) with regard to the problem of dementia. However, one central question remains unanswered: can the active plant substances cross the blood-brain barrier and thus reach the CNS?
Further studies and research are required to clarify this important question. Until then, we rely on the extensive experience from a classical Ayurvedic perspective. It is interesting to note that Ayurveda very often uses fatty preparations based on ghee or sesame oil to treat the nervous system and that these are not only administered orally but also through the nose and skin. From a Western perspective, this can be a way of overcoming the blood-brain barrier.
With best wishes for your health,
Ralph Steuernagel
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