Dementia

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    What is dementia?

    Dementia is a generic term used to describe chronic or progressive memory loss and deterioration in thinking, language, problem-solving and ability to carry out everyday tasks. According to the World Health Organisation (WHO), around 50 million people worldwide have dementia, with 5 to 8 percent of the population aged 60 and above being affected by this condition [1]. 

    Although dementia mainly affects the older population, it is not a normal part of the aging process. This is a common misconception about dementia which usually leads to the condition being left undiagnosed and untreated. In fact, research has estimated that around 61.7 percent of dementia cases go undetected. 

    Unlike the elderly population, individuals under the age of 65 are more prone to developing rapidly progressive dementias (RPDs). RPDs are dementias that progress at a rate faster than expected of a typical dementia, usually over the course of only a few weeks or months [2]. Common types of RPDs include vascular dementia, which is caused by brain damage from obstructed blood flow to your brain. Another example of an RPD is lewy body dementia, which is caused by abnormal deposits of a type of protein, known as alpha-synuclein, in your brain. 

    How will having dementia affect me?

    There are various ways in which having dementia may affect your day-to-day life. 

    Firstly, having dementia may prevent you from being able to carry out simple daily activities, such as cooking or getting dressed. This is because dementia inhibits your brain’s ability to process and carry out multi-step activities. 

    In addition, dementia often results in memory loss. You may experience episodes of forgetfulness, from not being able to remember where you placed your car keys to forgetting what your home address is. 

    Lastly, having dementia may alter your judgement, mood and even personality. You may begin making inappropriate decisions without realising, such as showering with your clothes on or going out shopping at midnight. You may also find yourself having less control over your emotions, becoming more irritable and prone to mood swings. In some cases, you may also find yourself being more unsociable or paranoid.

    How will I know if I have dementia?

    Memory loss. The main tell-tale sign of dementia is memory loss. Initially, you may experience slight forgetfulness every once in a while. However, as the condition progresses, you may find yourself not being able to recognise familiar places or faces. This is usually accompanied by confusion and delirium. 

    Inability to complete tasks. You may find yourself not being able to complete simple day-to-day and mental tasks.

    Personality and mood changes. Lastly, you may experience unexplainable, rapid mood swings and find yourself making rash and often unwise decisions. 

    What are the causes and risk factors of dementia?

    Contrary to popular belief, age is not a direct cause of dementia. Instead, dementia is usually caused by a separate underlying medical condition. The most common causes of dementia include: 

    Degenerative neurological diseases (eg. Alzheimer’s disease, Parkinson’s disease and some types of multiple sclerosis). According to the World Health Organisation, 60 to 70 percent of dementia cases can be attributed to Alzhimer’s disease [1]. 


    Vascular disorders. Vascular disorders arise due to brain damage from the lack of blood flow to your brain. The most common example of a vascular disorder is stroke. 


    Neuroinfections. Neuroinfections occur when pathogens such as bacteria, viruses, parasites, fungi or prion invade the nervous system through the bloodstream or peripheral nerves. Common examples of neuroinfections include meningitis and encephalitis. 


    Excessive long term alcohol and drug use. These may lead to brain damage, causing dementia. 


    Brain injury. This includes bleeding in the brain and brain lesions and can be caused by external injuries to the head or accidents.

    Despite not being a cause, age still remains as the strongest risk factor for dementia. Studies have indicated that for those between the ages of 65 and 90, the risk of dementia doubles approximately every 5 years [3]. In addition, family history of dementia may increase your risk of dementia as well. Lastly, smoking, excessively drinking and having a poor diet may increase your risk of dementia.

    How is dementia diagnosed?

    Medical examination. When visiting your doctor, he or she will most likely begin with a thorough medical examination. Your doctor may ask you about your recent habits, family history and medical history. 

    Neurological tests. Your doctor may then conduct several neurological tests to evaluate your cognitive function, reflexes and sensory response. 

    Neuroimaging tests. Your doctor may also make use of neuroimaging, such as MRI and CT scans to identify any potential tumours and strokes that may cause dementia.

    How can I prevent myself from getting dementia?

    As of now, there are no certain ways to prevent all types of dementia. However, you can reduce your risk of dementia by making healthy lifestyle choices. This includes exercising regularly and eating a healthy diet. Taking these simple steps can help to reduce other medical conditions which may cause dementia, such as stroke. 

    How can dementia be managed?

    There are currently no cures for dementia. However,  these are certain medications like cholinesterase inhibitors etc which can be used to treat the symptoms of some common types of dementia. 

    If you are taking care of someone with dementia, here are 3Rs of dementia care which you may use: 

    Remain calm. Remember that dementia patients often do not have control over how they act. Be patient and do not argue with or lash out at them. Instead, remain calm and understanding towards them. 

    Respond. Treat dementia patients as they are – humans. Validate their feelings and respond to them. 

    Reassure. Slowly losing your memory and part of yourself is scary. Empathise with these individuals and remind them that they are loved and cared for. 

    If you think that you may be experiencing dementia, visit a doctor and seek medical attention immediately. 

    References

    1. Dementia. (2020, September 21). Www.Who.Int; World Health Organisation. https://www.who.int/news-room/fact-sheets/detail/dementia#:~:text=Rates%20of%20dementia
    2. Geschwind, M. D. (2016). Rapidly Progressive Dementia. CONTINUUM: Lifelong Learning in Neurology, 22(2, Dementia), 510–537. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4879977/ 
    3. Corrada, M. M., Brookmeyer, R., Paganini-Hill, A., Berlau, D., & Kawas, C. H. (2010). Dementia Incidence Continues to Increase with Age in the Oldest Old The 90+ Study. Annals of Neurology, 67(1), 114–121. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3385995/