MHM Magazine

also heighten the risk of vascular dementia. Lifestyle Choices and Dementia Risk Lifestyle choices made in one’s 40s and 50s significantly influence dementia risk later in life. A healthier lifestyle, including avoiding smoking and excessive alcohol consumption while managing cardiovascular health, can help reduce risk. Sleep quality is crucial, as poor sleep—often induced by alcohol or sleeping pills—negatively affects brain health over time. Chronic alcohol use can lead to a specific form of dementia known as alcohol-related dementia, characterised by brain shrinkage from long-term excessive drinking. Obesity is a global issue linked to dementia risk. Individuals who do not manage their weight and exercise are at increased risk, as inactivity contributes to cognitive decline. The absence of meaningful daily activities—whether due to unemployment, semi-retirement, or other reasons—can adversely affect brain health. During the COVID-19 pandemic, prolonged inactivity and stress due to life events mirrored the cognitive impact of post- traumatic stress disorder (PTSD), further heightening dementia risk. To mitigate this risk, focusing on controllable factors is essential: maintaining a balanced lifestyle, monitoring diet, exercise, and sleep habits are critical to reducing dementia risk. Why Should Women Be Concerned About Dementia? While men should also be concerned, there are specific reasons for women to pay particular attention to dementia. Women tend to live longer than men, making a longer lifespan a risk factor for dementia. However, living longer does not guarantee dementia, but it increases likelihood, especially with suboptimal health habits. Women face slightly higher risks, compounded by societal issues. Many older women, particularly widows, may experience isolation, contributing to cognitive decline. Loneliness, especially in urban settings, poses significant challenges. Women living alone may encounter risks related to impaired vision, hearing, or mobility, often in unsupportive environments. Retirement villages or assisted care estates can provide security and social interaction for older individuals, especially women. These communities offer group activities while ensuring personal privacy and access to medical help. However, financial planning for retirement is crucial; crises can lead to overwhelming health and financial consequences. The Importance of Social Connection Dementia can be an isolating condition, exacerbated by stigma and misunderstanding. Creating environments that foster social interaction and support is vital to combat isolation. Trends in Depression and Dementia A key issue is sleep disruption; nearly every patient over 50 experiences some sleep difficulties. While sleeping less is normal with age, poor sleep quality—often caused by stress—can lead to cognitive decline. The impact of technology, particularly excessive screen time, also plays a role in sleep disruption. The COVID-19 pandemic significantly impacted mental health, with rising anxiety and depression levels. Many required psychiatric intervention during lockdowns due to the stress of job loss and financial instability. Research from Canada indicated that for every 1% drop in GDP, the suicide rate increased by 1%, highlighting the link between economic stress and mental health—a pattern observed globally. In South Africa, load shedding has added stress, particularly for older individuals reliant on consistent power for daily activities. Coupled with water shortages, these disruptions can significantly affect mental health, especially among the elderly. Accessing Help Seeking assessment for dementia or depression varies between private and public healthcare systems. In the private sector, one typically starts with a GP or a community nurse. The GP conducts a basic assessment to rule out conditions like vitamin deficiencies or thyroid issues that can mimic cognitive decline. It’s essential to seek a proper medical evaluation to determine the root cause of any symptoms. Access to Dementia Assessment and Care If the medical assessment identifies treatable issues, such as a vitamin deficiency or thyroid disorder, addressing these can improve mood and cognitive function. If symptoms persist, the GP may refer the individual to a specialist, like a neurologist or psychiatrist, for further evaluation. In the public healthcare system, the process is similar, although patients may first need to go through local clinics, particularly in rural areas. These clinics provide basic assessments and can refer patients to hospitals for detailed tests. For those without access to private care, government hospitals and community health centres offer mental health services, though waiting times may be longer. South Africa's public health system is strained, but options remain for those in need, emphasising the importance of early intervention. It’s crucial to address coexisting mental health concerns, such as depression, which often accompanies dementia. Treatment for depression may involve therapy, medication, or both. While managing depression may not cure dementia, it can significantly enhance the quality of life for both patients and their families. Dementia is a complex and often isolating condition. Early detection and maintaining a healthy, active lifestyle can significantly mitigate its impact. Through diet, exercise, social interaction, and medical intervention, we can all support cognitive health as we age. Women in particular face societal factors like isolation and financial insecurity that may heighten vulnerability, underscoring the need to foster supportive environments. Ultimately, we must ensure access to adequate healthcare and support systems to improve outcomes for those affected by dementia. References available on request. MHM | 2024 | Volume 11 | Issue 5 | Dementia and Alzheimer’s Risk in Women MHM Issue 5 | 2024 | MENTAL HEALTH MATTERS | 17 MHM