Dementia is the abnormal degeneration of brain function. In addition to the decline in various mental functions and memory, severe cases may also experience personality changes, paranoia, auditory and visual hallucinations, affecting interpersonal relationships and work abilities. The difference between simple brain aging and dementia is that what is forgotten due to aging can sometimes be recalled later, whereas what is forgotten in dementia is completely and utterly lost.
According to statistics, there were approximately 50 million people with dementia worldwide in 2019; in 2020, about 1 in 12 elderly people over 65 in Taiwan had dementia, and about 1 in 5 people over 80 had dementia. The prevalence increases with age, doubling every 5 years.
The causes of dementia can be broadly divided into three categories:
- Degenerative: Most patients fall into this category, with Alzheimer's disease being the most common. The initial stage symptoms mainly include memory decline and problems recognizing time, place, and people.
- Vascular: This is the second leading cause of dementia, often due to sudden rupture or blockage of cerebral blood vessels or chronic cerebrovascular disease, leading to poor cerebral blood circulation and resulting in intellectual decline. The initial stage symptoms include sudden deterioration of cognitive function, sluggish movements and reactions, and unsteady gait.
- Others: Such as nutritional imbalances, lack of B12, folic acid, etc.; or caused by other diseases, such as brain tumors, hypothyroidism, viral infections, alcoholism, etc.
Generally, people go through a period of grade I cognitive impairment before progressing from normal to degenerative dementia. Common signs at this stage include:
- Frequently forgetting recent events, conversations, and appointments, often searching for things.
- Misidentifying objects during rainy weather, at night, or in low light.
- Speech becoming less fluent than before, often struggling to recall words, easily getting stuck, and asking the same questions repeatedly.
- Becoming indecisive, suspicious, irritable, reclusive, unwilling to go out, and losing interest in various things.
- Others...
Currently, modern medicine has no drugs to treat dementia, while Traditional Chinese Medicine (TCM) has an abundance of methods to effectively prevent and treat existing dementia.
The Close Connection Between the Brain and the Kidneys
TCM discovered over two thousand years ago that the kidneys and brain marrow are closely connected, of course, the kidneys in TCM do not refer to the anatomical kidneys but to the broader kidney system, which includes the reproductive, urinary, and endocrine systems in modern medicine.Human life, from the moment of fertilization of the egg, undergoes growth, development, maturation, and eventually becomes an adult, all of which are regulated by the kidney system. The subtle nutrients used to construct various cells and tissues of the human body are collectively referred to in TCM as kidney water, kidney yin, or kidney essence. Their essence includes nucleic acids, amino acids, proteins, minerals, trace elements, and so on. Children, especially during their developmental period, need to grow their bodies and brains, and thus require the nourishment of kidney water. The metabolism of growing tissues and cells is very vigorous, and the consumption of kidney water is particularly high. Therefore, TCM has the saying that in children, "yang is often in excess, yin is often deficient." By adulthood, the construction of the body is largely complete, and kidney water is mainly used for the daily renewal of tissue cells, repair of damaged tissues, and partly for the production of sperm and the storage of menstruation. No matter how old a person is, they need to remember and learn, which requires sufficient kidney water as raw material to continuously weave new neural networks in the brain.
When the function of the kidney system is low or the reserve of kidney water is insufficient, the renewal of tissue cells throughout the body will deteriorate, the production of sperm will decrease, and the brain will find it difficult to weave new neural networks, or even maintain old ones. Not only will new memories fail to form, but old ones will also be forgotten, leading to various signs of dementia.Modern medicine once believed that brain nerve cells do not regenerate, but recent research has found that nerve cells used for memory and learning continue to regenerate, no matter how old you are. From the perspective of TCM, the inability to continue producing new nerve cells and neural networks is due to the low function of the kidney system or a lack of kidney water needed to build new cells and tissues.
As people age, the kidney system also ages, leading not only to brain degeneration but usually also to a decline in sexual ability. Frequently getting up to urinate at night indicates a decline in the urinary system. These functional declines are all within the scope of the kidney system, and replenishing kidney qi and kidney water can improve them. Only TCM can reverse this decline.
Dementia pattern identification and treatment
"Pattern identification" is to identify which pattern the current pathological state belongs to. Pattern = a certain macroscopic imbalance state of the human body system. First, analyze the crux of the system, then propose a treatment plan.Although the kidney system dominates the development, maintenance, and construction of new neural networks in the brain, the rise and fall of the five zang and six fu-organs and the patency of the circulation channels will all affect brain health. Below are several common patterns that lead to dementia:
- Kidney qi deficiency: This refers to the low function of the kidney system, leading to poor renewal of all tissue cells and the maintenance and construction of brain neural networks. Those with kidney qi deficiency often experience hearing loss, tinnitus, dizziness, soreness and weakness in the lower back and knees, frequent nighttime urination, spermatorrhea, premature ejaculation. The treatment is to replenish kidney qi. A further stage of kidney qi deficiency is kidney yang deficiency, which may also include cold intolerance, cold hands and feet, edema, urinary incontinence, impotence, and other cold signs. The treatment is to replenish kidney yang.
- Kidney yin deficiency: Kidney yin refers to kidney water and kidney essence, which are the raw materials used by tissue cells for daily repair, renewal, gamete production, and brain neural network construction. Those with kidney yin deficiency often have feverish palms and soles, dry mouth and throat, irritability, insomnia, night sweating, and other signs of deficiency heat. They may also experience heel pain, soreness and weakness in the lower back and knees, seminal emission, excessive or prolonged menstruation, etc. The treatment is to replenish kidney yin. These tonics are mostly rich in natural nucleic acids, amino acids, proteins, minerals, trace elements, etc., and have a slight "cooling" nature, which can slightly calm the hyperactive kidney system.
- Spleen qi deficiency: The spleen and stomach are the source of all nutrients in the human body. If digestive function is poor, the source of kidney water will be insufficient. Patients often experience poor appetite, gastrointestinal bloating, loose stools, easy fatigue, and reluctance to speak. The treatment is to replenish spleen qi. A further stage of spleen qi deficiency is spleen yang deficiency, which may also include cold intolerance, cold hands and feet, cold abdominal pain, watery stools with undigested food, and other cold signs. The treatment is to replenish spleen yang.
- Phlegm turbidity obstructing orifices: In TCM, phlegm does not solely refer to phlegm in the throat; it is a broad term encompassing all pathological, viscous fluids or metabolites in the body. For example, indulging in sweets and greasy foods can lead to excessively high blood lipid levels, which is a form of phlegm. The accumulation of excessive blood lipids in the intercellular spaces and blood vessels, affecting circulation, is a form of phlegm obstruction. Wherever the phlegm accumulates and becomes thick and turbid, that area is prone to blockage, affecting the functioning of tissue cells. If it slowly obstructs the brain, brain cells gradually die off, leading to a gradual decline in intelligence; if it suddenly blocks the brain, it can cause cerebral apoplexy. The treatment involves resolving phlegm and relieving stuffy orifices. TCM has the saying "the obese are prone to phlegm-dampness," and modern medical research also indicates that the risk of dementia in obese individuals is several times higher than in the general population.
- Qi stagnation and blood stasis: This "qi stagnation" specifically refers to the stagnation of the contraction, relaxation, and regulation of blood vessels, while "blood stasis" refers to high blood viscosity or poor circulation, or even blockage. Patients may exhibit many signs of obstruction, such as office workers who sit for long periods without moving, which can easily lead to this systemic disease state, affecting the brain and increasing the risk of dementia. Treatment should focus on regulating qi and resolving stasis. Exercise is the simplest, most cost-effective, and effective method for regulating qi and resolving stasis. Modern research has confirmed that regular exercise can effectively prevent dementia and slow its progression.
Acupoint massage and moxibustion
Local acupoints: Fengchi (GB20), Baihui (GV20), Sishencong (EX-HN1), Shenting (GV24), Benshen (GB13).Different acupoints can be selected based on different patterns (pattern = systemic imbalance or pathological state of the human body).
| Dementia pattern | Selected acupoints |
|---|---|
| Kidney yin deficiency | Taixi (KI3), Fuliu (KI7), Sanyinjiao (SP6) |
| Kidney qi deficiency | Taixi (KI3), Fuliu (KI7), Shenshu (BL23) |
| Spleen-stomach weakness | Zusanli (ST36), Hegu (LI4), Sanyinjiao (SP6) |
| Phlegm turbidity obstructing the orifices | Fenglong (ST40), Yinlingquan (SP9) |
| Qi stagnation and blood stasis | Taichong (LR3), Jianshi (PC5), Sanyinjiao (SP6) |
Each treatment session: Press each acupoint for 3-5 seconds, release for 3-5 seconds, repeat for 3-5 minutes, then move to the next acupoint. Perform one session in the morning, noon, and evening.
Acupoint massage method: Use a massage stick of moderate hardness or your own fingers to tuina the relevant acupoints in sequence. Press until a slight soreness is felt, but do not use excessive force. If pain is felt upon light touch, it indicates that the acupoint has been injured, and it should not be pressed again for the time being.
Patients with yang deficiency can use moxibustion on the acupoints, treating one acupoint at a time, and switch to the next acupoint when a burning sensation is felt. For mild cold deficiency, moxibustion should last 10 minutes per session; for severe cold deficiency, 15-20 minutes per session. If dry mouth and tongue occur, it indicates excessive moxibustion and internal heat, and moxibustion should be stopped temporarily.
Patients with yin deficiency and yang hyperactivity should not use moxibustion.
Other recommendations
- Moderating sexual desire: The production and secretion of anything by the human body comes at a cost, with the highest cost being the production of gametes. Normal sexual activity is not only acceptable but also necessary for procreation, as long as there is no physical discomfort. However, uncontrolled sexual desire can rapidly deplete the body's kidney essence, and a lack of kidney essence nourishment throughout the body will inevitably accelerate aging.
- Regular Exercise: Exercising regularly 2-3 times a week for at least 30 minutes each time can significantly reduce the risk of dementia. Examples include brisk walking, jogging, swimming, cycling, dancing, etc.
- Mental stimulation: Frequently engaging in activities that stimulate the mind can significantly reduce the risk of dementia. Examples include playing cards, various learning courses, reading books and magazines, traveling, attending concerts, painting, writing, etc.
- Social interaction: Participating in social activities can significantly reduce the risk of dementia. The risk of dementia increases significantly for those who are lonely.
- Maintain a healthy weight: The risk of dementia increases significantly for those who are obese. However, the elderly should not be too thin either.
- Change eating habits: A diet primarily consisting of beans, natural grains, vegetables, mushrooms, fish, eggs, and dairy products, while reducing meat intake, can significantly reduce the risk of dementia.
- The risk of dementia increases significantly for smokers and heavy drinkers, and it is recommended to quit early.
- Treating the three highs: The risk of dementia increases significantly for those with untreated high blood pressure, high cholesterol, and high blood sugar. Seeking treatment with TCM is far better than controlling with modern chemical drugs.
