Prof. Arif Herekar speaks on
prevalence of Dementia in Pakistan


KARACHI: Prevalence of dementia in Pakistan was discussed and elaborated by Prof. Arif Herekar, chairman department of Neurosciences at the Baqai Medical University. In two sessions, one delivered at the Auditorium of Baqai Medical Hospital and the second a few days later at the auditorium of Orthopaedic and medical institution, Prof. Arif Herekar spoke about the types of Dementias and the possibility of halting their progress.
He presented the different causes that can lead to Dementia and how can one actually diagnose the disorder. Diagnosis of dementia, he said, was extremely important though quite difficult. This was because until and unless diseases like dementia are not diagnosed properly treatment cannot be initiated. He discussed at length about Alzheimer’s disease and its prevalence in Pakistani population. He said that the population of patient suffering from this debilitating disorder may not be as horrendous as that in the West but those who are afflicted are definitely disabled. It was important to diagnose Dementia and exclude the treatable causes. Vitamin deficiencies and trauma especially subdural can be overcome. Deficiencies of nutrients and vitamins he stated, was very common especially in the rural population of the country.
He also emphasized on the fact that there was no confirmatory test till to-date in spite of all the developments and advancements regarding Alzheimer’s disease. We are still dependent on what we call the psychometric tests. Although many psychometric tests have come into the market, the basic and time tested simple bed side test called mini mental scale / score was still the best way to diagnose dementia.
MRIs are still not very helpful in diagnosing the various types of dementias. He then referred to a structural MRI which is the next option and still being introduced into the United States. This may be a further step in delineating the different types of dementias. Speaking about treatment, he said that supportive treatment guidance to the attendants and next of kin were still the mainstay of management. However, drugs like Mementine which if instituted early in the disease may well slow down the progress. Very few Alzheimer’s are detected early in the disease and by the time they reach a Neurologist, the disease has already advanced. However, these medications remain the key and should only be used when the diagnosis of dementia is fairly certain. The presentations were followed by lively discussion. (PR)

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