What is dementia and how does it affect you?
Dementia is a disease of the brain that causes damage to the brain cells and causes the affected person to lose their memory and other cognitive skills. This can affect their ability to carry out everyday activities and may cause changes to their behaviour, mood and personality.
Therefore, it can be emotionally distressing when a family member or you gets diagnosed with dementia. It gets even more distressing and taxing as the disease progresses, with the patient often requiring care for the simple things we take for granted like having a meal or going to the toilet.
There are many types of dementia such as Alzheimer’s Disease, Vascular Dementia, Lewy Body Dementia, Frontotemporal Dementia, etc. However, the two most common types are Alzheimer’s Disease and Vascular Dementia. The cause of Alzheimer’s Disease is unknown but can be partly attributed to genes causing production and deposition of beta-amyloid plaques that can damage brain cells. Meanwhile, Vascular Dementia is most often caused by multiple small strokes that usually occur over several years.
Causes of dementia from the TCM perspective
From the TCM perspective, dementia can be caused by the following:
1) Lack of marrow in the brain
Ageing or chronic illnesses can deplete the brain marrow, causing lack of nourishment to the brain. This can lead to degeneration which results in problems with memory and thinking skills.
2) Qi and blood deficiency
Lack of qi and blood, which arises from chronic illnesses or a weak digestive system, can reduce blood flow to the Heart (which governs emotions and thoughts from the TCM perspective). This results in the manifestation of emotional problems and psychiatric conditions such as agitation or anxiety.
3) Kidney essence deficiency
Kidney essence deficiency from old age and chronic illnesses can reduce the amount of essence that is being sent up to the brain to be stored as marrow for the nourishment of the brain.
4) Blood stasis and phlegm accumulation
These toxins can block the flow of qi and blood to the brain. Furthermore, blood stasis and phlegm can develop fire or heat in the body over time, which can disrupt proper brain functioning.
How can TCM help to cope with dementia?
As the population ages, the number of people living with dementia has been on the rise. Conventional Western medicine can help to delay the speed of disease progression, but only for a limited period of time. Patients may develop side effects to these western drugs and some may even find it intolerable. Hence, over the years, there has been an increasing trend of dementia patients turning to TCM for dementia support worldwide.
Patients and caregivers usually seek TCM to help cope with the variety of symptoms as dementia progresses, such as memory loss, attention problems, depression and anxiety. TCM is also used to help patients cope with the side effects from medication, such as nausea, poor appetite, constipation and headache.
There are many clinical studies that show that TCM is effective in supporting treatments against dementia. TCM herbal medicine and acupuncture have been effectively used in clinical settings to help slow down the progression of the disease and in some cases improve the cognitive functions and ability of patients to do everyday activities.
For patients who are unable to handle the side effects from their medication or patients who have reached the advanced stage of dementia where conventional drugs can no longer produce meaningful changes in memory or behaviour, TCM can play a dominant role to help improve the quality of life and reduce social and economic burdens of the patient and their family. Research has shown that TCM can reduce the need for special nursing care and medical expenses. Past studies revealed that integrated TCM therapies can reduce the risk of urinary catheterization for people who have difficulty emptying their bladder due to weakness of bladder muscles and reduce the risk of pneumonia among dementia patients who have difficulty in swallowing.
Acupuncture involves inserting very fine needles into specific points along the meridians to stimulate the flow of Qi in our body. Specifically, there is a special Meridian, Du Mai, which runs along the head and enters our brain. Several points on the Du Mai, as well as specific points on our head, can be used to improve cognitive functions. Acupoints Baihui (GV 20), Sishencong (EX-HN1) and Shenting (GV 24) are commonly used points with high clinical efficacy, especially so for acupoint Baihui (GV 20).
Research has shown that GV 20 exerts its therapeutic effects by increasing dopamine levels.  Dopamine serves various important functions. Its functions include acting as a neurotransmitter and being a key regulator in synaptic plasticity, playing a key role in the transmission of signals in our brain. In addition, GV 20, together with Zusanli (ST 36), also preserves the integrity of our Blood-Brain Barrier (BBB) and reduce permeability.
There are several herbs in TCM that are used to boost memory and cognitive functions. They are also used to manage behavioral and psychological symptoms associated with dementia. The most commonly used herbs for dementia patients include Thinleaf milkwort (远志), Ginseng(人参), Poria(茯苓), Chinese Angelica(当归) and Prepared rehmannia root(熟地).
From the TCM perspective, Thinleaf milkwort can anchor the mind, dispel phlegm, and reduce swelling. Ginseng tonifies Qi, strengthens the immunity and tranquilizes the mind. Poria induces diuresis to drain dampness, invigorates the spleen function, and calms the mind. Chinese Angelica tonifies and activates blood, regulate menstruation, relieve pain, moisten the intestines and relaxes bowels. Prepared rehmannia root nourishes yin and replenishes blood, as well as reinforcing essence and marrow.
There are numerous animals and in-vitro studies that indicate these herbs can elicit memory-cultivating effects through mechanisms such as eliciting estrogen-like effects, cholinergic, antioxidants, anti-inflammatory, antiapoptotic, neurogenetic, and anti-Aβ activities, which are similar to modern pharmaco-drugs prescribed for dementia.
Other commonly used and studied herbs such as Ginkgo biloba (银杏叶), Curcuma longa (姜黄), Panax notoginseng (三七) and Salvia miltiorrhiza (丹参) have anti-inflammatory and antioxidant properties to reduce oxidative stress and inflammation in the brain.
In essence, the treatment of dementia with TCM can be achieved through tonifying qi and blood, strengthening the kidney essence which can produce marrow to nourish the brain, and removing blood stasis and toxins from the body. Every patient will be assessed holistically and the techniques and herbs used will be specially curated for the individual to target the root cause.
Prevention and Dementia Care
Dementia usually develops slowly over time in months, or even years, and sometimes the memory deficits can be assumed to be attributed to the natural process of ageing. Hence, it often goes unnoticed. The early signs of dementia can include:
1) Forgetting things that happened recently or recent conversations
2) Saying things or asking questions over and over again
3) Having difficulty completing everyday tasks like paying bills or shopping for groceries
4) Reluctance to try new things and having trouble making decisions
5) Struggling to find words in the middle of a conversation
6) No longer interested in doing things that used to be enjoyable
7) Engaging in actions or doing things that are unusual for the person
If you find your loved ones displaying the above characteristics, he or she may be developing dementia. Do not hesitate to start treatment early.
In addition to getting treatment for dementia patients, dementia care is pertinent to help with their recovery. Caregivers should encourage dementia patients to engage in activities to keep their brains active, such as playing crossword puzzles or making a list of daily things for them to accomplish. In terms of food and diet, dementia patients are encouraged to drink more green tea as tea leaves has bio-active compounds with anti-apoptosis and anti-inflammatory effects. Adding herbs such as sage and rosemary to the food they eat can help to strengthen their cognitive functions as well.
Place of Practice: Oriental Remedies Group
Founded since 2013, Oriental Remedies Group has attracted a dedicated team of bilingual (English and Mandarin) physicians with combined more than 50 years of Traditional Chinese Medicine (TCM) experience and certified therapists, with the common goal of providing the best patient care to our patients by combining the best of TCM treatments as well as modern integrative protocols.
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