‘In India, dementia is more prevalent in people than diagnosed’

“By 2050, one in six people in the world will be over age 65 (16 per cent), up from one in 11 in 2019 (9 per cent),” mentions a 2019 United Nations Report. With the world’s population growing older, the rate of people getting dementia is also on the rise, says Dr Sonia Lal Gupta, neurologist and director, Metro Group of Hospitals, and managing director, Metro College of Health Sciences and Research. An Apeejay Noida alumna, Dr Gupta has been running a senior and assisted living centre with her husband to provide proper care to such people. She also runs an online portal called Voice of Health, which provides the latest information about the developments in the medical field with the right scientific data. In an interview, Dr Gupta sheds light on the causes of dementia and tips for their caregivers, common misconceptions about migraine, and more. Edited excerpts:

What are some of the major causes of dementia? How frequently do we find it affecting people in India?

Dementia is a broad term that means progressive memory deterioration in a way. It is a neurological disorder in which your cognitive abilities are affected. Under this, Alzheimer’s disease and vascular dementia (in people who tend to have high blood pressure, diabetes, and cholesterol, and the smaller blood vessels in the brain get blocked over the years) are the most common.

In India, dementia is more prevalent than diagnosed. The number of people with dementia is definitely going to increase. Many times, people blame it on old age, but dementia requires proper recognition and treatment. Even for the caregiver, it is a challenge to see their loved one go through a process where they might have trouble remembering names or doing their basic day-to-day activities.

We found many such patients with dementia living alone without any caregiver. Their safety becomes a very big concern in such cases. The biggest thing that helps people with dementia is socialisation. So, my husband and I have started a senior and assisted living in Gurugram called Aurum where we have proper memory-care programmes and people who have dementia get the right care.

What tips should the caregivers keep in mind?

*Being patient and compassionate is definitely very important.

*Patients with dementia are sometimes not able to realise how they are portraying their emotions—they may be angry, tired or frustrated–but that they are not doing it on purpose is what a caregiver must keep in mind. Be loving and reassuring to them. At the same time, get help if you as a caregiver are feeling frustrated.

*Ensure that you provide a safe environment for a person with dementia. For instance, when they are going to the bathroom, make sure there is nothing they might trip on.

*Ensure they eat properly and socialise. We have data to show that socialisation helps the most when it comes to memory disorders. Try to form a social group for them at least in the early or moderate stages of dementia. In the severe stage, make sure they get all the help they need. There are several care facilities that you can reach out to.

Tell us about your experience at Apeejay School, Noida.

My father, who is an interventional cardiologist, was to start his own hospital in Noida, so we moved there and that’s how I was enrolled in Apeejay Noida in the ninth grade. The four years that I spent in the school were definitely my formative years. I loved all my teachers—I remember Manjari Ma’am, Gaur  Ma’am  , Shubhra  Ma’am —who played a very important role in shaping me. It was a lovely environment that was conducive to studying and had a positive feel about it. I made very good friends for life.

‘Soaring high is my nature’ has literally been my motto for life. After Apeejay, I went to med school at Patiala and thereafter went to the US where I completed my neurology residency and further did my fellowships in headache and stroke. I worked for a year as an assistant professor after which I moved back to India. I completed my master’s degree from George Washington University. When it comes to education, I have strived to always do better.

Was it because of your father that you decided to become a doctor?

Partly, as the firstborn to a doctor, it was almost predestined for me (laughs). But I absolutely love what I do. The act of helping people out in the profession and the patient-doctor relationship are beautiful. Medicine is a wonderful field and I hope more and more people pursue it. With artificial intelligence coming on board and the way the field is progressing, there is scope to do a lot more.

How did the pandemic impact your work?

A major impact was that everybody was focusing more on Covid than anything else. As a medical professional, the pandemic made one feel more helpless than ever. We got numerous calls for help, especially during the second wave. Overall, the pandemic made us more aware as doctors of how much more we could do for the country, in terms of the infrastructure.

Can you tell us about chronic headaches and how to cope with them?

Believe it or not, there are about 300 types of headaches. If somebody is having a headache for more than 15 days a month and for three-four months in a year, then this problem falls under the category of chronic headache. Chronic headaches can be of different types like tension-type headaches (caused by lack of sleep, lifestyle issues) through which you can function, but it is always there. The more common one is chronic migraine, which is typically a one-sided or bilateral headache. People have nausea with it, light sensitivity or noise sensitivity. Migraine impacts life tremendously. People with chronic migraine end up having a poor quality of life because they are always in pain. The other challenge is that often people around them are not able to gauge the intensity; they think it is just a headache. In reality, it is a full phenomenon that the brain is undergoing. Migraine can and should be treated. Apart from chronic migraine, one can suffer from chronic daily headaches or chronic cluster headaches—what we first need is more awareness along with lifestyle changes.

What lifestyle changes would you recommend?

*Most important is to sleep, which is underrated. We need to understand that our body repairs itself when we sleep. However, most people tend to compromise on sleep. You need those seven-eight hours of sleep but even 10 hours of sleep is too much. It is very important, especially for youngsters to follow a balanced sleep schedule. We already know how excessive use of mobile phones and laptops can impact us and we will see the long-term effects in the years to come. The rate of anxiety, depression, and attention deficit hyperactivity disorder (ADHD) has increased. You cannot eliminate screen time altogether, so parents need to at least limit their usage.

*Physical activity is also at an all-time low. Obesity is increasing tremendously. Seven out of 10 people are obese today. Obesity increases the risk of hypertension, diabetes, and high cholesterol leading to the risk of a heart attack or stroke. Physical activity is very important—take out 30 mins to exercise, three to four times a week.

*Keep yourself hydrated. Drinking three-four litres of water a day is recommended given the scorching heat.

*Eat healthy. Fast and processed food intake must be limited. Eat fruits, vegetables, and healthy grains.

*Focus on mental health. Recognise when you need help. Anxiety and depression in young adults have become very common. It is important to reach out for help because that is the first step to getting better. Mental well-being is linked to physical well-being.

What are some of the common misconceptions about migraine?

People tend to think it is just a regular headache or an excuse. Besides, they tend to relate everything to gas. It is not that headaches are directly related to gas. There are triggers that can cause migraine—food triggers among which the more common ones are chocolate, wine, cheese, etc. It is important to recognise what your triggers are and not just blame gas. With migraine, people tend to have comorbidities like irritable bowel syndrome, anxiety, or even acidity, which are not the cause of migraine but can affect the body simultaneously and should be treated.

Also, stress, although a very big factor, is not the only cause of a migraine. In India, going out in the sun, not drinking enough water, or not sleeping enough are some common causes.