Understanding Dementia and importance of cognitive stimulation

Understanding Dementia and importance of cognitive stimulation

This article is the first in our series on dementia care, written by Dr Jayashree Dasgupta, MPhil, PhD, Neuropsychology, NIMHANS.

What is Dementia ?

Dementia is an umbrella term used to describe a group of symptoms where there is a gradual death of brain cells that eventually lead to problems in thinking and behavior.  There are many types of dementia and this is the leading cause of disability amongst the elderly. In fact, globally, there are about 50 million people with dementia and in India alone, there are over 4 million people with the disease. Staggeringly, one person develops dementia every 3 seconds which means 10 million new cases develop every year.

Although there are many types of dementia, the most common is Alzheimer’s disease which accounts for about 70% of all dementias. In the initial stages, a person may experience difficulty remembering things and making simple decisions, have difficulty finding words to express themselves and have episodes of confusion. Since the person usually has awareness about their difficulties at this stage, they often make attempts to hide memory lapses and excuses to avoid things they find difficult. Often, this is done very successfully making it hard to identify the initial symptoms. Both family members as well as the dementia patient themselves, often overlook these symptoms as being a normal part of ageing. However, it is important to remember that although age is the largest risk factor for dementia it is not a normal part of the aging process.

Reasons for change in behavior

So why do these problem behaviors occur? All our behavior is the result of billions of neurons that form a complex network and communicate with each other inside our brain, pretty much like a highly-complex rail network. But in Alzheimer’s disease, there are changes in the brain that disrupt these networks causing a breakdown in communication and neuronal death. Scientists understand that this is due to abnormal ways in which proteins behave causing what are known as neurofibrillary tangles and amyloid plaques.

In a healthy brain, protein fragments (amyloid) are broken down and eliminated from the body. However, in Alzheimer’s disease, these accumulate to form hard insoluble clumps or plaques in the spaces between neurons. Neurofibrillary tangles are found within a cell and formed as a result of abnormal Tau protein which is essential for building the cell’s transport network for nutrients, and other important substances. Once this essential transport system gets disrupted, the cells die. Imagine a highly efficient rail network (our brain) delivering goods (our behaviors). Over a period of time, if garbage accumulates at a particular junction the network gets blocked and goods cannot be delivered. Also, if there is disruption to a train’s fuel supply, the train won’t be able to run and eventually get discontinued. This is similar to how amyloid plaques and neurofibrillary tangles cause communication blocks and brain cell death in Alzheimer’s disease. The loss of memory and other behavioral problems are a result of this breakdown.

Need for cognitive stimulation

Unfortunately, scientists do not yet know how to stop or change these abnormal processes in the brain and there is no cure for dementia. However, that does not mean there is nothing one can do. Research has shown that cognitive stimulation and engaging in new activities helps slow progression of the illness and maintain quality of life. But how does cognitive stimulation help? The brain has a unique property called neuroplasticity which is the ability to reorganize itself by making new neuronal connections. Going back to how thinking about the neuronal connections in the brain like a train network, this would be similar to finding another route by which to deliver goods, bypassing the blocked junction. This property of neuroplasticity helps the brain adjust itself to disease and is believed to act as a buffer in some individuals. Although it will not reverse the degenerative processes, by encouraging and supporting a person with dementia to remain engaged in mentally stimulating activities, one can help stimulate the brain to make new connections and help maintain well-being.


We at Samvedna Senior Care aim to help seniors live happy, active and independent lives, in the comfort of their home and community through interactive caregiving.

Samvedna Senior Care was established in October 2013 with two complementary goals – firstly to provide quality home care services to seniors with limited mobility or dementia and hence social interaction, and secondly to facilitate stimulating community interaction and participation. Please call us for more info – Delhi NCR – 98184 21446, 124 4229659 or write to us on contact@samvednacare.com

Our Dementia Care services are

At-home services –
Dementia intervention activities by trained Care Specialists (already mentioned above). These services are available in Delhi NCR. More – http://www.samvednacare.com/dementia-care

In-Home Trained Attendant Service –
Samvedna Senior Care’s trained in-home attendant service brings to you verified attendants and nurses, specially trained by specialists in elder care and dementia. Our staff is trained to not only take care of your elderly loved one’s physical wellbeing through top class personal care and nursing, but also their emotional wellbeing.  The attendants are monitored by our Senior Care Specialists (psychologists and MSWs)

Our service is available across Delhi, Gurgaon and Noida. We offer both male and female attendants as per request, for 12 and 24 hour shifts. Know more about our Trained Attendant Services herehttp://www.samvednacare.com/attendant-care-services.

Counselling for Ageing Related Disorders in Anand Niketan, New Delhi –
Studies show that elderly may be more prone to depression and loneliness, which can lead to higher rates of unhappiness. To address this issue, we have designed counselling and therapies for seniors with anxiety, low mood or depression, mild cognitive impairment/ memory difficulties, or dementia. More –https://www.samvednacare.com/counselling

Dementia Cafe, Sector 57 Gurgaon –
From initial stage to advanced stage, all individuals with dementia feel the need for social interaction at times. Our Dementia Cafe is a safe and friendly place for your loved one with dementia to chill and socialize. The cafe is aplace where they will find a fun activity, a warm chair and companionship. Every Tuesday and Thursday, 11-1PM. More – https://www.samvednacare.com/dementia-cafe

Cognitive Wellness Programme, Sector 57  Gurgaon  –
Samvedna’s Cognitive Wellness Programme is designed for seniors with mild cognitive impairment, early dementia or Parkinson’s,and elderly lacking in enthusiasm and motivation. The aim is to stimulate the mind of the elderly to slow the progression of the disease or impairment. The sessions are 3 days a week – Monday, Wednesday and Friday, 11AM-1PM. More – https://www.samvednacare.com/cognitive-wellness-programme

Dementia Support Group –
Our Dementia Support group in Delhi NCR is a platform for caregivers to share feelings and support each other. More – https://www.samvednacare.com/dementia-support-group

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