2023-11-02 03:15:50
Kim Seong-mi, director of Mind and Mind Psychiatry Department
A woman in her 70s visited the hospital complaining that her memory continued to decline. I had forgotten the date of the step-meeting, and it was only when a friend called that I remembered it. I often searched for a long time to see where I had left my cell phone, so I was worried that I might have dementia. A few years ago, her husband passed away from a stroke, and she said she felt empty because she was alone and wished her husband was by her side.
The two of us always went to the mountains, ate together, and didn’t need any friends, so we stayed alone, but as the days got colder and the dark evenings approached, a lonely feeling of loneliness came over us. Now, there is no one to take care of me, so if I get dementia, it would be a big problem, so she wipes her tears and asks me to heal her.
I was waiting and waiting for a reunion with a person who had crossed the river of time, but like the separation of many people, time was something that might not be undone, and I thought that I had to wait quietly for the time to leave. When you are deeply immersed in the abyss of depression, you feel as if you are cut off from the world, your memory declines, you lose track of time, and you lose your sense of direction.
If you are unable to do things that you normally do, it can be mistaken for dementia. Therefore, cognitive decline caused by depression is called pseudodementia. If depression is properly treated, cognitive function is fully restored. If you manage your depression, loneliness, and social isolation well, the incidence of dementia will decrease. In this way, managing the software called the mind has a tremendous impact on the hardware called the brain.
There are many causes of memory decline, including forgetfulness, pseudodementia, mild cognitive impairment, and dementia. Up to 100 billion human brain cells reach out to each other to form synapses, giving the surface a wrinkled and crowded appearance. On the other hand, the rat brain has less synapse formation and has a flat surface.
As the brain ages, just as hair thins, brain cells gradually shrink, reducing the volume and creating a deep space like a sinkhole. By imaging the brain with an MRI, you can easily determine the age of the brain. Problems arise in the area called the hippocampus, which is responsible for inputting memories, and it becomes like a dried walnut, shriveled and eventually progresses to dementia. Forgetfulness and dementia are different problems.
Forgetfulness is a symptom that is not caused by the loss of hippocampal cells, but rather by the inability to store them as long-term memories. It appears when you live too busy and have too many things to do, multi-tasking piles up, or you lack the energy to handle them, making even the things you usually do difficult. Forgetfulness is a symptom of burnout syndrome.
Dementia is different in that the cells of the hippocampus are lost, so the memory itself is not input. Even if the same memory decline is observed, the treatment is different depending on the cause, and the course of the disease is also different, so it must be carefully differentiated.
Dementia is the disease that the elderly fear most during outpatient treatment. Dementia is a disease that causes problems in brain cells and blood vessels. Finding a way to prevent this damage can be a way to prevent dementia. So when should we start making efforts to prevent dementia? Right now. It’s easy to think that dementia is a problem for older people, but in fact, it progresses slowly over decades, so you can prevent dementia by taking good care of your mind and body starting today.
We are very interested in whether someone has a youthful face. If you don’t sleep well or pay too much attention, freckles appear and dark circles appear under your eyes. The skin and state of mind are closely related. Just as your face is youthful, it is important to maintain a youthful brain. Just as there are differences in the wrinkles and elasticity of the face, the brain also differs from person to person beyond the skin.
There are many studies on what things can help our brain health. The three most important methods are diet control, stress management, and exercise. The first thing to practice among these is exercise. Exercise not only makes your body healthy, but moving your body also improves your mood, which has a tremendous anti-stress effect.
You can never get dementia! If you obsessively focus on exercising with this mindset, you may get injured and your stress will increase. So, it is more important to have fun even if it is only for 10 minutes. It is more effective to do it consistently rather than just resolving to do it for three days. It’s best to set your goals low enough that you really can’t fail.
Walk for regarding 10 minutes a day a week. You may wonder what effect that amount of exercise will have, but the experience of success is more important. It will remain as a good habit for my body, and even though it is small, I will not fail, and even if I am told not to do it from one day, the time and intensity of exercise will gradually increase.
What is important in preventing dementia is increasing cognitive reserve. Just as you need to store enough iron if you have anemia, you need to increase your cognitive assets. For example, just as a rubber band stretches when you listen to lectures from time to time, engage in fun activities, or study humanities, brain cells have plasticity and can store a lot of information deep in the brain for a long time.
Good habits, consideration, and beautiful speech are stored as automatic memories, so even if the memories of your youth, your vitality, and even your eyes are all gone, you can remain with your manners until the end. When I treat these beautiful dementia patients, I often see their poor days, difficult relationships, and life trajectory shine even brighter.
A dementia patient who had been receiving treatment from me for a long time was upset that the doctor did not send congratulatory money to his son’s wedding. I loved her and depended on her like a mother, but she raised her voice and asked if it was unrequited love. The wife who came with me tried to stop this person, saying he was senile, but she mightn’t truly understand the feelings of an old man who was marrying off his son at a late age, saying that he heals people’s aching hearts and takes care of those who believe in me and open up to their own human weaknesses. He was a dull doctor.
I mightn’t live by being particularly generous, and as a psychiatrist, I blamed myself and wondered if I had given sincere comfort to anyone. When treating elderly patients, I often have a chilling awakening to my own insufficiencies, stinginess, and immaturity. Please call the account number where you would like to send the congratulatory money. When I asked, he called out the long account number fluently. I feel relieved that my dementia treatment is going well.
The second is cultural activities. After retiring from office, one principal took a vocal music class, participated in competitions, and memorized all the lyrics of opera arias. It’s huge. It’s nice to see nature, travel, and learn to dance with friends.
The third is an intimate relationship. How many healing friends you have with whom you can open up is important in managing your mind. My patient, a 90-year-old grandfather, said that he had notified his friend of his death, paid his respects, and worked as the secretary of the alumni association for half his life. By running the brain software properly, the brain is less likely to age and brain function is still maintained well.
‘Now I have no friends to tell me regarding my death.’ To listen to his grandfather’s words, everyone inevitably encounters a moment when they tell their soul to leave. Like the poem “For Whom the Bell Tolls” by British poet John Donne.
No one is an island in and of itself.
Every human being is a piece of the continent, a part of the whole.
If a clod of dirt is washed away by sea water,
The land of Europe becomes smaller,
Even if A (岬) is like that, it is the same.
The same is true if your friends or your territory become like this.
Anyone’s death diminishes me.
Because I am included in the whole of humanity.
So do not send anyone to find out for whom the bell tolls!
The bell rings for you!
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