Lapses in memory, changes in habits and slower responses – while many individuals are prone to withdrawing and slowing down as they age, this has created an alarming tendency in both families and individuals alike to dismiss dementia symptoms as common age-related problems.
Granted, dementia affects only about 1 in 10 Singaporeans1 above the age of 60. While this number may seem small, keep in mind that:
There is also no cure for dementia, a progressive disease that can advance in as fast as a few months.
As biomedical researchers around the globe continue to work hard to uncover the various aspects of Alzheimer’s disease and other dementias, the hope is that a better understanding of this debilitating condition will lead to new treatments.
As it already is, we have treatments that manage dementia and allow elders to feel, look, and stay better for much longer.
Knowing the symptoms and causes of dementia can be all the difference between a peaceful and trouble-ridden seniorhood. In this article, we’ll cover:
Dementia is an umbrella term. Instead of being a single disease, it is the end product of multiple conditions affecting the brain that result in cognitive failure in a person. These disorders, such as Alzheimer’s and stroke, are caused by abnormal brain changes and will gradually deteriorate one’s:
Dementia doesn’t only critically impact an individuals’ relationships and quality of life, but can also overwhelm the loved ones of sufferers.
While there are many causes of dementia, the most common causes in Singapore are:
AD accounts for 60 to 80% of all dementia cases and is the most common form of dementia. It results in short term memory, changes in thinking, judgement, behaviour and feelings, and a gradual decline in one’s cognitive abilities.
VaD refers to changes to one’s attention, memory, thinking, and behaviour resulting from conditions that affect the blood vessels in the brain (eg. stroke). VaD also leads to impairment of neuronal function and a gradual decline in a person’s cognitive ability.
In the early stages, FTD impacts an individual’s personality, behaviour, and speech. FTD patients may behave aggressively or rashly while keeping their memory and sense of direction intact.
LBDis a type of progressive dementia that results in noticeable changes in a person’s attention and daily ability to function. LBD sufferers may appear to have a lively imagination or even hallucinate. The symptoms of LBD resemble those of Parkinson’s Disease.
Often, these conditions present simultaneously. This is otherwise known as mixed dementia.
We categorise dementia into 3 stages4:
Stage | Symptoms |
---|---|
Early stage dementia | Losing track of time5 Everyday forgetfulness (eg. constantly losing items) Confusion about directions and getting lost in familiar places |
Middle stage dementia | Forgetting recent events and the names of others Getting lost in or failing to recognise familiar places Increasing difficulty when communicating Neglecting or being unable to maintain personal hygiene Behavioural changes |
Late stage dementia | Being unaware of time and place Memory disruptions and disturbances Finding it difficult to recognise friends and family Behavioural and mood changes that may be aggressive Requiring increasing assistance for personal care, or even heavy or total dependence (eg. dressing and eating) Cognitive failure (eg. having trouble walking) |
As symptoms progress slowly, dementia is often overlooked in its initial stages. So if you or someone you love are experiencing any of the above symptoms, please see a neurologist as soon as possible - In the most debilitating and severe of cases, dementia can even result in a vegetative state.
Dementia – not just an old person’s disease
While age is commonly associated with dementia and is the greatest risk known factor for the disease, dementia is not a normal part of the ageing process.
There is also an increasing number of patients with young-onset dementia, generally accepted as dementia affecting individuals below the age of 654.
Other risk factors for dementia include:
*Diabetes is a risk factor for both stroke and atherosclerosis, both of which contribute to the onset of VaD.
**Atherosclerosis is the buildup of plaque in an artery’s inner lining. It is a significant risk factor for vascular dementia because it compromises delivery of blood to the brain, which can cause a stroke. Habits such as smoking drastically increase the risk of Atherosclerosis.
While there is no cure for dementia, it is possible to provide holistic, personalised care to dementia patients in all stages of the disease, and crucial support to their loved ones. Here are a few dementia treatment options available in Singapore today:
Treatment | What it entails | Efficacy |
---|---|---|
Pharmacological management | Two cognitive enhancers that offer significant therapeutic benefits and cognitive function maintenance include: Acetylcholinesterase inhibitors, and N-Methyl-D-aspartate (NMDA) receptor antagonists Other examples with proven efficacy include: Donepezil Rivastigmine capsules or patches Memantine Gingko biloba (EGb 761) Do ensure that your doctor offers you a good understanding of both the pros and cons of any recommended medicines and treatments. | While Alzheimer’s drugs may help individuals temporarily manage symptoms such as thinking and reasoning impairments, memory loss, and daily functions, they are not to be viewed as theremedy for dementia. However, symptomatic drugs can definitely help delay the progression of a patient’s condition. Combined with psychosocial interventions, these pharmacological solutions may also increase a patient’s quality of life. |
Introduce good sleep hygiene | In patients with dementia, insomnia is common and can prove to be distressing to families. This is why having good sleep hygiene is so important - It helps both patient and caregiver face their daily demands better. Some tips include: Addressing any underlying conditions that might interfere with quality sleep (eg. heartburn, chronic itch, anxiety) Introducing regular sleep times and ensuring a good sleep environment Helping patients to relax before bedtime | Researchers in Europe found that for individuals aged 50 to 70, consistently sleeping 6 hours or less was associated with a 30%6 higher risk of dementia. Sleep hygiene is not only a good form of prevention against Alzheimer’s, but early death. The good news is that may reduce your risk of dementia or manage your condition by getting a solid six to eight hours of sleep nightly. A healthy sleep routine will also help persons with dementia to feel better, be less confused, more coordinated, and more energetic. |
Reminiscence and other activities | As many dementia patients often present with short-term memory loss whilst retaining older memories, reminiscing can be a powerful tool. It can help sufferers feel positive and peaceful, and reduce stress, which can improve their mood, reduce agitation, and minimise challenging behaviours. Some tips include: Listening to the patient’s favourite music Looking through old items or photos Tactile activities such as painting or pottery, which can help spark good memories. | For decades now, research has shown that dementia patients react well to their favourite music, as it improves their brain function and even slows the progress of the disease. Reminiscence7 in the form of humour, words, photos, and more, have been proven to evoke memories, stimulate mental activity, and improve a patient’s overall well-being. |
Cognitive impairment-related safety provisions | Since many dementia patients face safety issues such as forgetting to switch off the gas at home, or getting lost, it is crucial that patients and their families address these challenges by designing an environment that allows patients to continue living safely. Some simple tips include: Placing clear words or symbols around the patient to help them re-orientate location and date-wise. Having the patient wear an identity necklace or bracelet with contact details. Linking the patient’s mobile phone to a GPS tracking system to locate them. | Such solutions, while not having a direct impact on an individual’s condition, will help prevent them from getting into stressful or dangerous circumstances that could have larger consequences. |
Psychogeriatric services | There are hospitals that provide psychogeriatric services that aid dementia patients. With the help of multidisciplinary teams consisting of geriatric psychiatrists and nurses, clinical psychologists, medical social workers and more, outreach programmes, assessments, and interventions are provided for elderly individuals in communities around Singapore. These teams also run community outreach programmes that provide training for community partners. | Maintaining a healthy and active life is a key challenge8 for elderly individuals, especially when psychological complications come into play. Psychogeriatrics allows dementia patients to improve the quality of their relationships, self-esteem, and subjective well-being, as well as to reduce any overwhelming loneliness that they might be experiencing as a result of their condition. Group programmes are especially useful in helping patients maximise their daily cognitive functions, enhance their mood, and manage their behaviour. |
From the stress of treatments to having to face debilitating cognitive decline, dementia is no light matter. If you suspect you or your loved one might be displaying symptoms, it is crucial that you stop the disease from progressing too quickly.
Do you have any questions? Feel free to drop me a message and I’ll be happy to help.