Abstract:
Globally, over 55 million individuals are living with dementia, with more than 60% of these cases occurring in low- and middle-income countries. Each year, nearly 10 million new diagnoses are made, establishing dementia as a significant cause of disability and dependency among older adults. This condition imposes considerable physical, psychological, social, and economic challenges on patients, caregivers, and families, who provide most of the care. Stigma and a lack of awareness often hinder diagnosis and treatment, exacerbating the societal burden.
Homoeopathy posits that chronic illnesses typically manifest through mental changes before any physical symptoms, a principle advocated by Dr. Samuel Hahnemann and Dr. James Kent. Cognitive symptoms, encompassing a patient’s will, emotions, intellect, and memory, are crucial for selecting the appropriate remedy based on symptom similarity.
Given that dementia primarily impacts memory and cognitive abilities, it aligns well with homoeopathy’s emphasis on mental symptoms. Homoeopathic remedies can serve as a safe and cost-effective approach to supportive care for dementia, addressing individual mental profiles without causing adverse effects. This article explores the potential of homoeopathy in managing disorders related to memory.
Keywords: Mental health impact, Homoeopathy in dementia, Symptom similarity, Supportive care in homoeopathy, Cost-effective treatment.
Introduction:
Dementia is a profoundly debilitating neurodegenerative condition that imposes substantial physical, emotional, and financial strains on individuals affected by it, their caregivers, and society as a whole. Over the past few decades, the global impact of dementia has escalated alarmingly. Although there is some evidence supporting the efficacy of homoeopathic treatments for certain psychiatric conditions, research on the role of homoeopathy in dementia remains limited.
Dementia itself is a syndrome that can arise from various diseases, gradually leading to the destruction of nerve cells and brain damage. This typically results in cognitive decline that exceeds what might normally be anticipated from the natural ageing process. While consciousness often remains intact, cognitive impairment frequently occurs alongside even precedes alteration in mood, emotional regulation, behaviour or motivation.
The consequences of dementia extend beyond those diagnosed, affecting the physical, psychological, social, and economic realms of caregivers, families, and society at large. A significant lack of awareness and understanding regarding dementia often leads to stigmatization and creates barriers to effective diagnosis and care.
Incidence: Currently more than 55 million people have dementia worldwide, over 60% of whom live in low-and middle-income countries. Every year, there are nearly 10 million new cases.
Aetiology:
Dementia results from damage to or the loss of nerve cells and their connections within the brain. The specific symptoms exhibited vary based on the affected brain regions, meaning that dementia can manifest differently in each individual.
Dementia types are often classified based on shared characteristics. This may include the specific proteins that accumulate in the brain or the particular brain areas that are impacted. Additionally, some diseases exhibit symptoms similar to those of dementia, and certain medications can trigger reactions that present dementia-like symptoms. A deficiency in specific vitamins or minerals can also lead to symptoms associated with dementia. In such cases, addressing the deficiency may lead to an improvement in these symptoms.
Progressive Dementias
Progressive dementias get worse over time. Types of dementias that worsen and aren’t reversible include:
Alzheimer’s Disease is the most prevalent form of dementia. While the exact causes of Alzheimer’s remain largely unclear, it is known that a small percentage of cases are linked to alterations in three specific genes, which can be inherited from parents to offspring. Although multiple genes likely contribute to the development of Alzheimer’s, a significant one associated with increased risk is the apolipoprotein E4 (APOE) gene.
Individuals with Alzheimer’s disease exhibit the presence of plaques and tangles in their brains. Plaques consist of clusters of a protein known as beta-amyloid, while tangles are fibrous masses formed by tau protein. These accumulations are believed to disrupt the function of healthy brain cells and damage the connections between them.
Vascular Dementia is a form of dementia that arises from damage to the blood vessels supplying the brain. Issues with blood vessels can lead to strokes or other complications, such as harm to the fibres in the brain’s white matter.
The most prevalent symptoms of vascular dementia include difficulties with problem-solving, slowed cognitive processing and challenges with maintaining focus and organization. These symptoms often become more apparent than memory issues.
Lewy Body Dementia is characterized by the presence of Lewy bodies, which are balloon-like aggregates of protein found in the brains of individuals with Lewy body dementia, Alzheimer’s disease, and Parkinson’s disease. This type of dementia is among the more common forms.
Typical symptoms of Lewy body dementia include acting out dreams during sleep and experiencing visual hallucinations—seeing things that are not present. Other symptoms may include difficulties with attention and focus, as well as physical signs such as slow or uncoordinated movements, tremors, and stiffness, collectively referred to as parkinsonism.
Frontotemporal Dementia refers to a group of disorders that result from the degeneration of nerve cells and their connections in the frontal and temporal lobes of the brain. These regions are crucial for functions related to personality, behaviour, and language. Common symptoms include changes in behaviour, personality shifts, impaired thinking and judgment, as well as difficulties with language and movement.
Mixed Dementia is characterized by the presence of multiple underlying causes of dementia. Autopsy studies of individuals aged 80 and older with dementia have shown that many exhibited a combination of different types, such as Alzheimer’s disease, vascular dementia, and Lewy body dementia. Research is ongoing to better understand how mixed dementia impacts symptoms and treatment approaches. (7)
Sign and Symptoms: Changes in mood and behaviour can often occur before the onset of memory issues. As the condition progresses, symptoms typically worsen. Ultimately, many individuals with dementia will require assistance from others to manage daily activities.
Early signs and symptoms are:
- Forgetting things or recent events
- Losing or misplacing things
- Getting lost when walking or driving
- Being confused, even in familiar places
- Losing track of time
- Difficulties solving problems or making decisions
- Problems following conversations or trouble finding words
- Difficulties performing familiar tasks
- Misjudging distances to objects visually.
- Common changes in mood and behaviour include:
- Feeling anxious, sad, or angry about memory loss
- Personality changes
- Inappropriate behaviour
- Withdrawal from work or social activities
- Being less interested in other people’s emotions.
Dementia impacts individuals in various ways, influenced by the underlying causes, existing health conditions, and the person’s cognitive abilities before the onset of illness. Most symptoms tend to worsen over time, while some may diminish or only manifest in the later stages of the disease. As dementia progresses, individuals typically require more assistance with personal care. Those affected may struggle to recognize family members or friends, face mobility challenges, lose control over bladder and bowel functions, encounter difficulties with eating and drinking, and exhibit behavioural changes such as aggression. These changes can be distressing not only for the person with dementia but also for those around them.
Risk Factor
Various factors can contribute to the development of dementia over time. While some factors, such as age, are unchangeable, others can be managed to help lower your risk.
Unchangeable Risk Factors:
Age: The likelihood of developing dementia increases with age, particularly after 65. However, it’s important to note that dementia is not a normal part of the ageing process and can also affect younger individuals.
Family History: A family history of dementia elevates your risk of developing the condition. Nevertheless, many individuals with a familial background do not show symptoms, and conversely, some without any family history do experience it. Genetic testing can reveal specific genetic changes that may heighten your risk.
Down Syndrome: Many individuals with Down syndrome may develop early-onset Alzheimer’s disease by middle age.
Diagnosis
To identify the underlying cause of dementia, a healthcare professional must assess the specific pattern of skill and functional decline. They also evaluate the abilities that the individual still possesses. Recently, biomarkers have been introduced to facilitate a more precise diagnosis of Alzheimer’s disease.
A healthcare provider will review your medical history and symptoms, along with conducting a physical examination. Additionally, someone close to you may be consulted regarding your symptoms.
There is no single test that can definitively diagnose dementia. Instead, a series of assessments will likely be necessary to accurately identify the issue.
Cognitive and neuropsychological tests
These assessments examine cognitive abilities. Several tests are designed to evaluate skills related to memory, orientation, reasoning and judgment, language proficiency, and attention.
Neurological Evaluation
Your evaluation includes an assessment of memory, language abilities, visual perception, attention, problem-solving skills, movement, sensory functions, balance, reflexes, and other relevant areas
BRAIN SCAN
CT or MRI. These scans can check for evidence of stroke, bleeding, tumour or fluid buildup, known as hydrocephalus.
PET scans. These scans can show patterns of brain activity. They can determine whether amyloid or tau protein, hallmarks of Alzheimer’s disease, have been deposited in the brain.
Laboratory tests
Basic blood tests can identify physical issues that may impact brain function, such as a deficiency in vitamin B-12 or an underactive thyroid. In some cases, spinal fluid may be analyzed to check for infections, inflammation, or indicators of certain degenerative diseases.
Psychiatric evaluation
A mental health professional can determine whether depression or another mental health condition is contributing to your symptoms
Treatment
Managing dementia, including Alzheimer’s disease, involves a multifaceted approach that combines various therapies to alleviate symptoms and slow cognitive decline. Important treatments include conventional Medicines, Homoeopathy, and other allied medicines which enhance communication between brain cells, thereby improving cognitive function and addressing behavioural symptoms. In more advanced stages of the disease, memantine is often introduced to help preserve cognitive abilities. Additionally, newer therapies like leqembi and donanemab target amyloid plaques—proteins linked to the progression of Alzheimer’s—to slow down the disease in its early stages. However, these innovative treatments may come with risks, such as brain swelling, necessitating close monitoring.
Beyond medication, establishing a safe and structured environment can greatly benefit individuals with dementia. This includes organizing daily activities, securing valuable belongings, and employing location-tracking technologies to enhance safety. Research indicates that lifestyle modifications, such as engaging in physical activity and adopting a heart-healthy diet, may also help delay the onset of dementia and promote overall brain health.
Future treatment strategies are exploring innovative methods, such as targeting tau proteins, reducing inflammation, and examining the connection between brain and heart health, which may lead to more effective therapies in the future. Ongoing research into experimental treatments and lifestyle changes holds promise for improving the quality of life for both dementia patients and their caregivers. (7)
Treatment
Most types of dementia can’t be cured, but there are ways to manage your symptoms.
Medications (Conventional)
The following are used to temporarily improve dementia symptoms.
Cholinesterase inhibitors. These medicines work by boosting levels of a chemical messenger involved in memory and judgment. They include donepezil (Aricept, Adlarity), rivastigmine (Exelon) and galantamine (Razadyne ER).
Although primarily used to treat Alzheimer’s disease, these medicines also might be prescribed for other dementias. They might be prescribed for people with vascular dementia, Parkinson’s disease dementia and Lewy body dementia.
Side effects can include nausea, vomiting and diarrhoea. Other possible side effects include slowed heart rate, fainting and sleep problems.
Memantine. Memantine (Namenda) works by regulating the activity of glutamate. Glutamate is another chemical messenger involved in brain functions such as learning and memory. Memantine is sometimes prescribed with a cholinesterase inhibitor.
A common side effect of memantine is dizziness.
Other medicines. You might take other medicines to treat symptoms or other conditions. You may need treatment for depression, sleep problems, hallucinations, parkinsonism or agitation.
Therapies
Several dementia symptoms and behavioural problems might be treated initially with therapies other than medicine. These may include:
Occupational therapy. An occupational therapist can show you how to make your home safer and teach coping behaviours. The purpose is to prevent accidents, such as falls. The therapy also helps you manage behavior and prepare you for when dementia progresses.
Changes to the environment. Reducing clutter and noise can make it easier for someone with dementia to focus and function. You might need to hide objects that can threaten safety, such as knives and car keys. Monitoring systems can alert you if the person with dementia wanders.
Simpler tasks. Breaking tasks into easier steps and focusing on success, not failure, can be helpful. Structure and routine help reduce confusion in people with dementia.
Lifestyle and Home Medicine
As dementia symptoms and behavioural issues tend to worsen over time, caregivers and care partners may consider the following strategies:
Improve Communication: When conversing with your loved one, maintain eye contact and speak slowly using simple sentences. Allow them time to respond and present one idea or instruction at a time. Incorporate gestures and cues, such as pointing to relevant objects, to aid understanding.
Promote Physical Activity: Exercise can enhance strength, balance, and cardiovascular health in individuals with dementia. It may also alleviate symptoms like restlessness. Increasing evidence suggests that regular physical activity protects the brain from dementia, particularly when paired with a healthy diet and management of cardiovascular risk factors. Some studies indicate that exercise may slow cognitive decline in those with Alzheimer’s disease and help reduce symptoms of depression.
Encourage Engaging Activities: Organize activities that your loved one enjoys and can participate in, such as dancing, painting, gardening, cooking, or singing. These activities not only foster connection but also help individuals with dementia focus on their remaining abilities.
Establish a Nighttime Routine: Behavioral issues can often escalate in the evening. Developing a calming bedtime routine can be beneficial, away from distractions like television, meal cleanup, and active family members. Keeping night lights on in the bedroom, hallways, and bathrooms can help prevent disorientation. Additionally, limiting caffeine intake, discouraging daytime napping, and providing opportunities for exercise during the day may alleviate nighttime restlessness.
Maintain a Calendar: A calendar can assist your loved one in remembering important events, daily tasks, and medication schedules. Sharing a calendar may enhance their ability to stay organized.
Plan for the Future: It’s essential to create a care plan while your loved one can still participate. This plan should outline goals for future care, and support from groups, legal advisers, family members, and other resources can be invaluable.
Other Therapies
Various techniques may help reduce agitation and encourage relaxation for individuals with dementia:
Music Therapy: Listening to calming music.
Gentle Exercise: Engaging in light physical activity.
Family Videos: Watching videos featuring family members.
Pet Therapy: Interaction with pets, such as dogs or other animals, can improve mood and behaviour.
Aromatherapy: Utilizing fragrant essential oils from plants.
Massage Therapy: Providing therapeutic massages.
Art Therapy: Engaging in the creative process of making art without focusing on the final product.
Homoeopathic Management:
Homoeopathic management of dementia is a supportive approach focused on individual symptoms rather than a one-size-fits-all cure. Since dementia affects cognitive functions like memory, judgment, and personality, homoeopathy seeks to treat each patient’s unique mental and emotional profile through symptom similarity—a principle emphasizing remedies that match the patient’s specific symptoms and mental state.
Remedies:
Anacardium Orientalis:
Hypochondriacal sadness, and melancholy ideas. Anthropophobia. Anxiety, apprehension, and fear of approaching death. Fear and mistrust of the future, with discouragement and despair. Disposition to take everything a miss, to contradict, and to fly into a rage. Frequently screams loudly, as if to call someone; so furious has to be restrained. manners were awkward and silly. Disposition to laugh at serious things, and to maintain a serious demeanour when anything laughable occurs. State as if there were two wills, one of which rejects what the other requires. Irresistible desire to blaspheme, and to swear. The sensation is as if the mind were separated from the body. Weakness of mind and memory. Loss of memory. Soon forgets everything; consciousness of forgetfulness takes away appetite. Weakness of all the senses. Absence of ideas. Fixed ideas. Hallucinations; thinks he is possessed of two persons or wills. Anxiety when walking, as if pursued. Profound melancholy and hypochondriasis, with a tendency to use violent language. Brain-fag. Impaired memory. Absent-mindedness. Very easily offended. Malicious; seems bent on wickedness. Lack of confidence in himself or others. Suspicious (Hyos). Clairaudient, hears voices far away or of the dead. Senile dementia. Absence of all moral restraint.
Baryta Carb:
Loss of memory, mental weakness. Irresolute. Lost confidence in himself. Senile dementia. Confusion. Bashful. Aversion to strangers. Childish; grief over trifles.
Carboneum Sulphuratum:
Difficult thinking. Memory is defective; cannot find the right word. Great loquacity, but frequent loss of memory for words. Sought for things lying before them. Childish and idiotic. Surly, morose; vehement, irascible. Exhilaration bordering on drunkenness. Indifferent to the surroundings. Irritability is followed by indigestion. Laughter without cause.
Delusions; heard voices and believed he had committed a robbery. Saw obstacles in front of him that did not exist. A sensation of a hole close by into which he was in danger of falling. Attacks of semi-unconsciousness with convulsive movements of the limbs lasting half a minute.(10)
Nux Moschata
Weeping mood with burning in eyes and lachrymation. Fickleness, with desire sometimes for one thing, at others for something else. Great inclination to laugh, to make a jest of everything, esp. when in the open air, sometimes with a stupid look, as if imbecile. The Incessant flow of facetious ideas. Everything about him seemed ludicrous. Humour grave and gay alternately. Mentally excited and exhilarated. Facility of arguing. After dining, my head felt strange as if in a dream. Seemed to be two persons, his real conscious self seemed to be watching his other self-playing (piano). They could not play well, struck false notes, and were obliged to give it up. He seemed lost when spoken to, and would come to himself with a start. Transient loss of memory, but a perfect consciousness of all that I said or did. Surroundings seem changed; fanciful, dreamy images; do not recognize well-known streets. Weakness of memory; loss of memory. Entirely lost memory of his past life. A hallucination that she has two heads. Sense of impending dissolution; besought me piteously not to let her die. The slowness of apprehension, dizziness, and difficult conception. Lack of ideas, from absence of mind; vanishing of thoughts in reading, disposition to go to sleep. Dullness of senses, thoughtlessness, with slowly returning consciousness. Dementia and mental alienation (idiocy). Mania, with odd speeches and ridiculous gestures. Delirium with violent vertigo, improper talk, loud tone and voice and total sleeplessness. The least exertion or mental excitement = somnolence. Unable to use words properly; frequently obliged to stop in the middle of a sentence and change it entirely from not being able to use appropriate words.
Cannabis Indica
Exaltation of spirit, with excessive loquacity. Full of fun and mischief, and laughs immoderately. Hallucinations and imaginations were innumerable. Anguish, accompanied by great oppression: > in the open air. The constant fear of becoming insane. Exaggeration of duration of time and extent of space; seconds seem ages, a few rods an immense distance. Horror of darkness. Fear of approaching death. Inability to recall any thought or event, on account of different thoughts crowding in his brain. Sudden loss of speech; begins a sentence but cannot finish it. Stammering and stuttering. Exaltation of spirits, with excessive loquacity. Very absentminded. Every few minutes he would lose himself, and then wake up, as it were, to those around him. Constant theorizing. Clairvoyance. Delirium tremens; trembling; hallucinations; tendency to become furious; nausea; unquenchable thirst. Laughs at merest trifle. Sudden loss of memory.
Phosphorus: Affections of the mind in general; amativeness; dizziness of the mind. Nymphomania. Melancholy sadness and melancholy, sometimes with violent weeping, or interrupted by fits of involuntary laughter. Laughs at serious things. Stupor, low, muttering delirium; loquacious. Thinks he has several pieces, and cannot adjust the fragments. Stupor from which he could be aroused for a moment only to lapse back into a muttering lethargy; and forgetfulness. Great apathy; very sluggish; dislike to talk; answers slowly or not at all. Anguish and uneasiness, esp. when alone, or in stormy weather, principally in the evening, with timorousness and fright. Anguish respecting the future, or respecting the issue of the disease. Susceptibility to fright. Fear: in the evening; of darkness; of spectres; of things creeping out of corners. Hypochondriacal sadness. Disgust to life. Apathy alternates with angry words and acts. Becomes easily vexed and angry, which makes him exceedingly vehement, from which he suffers afterwards. Any lively impression = heat, as if dipped in hot water. Great irascibility, anger, passion, and violence. Involuntary and spasmodic weeping and laughter. Misanthropy. Repugnance to labour. Shamelessness, approaching insanity. Great indifference to everything, and even to the patient’s own family. Great forgetfulness, esp. in the morning. Great flow of ill-assorted ideas. Zoomagnetic condition; state of clairvoyance. Ecstasy.
Phosphoricum Acidum:
Difficulty of comprehension, the patient will think a little while about a question, perhaps answer it, then forget all about it; dizziness of the mind. When reading, a thousand other thoughts came into his head, could not rightly comprehend anything; what he read became as dark in his head and he immediately forgot all; what he had long known he could only recall with difficulty. inability to endure noise or conversation. dullness and indolence of mind, with want of imagination. weakness of memory. imbecility. cannot connect his thoughts. the paucity of ideas and unfitness for intellectual labour. illusions of the senses; hear a bell pealing; sees only cyphers before his eyes.
Nitric Acid:
Weakness of intellectual faculties, with unfitness for intellectual labour. Excessive weakness of memory. Comes over with feeling as if would go out of her mind, with burning feeling on vertex (Agg. from 3x, R. T. C.).─Woman, 20, intemperate, syphilitic, poor physical condition, restless, destructive of clothing, talking incoherently and continuously sleepless, excited at any one’s approach, using profane and vulgar language (cured with 2x. G. S. Adams, Westb. As. Rep., 1889).
Medorrhinum:
Forgetfulness: of names; later of words and initial letters. Time moves too slowly. Dazed feeling; a far-off sensation, as though things done today occurred a week ago. Loses constantly the thread of her talk. Seems to herself to make wrong statements, because she doesn’t know what to say next, begins all right but does not know how to finish; weight on vertex, which seems to affect the mind. Difficult concentration of his thoughts on abstract subjects. Could not read or use my mind at all because of the pain in my head. Thinks someone is behind her, hears whispering; and sees faces that peer at her from behind the bed and furniture. One night saw large people in the room; large rats running; felt a delicate hand smoothing her head from front to back. Is sure she is going to die. Sensation as if all life were unreal, like a dream. Wild and desperate feeling, as of incipient insanity. Cannot speak without crying. Suicidal. Is in a great hurry; when doing anything is in such a hurry that she gets fatigued. Spirits in the depths, weighed down with heavy, solid gloom, > by torrents of tears. Is always anticipating; feels most matters sensitively before they occur and generally correctly. Dread of saying the wrong thing when she has a headache. Apprehensive. Fear of the dark. Feeling as if he had committed the unpardonable sin and was going to hell. Irritated at little things. Very impatient. Great selfishness.
Lachesis:
Apathy and extraordinary weakness of memory, everything that is heard is, as it were, effaced, even orthography is no longer remembered, and there is forgetfulness even of things on the point of utterance. Confusion as to time. Mistakes are made in speaking and writing, as well as in the hours of the day and the days of the week. Imbecility and loss of every mental faculty. Over-excitement and excessive nervous irritability, with a tendency to be frightened. Perfect happiness and cheerfulness followed by gradual fading of spirituality, want of self-control and lasciviousness; felt as if she was somebody else and in the hands of a stronger power. Amativeness. Affections of the intellect in general. State of ecstasy and exaltation which even induces tears, desire to meditate, and to compose intellectual works, with a sort of pride. Frantic loquacity with elevated language, nicely chosen words, and rapid and continual change of subject matter. Loquaciousness, with mocking jealousy, with frightful images, great tendency to mock, satire and ridiculous ideas. Nocturnal delirium with much talking, or with murmuring. Dementia and loss of consciousness.
References:
- https://www.ijrh.org/cgi/viewcontent.cgi?article=1065&context=journal
- https://www.who.int/health-topics/dementia#tab=tab_2
- Tiwari Shashikant Essentials of repertorization, New Delhi: B Jain Publishers Pvt. Ltd; 5th edition: 2012. P 41, 148,257,273.
- https://www.who.int/news-room/fact-sheets/detail/dementia
- https://en.wikipedia.org/wiki/Dementia
- https://www.who.int/health-topics/dementia#tab=tab_2
- https://www.mayoclinic.org/diseases-conditions/dementia/symptoms-causes/syc-20352013
- https://www.who.int/news-room/fact-sheets/detail/dementia
- http://www.homeoint.org/clarke/a/anac.htm
- http://www.homeoint.org/books/boericmm/b/bar-c.htm
About the Author
Dr. Md. Rezaul. Moin.
PG Scholar, Department of Homoeopathic Materia Medica
Government Homoeopathic Medical College and Hospital Bhopal, Madhya Pradesh India
GUIDE by:
Dr. Sunita Tomar.
Associate professor,
Government Homoeopathic Medical College and Hospital Bhopal, India
