Medically reviewed by Dr Raina Loh, MMed (Family Medicine), Singapore
What is Dementia?
Dementia is a syndrome characterised by a decline in cognitive abilities, such as memory, thinking, and reasoning, that is severe enough to interfere with daily functioning. It is not a specific disease but rather a group of symptoms associated with underlying conditions such as vascular dementia, Alzheimer’s disease, frontotemporal dementia, or Lewy body dementia.
Apart from memory loss, people with dementia may experience difficulty with language and communication, impaired judgement, changes in mood and behaviour, and a decline in the ability to perform basic day to day tasks. The symptoms usually worsen over time and can have a significant impact on the individual’s quality of life and independence.
Who is At Risk of Dementia?
Dementia can occur at any age. However, the risk of dementia increases with age, and is more common in adults above 60 years of age. Other factors such as genes, high blood pressure, smoking, diabetes and obesity increases the risk of developing dementia.
Currently, in Singapore, 1 in 10 people aged 60 and above suffer from dementia. With Singapore’s rapidly ageing population, the number of persons living with dementia is expected to continue to rise. It is projected that more than 100,000 people in Singapore will suffer from dementia by 2030. It is hence important to understand what dementia is and how it affects individuals.
1. Alzheimer’s Disease
Alzheimer’s dementia is a common form of dementia. It is thought to be caused by the formation of abnormal protein deposits in the brain. These deposits disrupt the normal communication between brain cells. Symptoms of Alzheimer’s disease typically start with mild memory loss and difficulty with cognitive tasks, such as problem solving and word finding.
2. Vascular Dementia
Vascular Dementia is another common form of dementia caused by a reduction of blood supply to the brain due to damaged, narrow, or blocked blood vessels which deprives the brain of vital nutrients and oxygen. It is often associated with stroke or damage to blood vessels caused by high blood pressure or diabetes.
3. Lewy Body Dementia
Lewy Body Dementia is caused by the build-up of protein deposits in the brain called Lewy bodies. These deposits disrupt the normal functioning of brain cells, leading to a decline in cognitive abilities, movement problems and changes in behaviour and mood. Lewy Body Dementia is sometimes confused with Parkinson’s disease as they may have similar symptoms.
4. Frontotemporal Dementia
Frontotemporal Dementia is a rare form of dementia that is due to the progressive degeneration of the nerve cells in the frontal and temporal lobes of the brain. Frontotemporal dementia is characterised by changes in behaviour, personality and language abilities.
Signs to Look Out For
There are some signs which you can look out for that differentiate normal ageing from dementia.
A person suffering from dementia usually:
- Has difficulty performing simple daily tasks
- Has difficulty recalling recent events
- Has difficulty making rational decisions and/or acting inappropriately
- Has difficulty communicating and understanding information
- Loses their train of thought easily, causing them to unknowingly repeats phrases and questions in conversations
- Appears disoriented despite being in familiar surroundings
This is unlike people who are ageing normally as they are still able to make sound judgements and recall recent memories albeit taking more time to do so. While older people may still have the occasional difficulty in finding the right words, they are still able to maintain a decent conversation. The most significant difference is the impact that the above symptoms have on a person’s independence. In dementia, memory loss and cognitive impairment interferes with a patient’s independence.
Paying attention to these warning signs allows us to be able to identify dementia in its early stages. A timely diagnosis allows loved ones to make informed decisions early.
Treating Dementia
While there is no cure for most forms of dementia, certain treatments and strategies can help manage the symptoms and improve the quality of life for patients with dementia. These strategies have to be tailored according to each individual patient. Hence, it is important to consult a doctor for an assessment if you suspect that someone has dementia. During the consultation, the doctor can perform a thorough assessment and determine if the patient is truly suffering from dementia or if they have other treatable conditions such as delirium, metabolic/ hormonal conditions, vitamin deficiencies or depression, which may present similarly to dementia.
You may also consider making a Lasting Power of Attorney (LPA) that can be evoked in the event of loss of mental capacity. An LPA is a legal document that allows us to appoint someone we trust to make decisions on our behalf if we become unable to do so. The LPA allows you to ensure that your wishes are respected and your best interests are taken into account. It also provides you assurance that your affairs will be handled by someone trustworthy in the event that you are no longer mentally competent to make decisions.
Reducing the Risk of Dementia
There are a few ways to reduce your risk of dementia.
- Staying physically fit
Exercising regularly maintains your body’s heart and blood circulatory systems. Through regular physical activity, you also lower your body’s cholesterol levels and maintain your blood pressure at a healthy level which decreases the risk of developing Alzheimer’s Disease and Vascular Dementia.
- Maintaining a healthy diet and good health habits
A well-balanced and nutritious diet helps to maintain overall health. It is recommended to eat a balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats. Food that is high in saturated fats and salt should be avoided. Drinking plenty of water over sweet drinks is also recommended.
Limiting alcohol intake and quitting smoking reduces your risk of chronic health conditions. Getting sufficient rest also enables your body to stay healthy and fit.
- Keeping mentally active
Keeping your mind engaged through mentally stimulating activities, such as puzzles and word games can be beneficial. Being socially engaged with constant interactions can also contribute to mental stimulation.
Living with Dementia as a Caregiver
Dementia can be emotionally challenging for both individuals with dementia and their caregivers. Often, the caregiver can feel frustrated because of the mood swings and abrupt behavioural changes the patient exhibits. The caregiving process can become more demanding when dementia progresses to the late stages and the patient becomes increasingly dependent on the caregiver. This can result in significant emotional distress and caregiver stress. Understanding the progression of dementia helps to ensure that caregivers are better equipped to manage the patient’s symptoms, thereby reducing caregiver stress.
It is also highly advisable for caregivers to get connected with communities or support groups such as Dementia-Friendly Singapore where they can feel included, involved and supported. They can utilise resources such as the ‘Community, Assurance, Rewards and Acceptance’ (CARA) app, created by Dementia Singapore, to gain easy access to an ecosystem of solutions.
Conclusion
Living with dementia can be taxing on both the patient as well as the caregiver. As there is currently no cure for dementia, it is vital for us to be on the lookout for the signs of dementia so that early diagnosis can be made and treatment can be initiated early. It is important to note that the treatment plan for dementia should be individualised based on the specific needs and circumstances of each person. Regular monitoring and follow-up with healthcare professionals are necessary to assess the effectiveness of treatments and make adjustments as needed.
At Keystone Clinic & Surgery, we are able to aid in assessing if your loved one’s memory loss is due to dementia or another treatable cause. We also provide LPA services so that our patients can have the peace of mind that their future affairs will be taken care of by someone whom they trust.
Feel free to read up more about dementia at https://www.aic.sg/resources/Documents/Brochures/Mental%20Health/Consolidated%20Dementia%20Resources.pdf.
References:
Agency of Integrated Care. Knowing Dementia. 2023. https://www.aic.sg/resources/Documents/Brochures/Mental%20Health/4Books%202022/AIC_Living%20With%20Dementia_Booklet%201_Eng.pdf
Alzheimer’s Society. How does dementia change a person’s behaviour? 2021. https://www.alzheimers.org.uk/about-dementia/symptoms-and-diagnosis/symptoms/behaviour-changes
Ang, P.C. Alzheimer’s Disease: Everything You Need to Know. Mount Elizabeth. 2019. https://www.mountelizabeth.com.sg/health-plus/article/alzheimers-disease
Health Promotion Board. Let’s Talk About Vascular Dementia. Accessed 2023, May 19. https://www.healthhub.sg/programmes/186/MindSG/vascular-dementia
Health Promotion Board. Understanding Dementia. 2021. https://www.healthhub.sg/sites/assets/Assets/Programs/mindsg/vascular-dementia/pdfs/HPB-Understanding-Dementia-Booklet-English.pdf
Lim, S. C. Dementia: Symptoms and How It Affects Behaviour. HealthXchange. Accessed 2023, May 19. https://www.healthxchange.sg/head-neck/brain-nervous-system/dementia-symptoms-affect-behaviour
Singapore General Hospital. Dementia. Accessed 2023, May 19. https://www.singhealth.com.sg/patient-care/conditions-treatments/Dementia-Alzheimer
Tai, C. Nutrition & Hydration Needs for Persons Living with Dementia. DementiaHub SG. Accessed 2023, May 19. https://www.dementiahub.sg/living-well-with-dementia/nutrition-hydration-needs-for-persons-living-with-dementia/