HEALTH CONDITIONS: Dementia
Keeping blood glucose levels under control can help prevent many diabetes-related problems, including dementia.
BY:MARGARET FARLEY STEELE
Too much sugar in the blood, high cholesterol and high blood pressure—all of which are common among diabetics—contribute to arteriosclerosis (commonly referred to as hardening of the arteries). Besides increasing the likelihood of heart disease and stroke, as well as peripheral vascular disease (PVD), arteriosclerosis can reduce blood flow to the brain, causing the loss of cognitive function. The medical name for this condition is cerebrovascular disease.
In addition, a link between insulin resistance, which is a precursor to type 2 diabetes, and Alzheimer's Disease has also been established. This means that older people with diabetes may be more likely than others to experience cognitive dysfunction, says Alan M. Jacobson, MD, senior vice president and director of the strategic initiatives division, Joslin Diabetes Center in Boston.
If you notice mental deficits in the person you care for—forgetfulness or confusion, for instance—a diagnosis is necessary. The symptoms might stem from something treatable. For example, depression in older people sometimes presents as cognitive dysfunction, says Dr. Jacobson.
If dementia is confirmed, it is important to document the stage and rate of progression. Over time, as different thresholds are crossed, you might need to evaluate whether the individual can continue living alone or is capable of driving. Is she a danger to herself or others? Will she require full-time assistance?
Also, know that cognitive impairment affects judgment. As a result, disagreements over seemingly straightforward issues are more likely to occur. Patience and practice of calm communication skills will prove helpful.
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