Mental Illness and Dementia Link – Is there cause for concern?

I have Bipolar Disorder, Social Anxiety Disorder, Depression, Panic Disorder, General Anxiety Disorder, PTSD, and a slew of other medical issues not related to psychology. However, I have become concerned about developing Alzheimer’s disease or Dementia as I grow older. I’m already middle age and have had some cognitive issues such as loss of memory.

I know, memory loss comes with getting older, right? But, when is it just “getting older” and not something more serious? Especially considering the number of mental health issues others or I may have.

So, I decided to talk to my psychiatrist about the concerns I had by giving him a list of my questions and asking him to consider them before responding. He’s a wonderful psychiatrist and has experience treating patients with Dementia and Alzheimer’s as well. I’ve been seeing him since 2008 after my first psychiatric hospitalization.

My fear was that I’d end up with Dementia either because I had Bipolar Disorder or because of the assortment of medications I was going to be on for the rest of my life that are used to control and stabilize my mental health issues.

Here is the list of questions I asked my doctor. I told him I would be writing an article on the topic.

1. Is this a healthy or normal fear for a person with mental illness?

2. Do you know the “odds” of a person with mental illness ending up with dementia and when does it usually set in?

3. What can a person with mental illness do to help prevent dementia from occurring? Or is there anything?

4. Have you had any personal experience with a mental ill person having dementia? What can you tell me about it?

5. Do you know the percentage of people with dementia who were also mentally ill?

6. Can dementia be medicinally invoked?

7. What types of medications, if there are any, are more apt to cause dementia in mentally ill patients?

8. Are there medications for dementia that can help ease the symptoms?

9. Are there medications that can prolong the onset of dementia?

10. Have I not asked questions on any other topics that you’d like me to bring up in the article?

His response to me was the following:

“These fears and questions you have are fairly common. There does seem to be a relationship between developing dementia and having mental illness but it also appears that staying in treatment reduces this. As far as my personal experience what I have seen is people who are older and suffering from severe depression appearing demented. In the best case scenario I have seen the person appear to regain normal functioning once the depression subsides. In the worst-case scenario I have seen the dementia appear to take hold but in those few cases the depression did not get better either. I really don’t think there is much evidence that medications cause dementia in patients.“

Sometimes if it seems that cognitive issues are becoming prominent will prescribe Alzheimer’s medications and I think we have done with this with you (Namenda). It sounds like this will be a very interesting piece and I will be curious to see if your research digs up any other issues I haven’t addressed here.” (Dr. Kenneth Pages, M.D. General Psychiatry, Tampa, FL)

So, as you can see, more research is needed. Imagine my surprise when I used Google to search for “Mental Illness, Dementia, Link” and the pages of responses I received. I did not realize that there was that much information out there about a subject I thought was an abject fear floating around in my head.

From what I’ve read, here’s what I can tell you. There is a link between Depression and Dementia. It has been proven through several studies from as early as the 1970s. One of the studies used participants from the Framingham Heart Study (http://articles.cnn.com/2010-07-05/health/depression.dementia_1_dementia-depressed-people-large-study?_s=PM:HEALTH). It concluded “Those who were depressed when first examined almost doubled their risk for dementia and also increased their risk for Alzheimer’s disease.” (http://articles.cnn.com/2010-07-05/health/depression.dementia_1_dementia-depressed-people-large-study?_s=PM:HEALTH).

So, that got me wondering. Is there anything a person can do to help slow down the progression of Dementia or halt it altogether?

“If depression is indeed a risk factor for dementia, treating depression should help stave off dementia, but no studies have shown this effect” (said lead author Jane Saczynski, assistant professor of medicine at the University of Massachusetts Medical School).

Another study identified in the PsychNet Journal, tested twins for more than 10 years. They determined a “History of depression and other psychiatric illness as risk factors for Alzheimer disease in a twin sample.” (Wetherell, Julie Loebach; Gatz, Margaret; Johansson, Boo; Pedersen, Nancy L. Alzheimer Disease and Associated Disorders, Vol 13(1), Mar 1999, 47-52. doi: 10.1097/00002093-199903000-00007).

I must tell you, that every study I’ve read has found a link between mental illness and Dementia, but none of them have found the reason or cause.

In an article about Dementia, I discovered the following: Dementia can be caused by one medical condition or by multiple medical problems. Some types of dementia can be cured partially or completely with treatment. The degree of reversibility often depends on how quickly the underlying cause is detected and treated. Other types of dementia are irreversible and cannot be cured (e.g., dementia due to Alzheimer’s Disease)(http://www.psychiatry24x7.com/bgdisplay.jhtml?itemname=dementia_about).

According to the Mayo Clinic, “Treatment of the underlying causes of dementia can also slow or sometimes stop its progress.” (http://www.mayoclinic.com/health/dementia/DS01131/DSECTION=treatments%2Dand%2Ddrugs). 

Particularly, the specific drugs:

Cholinesterase inhibitors. These drugs — donepezil (Aricept), rivastigmine (Exelon) and galantamine hydrobromide (Razadyne) — are Alzheimer’s drugs that work by boosting levels of a chemical messenger involved in memory and judgment. Side effects can include nausea, vomiting and diarrhea. Although primarily used as Alzheimer’s drugs, they’re also used to treat vascular, Parkinson’s and Lewy body dementias.
Memantine (Namenda). This drug for Alzheimer’s disease works by regulating the activity of glutamate, another chemical messenger involved in all brain function, including learning and memory. Its most common side effect is dizziness. Some research has shown that combining memantine with a cholinesterase inhibitor may have even better results. Although primarily used to treat Alzheimer’s disease, it may help improve symptoms in other dementias.

But, are all the memory lapses we may have a sign of impending Dementia?

Hardly.

Check out this article I read in the AARP e-magazine, 6 Types of Normal Memory Lapses. According to the author, many memory lapses and “brain freeze” are just a normal part of growing older and gives memory tips to help you with each kind of memory lapse.

“Studies have shown that people who exercise, stay mentally active, socialize regularly and eat a healthy diet canminimize memory loss.” (Mary A. Fischer | from: AARP | August 1, 2012)

So, don’t freak out like I did and get all paranoid and full of fear about impending aging brain diseases. We all have enough to deal with as it is.

Don’t worry. Be Happy.

And, don’t forget to take care of yourself, both physically and mentally. It’s for your own good.

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