Dementia is increasingly becoming a common problem as our population ages. Read more about some common questions we get about memory problems and their treatment.
Isn't memory loss part of normal ageing?
As people age, they do get more forgetful. However, it is usually age appropriate and does not interfere with their daily life and function.
Dementia is not part and parcel of ageing as not everyone who age gets dementia. It is a disorder of the brain with progressive worsening of memory and cognitive abilities. Persons with dementia may start with losing their ability to handle money and with more complex tasks that involve planning. They may also present with word-finding difficulties which subsequently progress to language difficulties. With time, the poor short term memory becomes more apparent, with repetitions and forgetting of recent events and appointments. There might also be difficulties with recognizing people and calling them by the correct names as well ass carrying out certain tasks and activities. All these symptoms interfere with their daily life and function, as opposed to normal ageing.
As dementia progresses, the elderly might be increasingly dependent for their activities of daily living ie feeding, toileting and bathing. They might also develop psychological and behavioral symptoms of dementia such as suspicions, accusation of people stealing their things, sleep wake reversal, late-life depression and personality changes.
What causes Dementia?
Some causes of memory decline can be potentially reversed and treated. These include thyroid gland dysfunction (hypothyroidism – low levels of thyroid hormones) and Vitamin B12 deficiency. With treatment and replacement of these deficient hormones and vitamins, the memory impairment and cognitive symptoms may be reversed and treated.
Other causes of Dementia are not reversible as they are neurodegenerative (due to dysfunction or degeneration of brain cells). It is now known that part of the disease process involves the deposition of abnormal proteins (phosphorylated Tau proteins and beta amyloid for example) in the brain. Some examples of neurodegenerative processes include Alzheimer’s Disease and Parkinson’s Disease. However, their progression can be slowed down with treatment that includes both medication and lifestyle approaches.
Are there different types of Dementia?
Alzheimer’s disease is one of the most common types of Dementia. It usually has a slow onset and progression. It is named after German psychiatrist Alois Alzheimer who identified the first case of what is later known as Alzheimer’s Disease.
Vascular Dementia is another common type of Dementia. It may be caused by a major stroke or multiple minor strokes. As such, control of vascular risk factors such as high blood pressure, diabetes and cholesterol is important in the prevention of further progression.
Other less common types of Dementia include Parkinson’s Disease Dementia, Lew Body Dementia and Fronto-Temporal Dementia. Parkinson’s Disease is movement disorder characterized by fine resting tremors of the hand, stooped postures and small shuffling steps when walking. However, not every patient with Parkinson’s Disease will get Dementia.
Can Dementia be treated?
Memory impairment caused by medical conditions as mentioned above can be treated with the treatment of the underlying medical conditions. Alzheimer’s Dementia cannot be reversed. However, some symptoms can be improved and their progression can be slowed down by both medication and non-drug approaches.
Acetylcholinesterase inhibitors are medications that are sometimes used to slow down its progression. They can also help with some of the associated psychological and behavioral symptoms. It is beneficial to start these medications in the earlier stages so as to help preserve a good quality of life, good function and independence for many more years. These medications come in oral tablets/pills, as well as drug patches that are placed on the skin.
There are also other medications for moderate to severe stages of the disease, and medications to help with the Behavioral and Psychological Symptoms of Dementia (BPSD). Discuss with your psychiatrist about the benefits and options available.
Are there other ways to help slow down Dementia?
Lifestyle approaches are as important if not more important than the role of medications. Akin to your muscles losing his strength if you do not exercise them for a period of time. This applies similarly to the brain. As such, it is important to have cognitive stimulation (ie brain exercises). It can include reading, doing word puzzles and sudoku. For those who are interested in handicrafts, such activities involving eye and hand coordinations serves as a good activity for cognitive stimulation. Social interaction is another good activity, hence simple activities such as chatting with fellow elderly or friends at social gatherings or even at the void decks is beneficial.
In addition, it is important to take good care of general physical health as well, including adequate control of risk factors such as high blood pressure, diabetes or high cholesterol.
Locally, there are different types of drop-in centers as well as day centers which encourages both activities and social interactions. Depending on your needs, you could attend a senior activity center, rehabilitation center, or a dementia day center. Visit www.silverpages.sg for the list of resources available, or discuss with your treating psychiatrist on which activities are most beneficial for you.