I-Dementia

I-Dementia yisimo esihlobene neminyaka esithinta ukusebenza kwengqondo, okubangela ukwehla kwenkumbulo, ukucabanga, namakhono okucabanga. Lokhu kuphazamiseka kobuchopho okuqhubekayo kungase kube nomthelela omkhulu ekuphileni kwansuku zonke, kukwenze kubaluleke kakhulu ukuqaphela izimpawu zokuqala nezimpawu.

Ukuqonda ukuwohloka komqondo kubalulekile ekuhlonzweni kusenesikhathi nokuphathwa ngempumelelo. Lesi sihloko sihlola izinhlobo ezahlukene zokuwohloka komqondo, izimbangela zakho, kanye nezimpawu ezivame kakhulu okufanele uziqaphele. Sizophinde sihlolisise izindlela zokuxilonga, izindlela zokwelapha ezitholakalayo, nezindlela zokuvimbela noma zokunciphisa ukukhula kwalesi simo. Kungakhathaliseki ukuthi ukhathazekile ngawe noma othandekayo, lo mhlahlandlela uhlose ukuhlinzeka ngemininingwane ebalulekile ekuboneni nasekubhekaneni nokuwohloka komqondo.

Iyini I-Dementia?

I-Dementia yisimo se-neurodegenerative esibonakala njengokuncipha kokusebenza kwengqondo okunamandla ngokwanele ukuphazamisa impilo yansuku zonke. Kuthinta ukuqonda, inkumbulo, ukucabanga, ukuma, ukubala, amandla okufunda, ulimi nokwahlulela. Lesi simo akusona isifo esingasodwa kodwa siyiqembu lokubonakaliswa okungabangelwa ukuphazamiseka okuningi okuthinta ubuchopho. I-Dementia ngokuyinhloko ihlasela abantu abadala asebekhulile kodwa akuyona ingxenye evamile yokuguga. Kubangelwa ukulimala kwamangqamuzana obuchopho, okuthikameza ikhono lawo lokukhulumisana. Njengoba isimo siba sibi kakhulu, singathinta kakhulu ikhono lomuntu lokusebenza ngokuzimela.

Izinhlobo zokuwohloka komqondo

I-Dementia ihlanganisa izinhlobo ezihlukahlukene, ngayinye enezici ezihlukile. 

• Isifo Se-Alzheimer's: Lolu uhlobo oluvame kakhulu, olubalelwa ku-60-70% wamacala. Kubangela ukulahlekelwa inkumbulo nokuncipha kwengqondo. 
• I-Vascular Dementia: Ifomu lesibili elivame kakhulu, ukuwohloka komqondo kwemithambo, likhula ngenxa yokuncipha kokugeleza kwegazi eliya ebuchosheni, okubalelwa ku-15% kuya ku-25% wazo zonke izimo zokuwohloka komqondo. 
• I-Lewy body Dementia: Lolu hlobo luqala lapho amaprotheni (umzimba we-Lewy) efaka kumaseli ezinzwa, okuholela ezinkingeni zokucabanga nokunyakaza. Cishe u-5% kuya ku-10% wezigameko zokuwohloka komqondo ukuwohloka komqondo komzimba ka-Lewy.
• I-Frontotemporal Dementia: Lokhu kuwohloka komqondo kuthinta ukuziphatha kanye nolimi ngenxa yokulimala endaweni yobuchopho engaphambili neyesikhashana, okubalelwa ku-5-6% wezimo.
• Ezinye izinhlobo zihlanganisa Isifo sikaParkinson ukuwohloka komqondo kanye nokuwohloka komqondo okuxubile, lapho izinhlobo eziningi zihlangana khona. 
• Ukuqonda lezi zinhlobo kusiza ekuboneni izimpawu nokufuna ukunakekelwa okufanele.

Izimpawu Zokuwohloka komqondo

Ukuwohloka komqondo kubonakala ngezimpawu ezihlukahlukene ezithinta ukusebenza kwengqondo nokuphila kwansuku zonke. Nazi ezinye zezimpawu ezijwayelekile zokuwohloka komqondo:

• Ukulahlekelwa inkumbulo ngokuvamile kuwuphawu lokuqala olubonwa iziguli noma abathintwayo, ikakhulukazi ubunzima bokukhumbula izehlakalo zakamuva noma izingxoxo. 
• Abantu abanokuwohloka komqondo bangase bathwale kanzima ekuxazululeni izinkinga, ukuhlela, kanye nokuqeda imisebenzi abayijwayele. 
• Abantu abanokuwohloka komqondo bangase babe nokudideka mayelana nesikhathi noma indawo, babe nenkinga yokuqonda ulwazi olubukwayo, futhi babhekane nezinselele ngenkulumo nokubhala. 
• Ukushintsha kwemizwa nokuziphatha kuvamile, kuhlanganisa ukucindezeleka, ukukhathazeka, kanye nokusabela okungafanele. 
• Kwesinye isikhathi, abantu abanokuwohloka komqondo bangase babonise izinsolo (i-paranoia) ezindabeni ezincane noma babone izinto ezingekho.
• Abantu abanokuwohloka komqondo bangase babe nezinkinga ngokuxhumanisa nokulawula ukunyakaza.
• Njengoba lesi simo siqhubeka, abantu ngabanye bangase bangakunaki ukunakekelwa komuntu siqu futhi balwe nokusebenzelana komphakathi. 
• Lezi zimpawu zingahluka ngobukhulu kanye nenhlanganisela ngokusekelwe ohlotsheni kanye nesigaba sokuwohloka komqondo.

Izimbangela Zokuwohloka Komqondo

Ukuwohloka komqondo kungenxa yamangqamuzana obuchopho alimele, okuthikameza ikhono lawo lokuxhumana. Kunezici ezahlukahlukene ezinomthelela kulesi simo, njenge: 

• Iminyaka yobudala iyisici esiyingozi kakhulu, futhi amathuba okuba nokuwohloka komqondo akhuphuka ngemva kweminyaka engama-65. 
• I-Genetics idlala indima, ikakhulukazi ekuqaleni kwesifo i-Alzheimer's. 
• Izinkinga zenhliziyo, njengomfutho wegazi ophakeme kanye ne-cholesterol, zingaholela ekuwohlokeni komqondo kwemithambo. 
• Ukulimala kwengqondo okubuhlungu kwandisa ingozi yezinhlobo ezithile zokuwohloka komqondo. 
• Izici zendlela yokuphila, okuhlanganisa ukubhema, ukuphuza ngokweqile, nokungawuvivinyi umzimba, nazo zingase zibe nomthelela. 
• Ezinye izimo zezokwelapha, njengesifo sikaParkinson kanye HIV, kungabangela ukuwohloka komqondo. 
• Kwesinye isikhathi, izimpawu ezinjengokuwohloka komqondo zingase zivele ngenxa yomkhuhlane noma eminye imiphumela yomzamo womzimba wokuzivikela ekuthelelekeni.

Izingozi Zokuwohloka komqondo

Ezinye zezinto ezandisa ubungozi bokuwohloka komqondo yilezi: 

• Impilo yokunganyakazi ingase yenyuse ingozi yokukhula kokuwohloka komqondo.
• Izimo ezithile zezokwelapha, njengesifo sikashukela, i-Down syndrome, nesifo sika-Parkinson, zihlotshaniswa nengozi enkulu. 
• Abantu abane-apnea yokulala kanye nezinye izinkinga zokulala bangase babe sengcupheni enkulu yokuba nalesi simo se-neurodegenerative.
• Ukulimala ekhanda nokungezwa kuye kwaxhunyaniswa nokuwohloka komqondo. 
• Izinga lemfundo nokuzibandakanya komphakathi kungase kube nomthelela engcupheni, ngamaleveli aphansi okungenzeka akhulise ubungozi.
• Amazinga aphansi amavithamini athile nemisoco, njengamavithamini B6, B12, no-D, angase andise ukungenwa kalula.
• Imithi ethile yokulala kanye nama-sedative angenza inkumbulo ibe yimbi.

Ukuxilongwa Kwe-Dementia

Ukuhlola ukuwohloka komqondo kuhilela indlela ebanzi: 

• Odokotela baqala uhambo lokuxilonga ngomlando wezokwelapha ophelele kanye nokuhlolwa komzimba. 
• Odokotela bahlola ukusebenza kwengqondo besebenzisa izivivinyo ezijwayelekile ezihlola inkumbulo, ukuxazulula izinkinga, namanye amakhono engqondo. 
• Izindlela zokuthwebula izithombe zobuchopho (i-MRI noma i-CT scan) zisiza ukukhomba izinguquko zesakhiwo noma umonakalo. 
• Ukuhlolwa kwegazi kukhipha ezinye izimo ezingase zilingise izimpawu zokuwohloka komqondo. 
• Akuvamile, odokotela bangase batuse ukuhlolwa kofuzo. 

Ukwelashwa Kokuwohloka Komqondo

Nakuba lingekho ikhambi lokuwohloka komqondo, izindlela zokwelapha ezihlukahlukene zihlose ukulawula izimpawu nokuthuthukisa izinga lempilo. 

• Ukuphathwa Kwemithi: Odokotela bavame ukunikeza imithi yokubhekana nezimpawu zengqondo kanye nezinguquko zokuziphatha. 
  • Ama-Cholinesterase inhibitors angasiza ngenkumbulo nokwahlulela esifo i-Alzheimer's. 
  • I-Memantine ingase ibambezele ukuqhubeka kwezimpawu ezimeni ezimaphakathi nezinzima. 
• Izindlela zokwelapha ezingezona izidakamizwa: Lokhu kufaka phakathi ukwelashwa kokuvuselela ingqondo, ukwelashwa kwenkumbulo, nokwelashwa komsebenzi. 
• Ukuguqulwa Kwendlela Yokuphila: Ukuvivinya umzimba njalo, ukuyeka imikhuba engemihle, nokunamathela ekudleni okunempilo nakho kungasiza ekulawuleni izimpawu. Ukwesekwa okuvela emndenini, abangani, kanye nabanakekeli kubalulekile ekuhlinzekeni indawo ephephile nenethezekile yabantu abanokuwohloka komqondo.

Izinkinga zokuwohloka komqondo

Ukuwohloka komqondo kunomthelela ezicini ezihlukahlukene zokuphila komuntu. Njengoba isimo siqhubeka, abantu bangabhekana nobunzima ngemisebenzi yansuku zonke, okuholela ekulahlekelweni ukuzimela. 

• Abantu bangase bakuthwale kanzima ukuxhumana ngokuphumelelayo, okubangela ukukhungatheka nokuhlukaniswa nabantu. 
• Izinkinga ezingokomzimba zingavela, kuhlanganise nezinkinga zokuhamba kanye nengozi eyengeziwe yokuwa. 
• Izinkinga zokudla okunomsoco zivame ukwenzeka ngenxa yobunzima bokudla nokugwinya. 
• Izinguquko zokuziphatha, ezifana nolaka noma ukuzulazula, zingadala ukukhathazeka ngokuphepha. 
• Isifo sokuwohloka komqondo siphinde sithinte impilo yengqondo, esingase sibangele ukucindezeleka nokukhathazeka. 
• Lezi zinkinga zinciphisa kakhulu izinga lempilo futhi zandise isidingo sokunakekelwa nokusekelwa.

Uzoyibona Nini Udokotela

Ukufuna iseluleko sezokwelapha kubalulekile lapho kuvela izimpawu zokuwohloka komqondo. Abantu kufanele babonane nodokotela uma bona noma abathandekayo babo belahlekelwa inkumbulo ephikelelayo, bedidekile, noma benenkinga yokwenza imisebenzi yansuku zonke. Izimpawu zokuqala ongazibuka zihlanganisa ukukhohlwa ulwazi olusanda kufundwa, ukulwa nokuxazulula izinkinga, noma izinguquko zesimo sengqondo nokuziphatha. Bonana nodokotela uma lezi zimpawu ziphazamisa umsebenzi, imisebenzi yomphakathi, noma ubudlelwano. 

Ukuhlolwa njalo kuba bucayi kakhulu njengoba abantu bekhula, ikakhulukazi ngemva kweminyaka engama-65. Abantu abanomlando wokuwohloka komqondo emndenini noma labo abalimele ekhanda kufanele baqaphe ngokukhethekile. Ukuxilongwa kusenesikhathi kuvumela ukuphathwa nokuhlela okungcono, okwenza kubaluleke ukuxazulula izinkinga ngokushesha.

Ukwelashwa Kokuwohloka Komqondo Ekhaya

Ukulawula isifo sokuwohloka komqondo ekhaya kuhilela ukwakha indawo esekelayo kanye nokusungula izinqubo. 

• Abanakekeli bangasiza ngokugcina umoya ozolile, ngokunciphisa imfuhlumfuhlu, nokuqinisekisa ukuthi zikhona izinyathelo zokuphepha. 
• Ukukhuthaza ukuzimela emisebenzini yansuku zonke, njengokugqoka nokudla, kusiza ukugcina isithunzi nokusebenza kwengqondo. 
• Ukuzivocavoca okuvamile, ukuvuselela ingqondo ngokusebenzisa izindida noma imidlalo, nokuxhumana nabantu kubalulekile ukuze ube nempilo enhle. 
• Ukudla ngendlela efanele kanye nokuphathwa kwemithi nakho kunendima ebalulekile. 
• Ubuchwepheshe bokusiza, njengamasistimu esikhumbuzi nezilandeleli ze-GPS, zingathuthukisa ukuphepha nokuzimela. 
• Gcina isimiso sokulala sansuku zonke, esifana nokugwema i-TV noma ifoni ngaphambi kokulala, ishejuli efanayo yokulala, neminye imisebenzi epholile. 

Prevention

Nakuba ingekho indlela eqinisekisiwe ekhona yokuvimbela ukuwohloka komqondo, ukuthola indlela yokuphila enempilo kunganciphisa ingozi. 

• Ochwepheshe bayavuma ukuthi impilo yenhliziyo ithinta ngqo impilo yobuchopho. 
• Abantu ngabanye bangehlisa amathuba abo okuba nokuwohloka komqondo ngokunamathela ekudleni okulinganiselayo, ukuvivinya umzimba njalo nokulawula isisindo esifanele. 
• Ukulawula umfutho wegazi, ukubhekana nesifo sikashukela, nokuyeka ukubhema kuyizinyathelo ezibalulekile. 
• Ukuhlala umatasatasa ngokwengqondo ngokuzilibazisa, ukufunda, noma izindida nokuhlala uhlanganyele nomphakathi nakho kudlala indima ebalulekile. 
• Ukwengeza, ukukhawulela ukuphuza utshwala kanye nokulala ngokwanele kunomthelela empilweni yobuchopho iyonke kanye nobungozi bokuwohloka komqondo obungase bube phansi.

Isiphetho

I-Dementia inikeza inselele eyinkimbinkimbi, enomthelela omkhulu kubantu ngabanye nasemindenini yabo. Singakwazi ukusekela kangcono labo abathintekayo ngokuqonda izinhlobo zayo ezihlukahlukene, ngokubona izimpawu zokuqala, kanye nokuhlola izinketho zokwelapha. Lolu lwazi luhlomisa wonke umuntu ukuthi anikeze ukunakekelwa okunozwelo futhi enze izinqumo ezinolwazi mayelana nempilo nendlela yokuphila ezingase zinciphise ingozi yokuba nokuwohloka komqondo.

Ngokuhlala sinolwazi futhi simatasa, singasebenzela ukuthuthukisa izinga lempilo yalabo abanokuwohloka komqondo. Khumbula, ukutholwa kusenesikhathi nokungenelela kudlala indima ebalulekile ekulawuleni lesi simo, ngakho ukufuna iseluleko sezokwelapha kubalulekile uma wena noma othandekayo nihlangabezana nezinguquko eziqhubekayo zengqondo.

FAQ sika

1. Ingabe ukuwohloka komqondo kungelapheka?

Okwamanje, alikho ikhambi lokuwohloka komqondo. Kodwa-ke, abacwaningi basebenzela ukuthola amakhambi ezifo ezibangela ukuwohloka komqondo njenge-Alzheimer's kanye nokuwohloka komqondo we-frontotemporal. Nakuba ikhambi kungase kusasele iminyaka eminingi, kuye kwenziwa intuthuko ethembisayo. Ukwelashwa kugxile ekulawuleni izimpawu nokwenza ngcono izinga lempilo yalabo abathintekile.

2. Ungakugwema kanjani ukuwohloka komqondo?

Nakuba ukuwohloka komqondo kungenakuvinjelwa ngokuphelele, abantu bangayinciphisa ingozi ngokuthatha imikhuba yokuphila enempilo. Lokhu kuhlanganisa ukuvivinya umzimba, ukungabhemi, ukugwema utshwala ngokweqile, ukugcina isisindo esinempilo, ukudla a Ukudla okunazo zonke, nokulawula umfutho wegazi, cholesterol, kanye namazinga kashukela egazini. Ukuhlala umatasatasa ngokwengqondo nokuzibandakanya nomphakathi nakho kudlala indima ebalulekile ekwehliseni ubungozi bokuwohloka komqondo.

3. Ubani osengozini yokuwohloka komqondo?

Izinto ezimbalwa ezandisa ingozi yokuba nokuwohloka komqondo iminyaka (ikakhulukazi engaphezu kuka-65), izakhi zofuzo, izinkinga zenhliziyo nemithambo yegazi, ukubhema, ukuphuza ngokweqile, kanye nezimo ezithile zezokwelapha ezifana nesifo sikashukela nesifo sika-Parkinson. Abantu abanokukhubazeka okuncane kwengqondo futhi banengozi enkulu yokuba nokuwohloka komqondo.

4. Iyini imbangela ehamba phambili yokuwohloka komqondo?

Ukuwohloka komqondo kuwumphumela wokulimala kwamangqamuzana obuchopho, kukhinyabeza ikhono lawo lokuxhumana. Isifo i-Alzheimer's siyimbangela ehamba phambili yokuwohloka komqondo, okubalelwa ku-60-70% wamacala. Ezinye izimbangela zihlanganisa ukuwohloka komqondo kwemithambo, ukuwohloka komqondo komzimba ka-Lewy, nokuwohloka komqondo we-frontotemporal.

5. Ingabe ukuntula ubuthongo kubangela ukuwohloka komqondo?

Ukungalali ngokwanele kanye nezinga eliphansi kungase kwenyuse ingozi yokuwohloka komqondo. Ucwaningo luthole ukuthi ukwehla ngo-1% ebuthongweni obujulile unyaka ngamunye kubantu abangaphezu kweminyaka engamashumi ayisithupha kulingana no-27% wengozi ekhulayo yokuthuthukisa ukuwohloka komqondo. Ukulala okuhle kwekhwalithi kusiza ukususa udoti we-metabolic ebuchosheni, kuqinise izinkumbulo, futhi kuvikeleke kwezinye izici eziyingozi zokuwohloka komqondo.

UDkt. Shashank Jaiswal

MBBS, DM (Neurology), PDF (Isithuthwane)
CARE Hospitals, Banjara Hills, Hyderabad

Ukuze Ubhukhe Isikhathi, shayela:

+ 91 40-68106529

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