What's the link between Dementia and Mental Health?

Li-Ning Wang
May 30, 2024
6 min read

Introduction:

Dementia is one of the diseases which is much more popular than before. Currently, there are 55 million people who have dementia in the world, especially in low and middle-income countries. Experts predict that there will be 139 million in 2025. Although the number of dementia patients is egregious, not everyone knows what the disease is and how they should take care of the patients. Due to the unfamiliarity of it, fewer people care about the patient's mental health. Most of their families only deal with their general life problems. Unfortunately, dementia patients not only experience life obstacles like losing their way home but also be bothered by mental issues such as anxiety and depression, which should be focused on by people.

What is dementia?

Dementia is a group of conditions characterized by the impairment of at least two brain functions, such as abnormal buildups of proteins known as amyloid plaques and tau tangles. Both dementia and mental illness are related to brain defects or injuries, and there is also a link between them. In the study “Longitudinal Associations of Mental Disorders With Dementia 30-Year Analysis of 1.7 Million New Zealand Citizens,” investigated on February 16, 2022, researchers such as Leah S. Richmond-Rakerd and Stephanie D’Souza designed a program that observed individuals born in New Zealand between 1928 and 1967, to determine the relationship between mental illness and dementia. The result, produced by collecting the mental health admissions to the public hospital record and dementia information via ICD-10 and corresponding ICD-9 dementia codes in public hospitals and mortality records from the New Zealand Ministry of Health, shows that people diagnosed with a mental disorder were more likely to develop dementia than those who did not. Those researchers designed this program to figure out the link between mental illness and dementia, and the purpose of that was to figure out some new ways of treating or preventing people from getting dementia. “Dementia was overrepresented among individuals with a mental disorder: of individuals diagnosed with a mental disorder, 6.1% (3957 of 64 857) were also diagnosed with dementia during the observation period, compared with 1.8% of individuals (30 072 of 1 646 529) without a mental disorder.” The percentage of people with mental illness getting dementia is almost 3.5 times greater than people who do not. This study also mentions that among individuals diagnosed with dementia, those diagnosed with a mental disorder developed dementia a mean of 5.60 years earlier than those without a mental disorder diagnosed. Based on these two results, the link between mental illness and dementia is getting clearer. Mental disorders not only affect the probability of getting dementia but also the timing of getting it. “ Mental disorders are a particularly salient antecedent of dementia among younger individuals. We observed stronger associations among the most recently born cohorts,” this shows that besides the impairments of brain functions that naturally happen with the growth of age, human behaviors may also cause brain damage. Some people may think that being forgetful is a natural thing that will happen when they get older, but the results show that there are other factors, and mental disorders are one of them. Based on this discovery, people had the opportunity to develop a new method of preventing and treating dementia.

Behavioral and psychological symptoms of dementia (BPSD):

Mental illness is not only the predictor of dementia but also the effects or results of it. Behavioral and psychological symptoms of dementia (BPSD), which include a range of neuropsychiatric disturbances such as agitation, aggression, depression, and apathy, affect up to 90% of all dementia patients. According to the study. “Behavioral and Psychological Symptoms of Dementia,” written by researchers such as J. Cerejeira, L. Lagarto, and E. B. Mukaetova-Ladinska, behavioral and psychological symptoms of dementia (BPSD), also known as neuropsychiatric symptoms, representing a heterogeneous group of non-cognitive symptoms and behaviors occurring in subjects with dementia. BPSD includes depression, delusions, hallucinations, et cetera. By interviewing the patients, caregivers could use the standardized clinical assessment to determine their severity. “ BPSD constitutes a major component of dementia syndrome irrespective of its subtype. They are as clinically relevant as cognitive symptoms as they strongly correlate with the degree of functional and cognitive impairment.” Based on this piece of the article, dementia patients not only experience life obstacles caused by forgetting but also be bothered by their emotional problems frequently. “ It is estimated that BPSD affects up to 90% of all dementia subjects throughout their illness and is independently associated with poor outcomes, including distress among patients and caregivers, long-term hospitalization, misuse of medication, and increased health care costs.” The article mentions that the percentage of patients having BPSD is egregious. Besides this, the caregivers such as the nurses in the hospital and dementia patients’ families are also bothered by the effects of BPSD. “ Moreover, the increased number of BPSD correlates negatively with survival rates over three years.” It is horrible that BPSD will also affect the survival rates of dementia patients. To save dementia patients as well as caregivers, BPSD should be faced with and gotten attention by people. According to this study, behavioral and psychological symptoms of dementia are one of the main symptoms of dementia, which influence not only a good amount of patients but also bother their caregivers. To reduce the harm of it, BPSD should be faced and treated by people as soon as it appears. Also, the caregivers should observe and notice if some symptoms appear in the patients.

How to cope with dementia patients?

To dive deeper into behavioral and psychological symptoms of dementia and the way to cope with the patients, the article “Common Dementia Behaviors: Expert Tips for Understanding and Coping” discusses almost every common kind of BPSD and the way for caregivers to cope with patients, by Grace Hobson, mental problems such as sleep issues, confusion, and aggression are common symptoms of dementia patients. "It’s important to discuss all new symptoms to rule out or treat any medical conditions that could be causing the behavior, such as comorbid mental illness." A comorbid mental disorder means a person has multiple psychiatric disorders. For instance, a person may have schizophrenia and OCD, social anxiety, PTSD, et cetera, at the same time. The more kinds of illnesses, the more challenging to treat and cope with. The author also includes Dr. Ardeshir Hashmi’s words in the article. ”Lastly, Hashmi says, 'It helps if you can learn to accept the confusion. At the moment, he says, whatever your loved one thinks is real is their reality.'" For example, they might think they’re at work when they’re really at home. If that belief isn’t hurting them or anyone else, it’s OK for you to play along a little bit. Confronting or trying to change the belief often leads to agitation and aggression.” Not to deny patients who have confusion is one of the most momentous parts of coping with them. Telling them the truth may not let them become clear but let them go into an aggressive mood. Another example is to cope with a person who is in aggressive mode. “When you are faced with a loved one’s aggression, Hashmi suggests employing these 4 Rs: Reassure, Reorient, Redirect, and Reminisce.” First, the caregivers should reassure the patients, “I’m here for you. I’m still here for you. It’s OK,” may calm them down. Besides the way to cope with dementia patients, it is also crucial for caregivers to learn how to relax and seek help. "Dealing with dementia behaviors can quickly wear out a caregiver or family member, causing caregiver burnout. Before burnout, it is helpful to turn to respite care to provide you some relief as you recharge." People are like springs that need to relax after being compressed. Accepting too much pressure without rest may cause elasticity fatigue such as the spread of negative emotions and mental breakdown. To take good care of dementia patients who are struggling with BPSD, caregivers should know how to deal with each kind of symptom, and how to relax and stay in a healthy state, at the same time.

Summary:

From what has been discussed above, it is reasonable that there is a strong link between dementia and mental illness. According to the study, mental illness is a predictor of dementia which has a strong influence on the percentage of individuals getting dementia, especially younger people. Besides that, most dementia patients are affected by behavioral and psychological symptoms of dementia, and that makes the work of their caregivers much more difficult. While knowing how to deal with each symptom and carefully cope with the patients, caregivers should also take good care of themselves. In conclusion, there is a double arrow between dementia and mental illness, which should be focused on by patients' families and caregivers.

Written by Li-Ning Wang