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What is Dementia?

What is Dementia?

Dementia is a general term for many types of cognitive impairment afflictions. People with dementia show a visible decline in focus, executive functions, memory, language skills, sense and coordination, and social skills. The decline often affects daily life and may even lead to personality changes, day and night reversals, hallucination and delusion.
 
A medical diagnosis of dementia is usually based on the “The Diagnostic and Statistical Manual of Mental Disorders” (DSM–5) published by the American Psychiatric Association. Aptitude tests, CT scans, MRI and blood tests are also used to assist with medical diagnosis if specific symptoms indicate cognitive degeneration or other ailments.
 
Vascular diseases, depression, strokes and obesity are considered risk factors for dementia. Both physical and psychological well-being are vital for striking off dementia.

Find out some Symptoms of Dementia

Alzheimer’s Disease
  • The most common form of cognitive degeneration, accounting for 50-70% of dementia cases; more common among females.
  • Slow decline, most common early symptoms are memory loss, difficulties in remembering information and learning new things.
Vascular Dementia
  • The second-most common cause of dementia for people aged 65 or above, accounting for 30% of dementia cases; more common among males.
  • Closely associated with strokes, heart disease and circulatory problems.
Frontotemporal Dementia
  • The second-most common form of dementia among the population aged 35 to 75.
  • The first signs are usually memory loss, difficulties in arranging everyday living, prioritisation of issues and emotion control.
Lewy Body Dementia
  • Non-hereditary, caused by the death of cells in the basal ganglia and a part of the brain called the substantia nigra.
  • Possible symptoms include visual hallucinations, confusion, daily changes in attention and alertness, sleep disorders, frequent falls, poor judgement and apathy.
Others
  • A lack of vitamin B12, thyroid disorders, long-term alcohol abuse, neurosyphilis and brain tumours could also lead to a degeneration of cognitive functions
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Aware of the Warning Signs

  • Being apathetic
  • Unwilling to learn new things
  • Declining ability in planning or decision-making
  • Accusing others of stealing misplaced items
  • Forgetting recent issues
  • Being confused about time and location
  • Being angry and anxious
    suddenly
  • Loss of interest in previously enjoyed activities
  • Difficulty in adapting to changes
  • Difficulty in grasping complicated concepts
  • Being more subjective
  • Repeating speech or gestures
  • Unable to handle personal hygiene or manage dietary needs
  • Experiencing hallucinations

Keep Track of Dementia Progress

Cognitive decline progresses in broadly three stages. It’s advisable to have professional help to evaluate this. The following can be used for reference.
Symptom Early stage * 1st - 3rd year Mid stage *3rd - 8th year Late stage *8th - 10th year
Deal with complicated matters unassisted, such as managing bank accounts
Return home from a familiar location
State the approximate date and time
Feel what’s happening around
Express one’s thought
Self-care in daily routine
Bowel control

*the duration in each stage may vary depending on the quality of care.

✔✔✔=able to do
✔✔=need prompts or guidance
✔=need assistance
✘=unable to do

Treatment

You may be searching for treatments when a loved one is diagnosed with dementia. Appropriate treatment and personalised community support could improve the well-being of people with dementia. Treatments come in two forms: pharmacological interventions and non-pharmacological interventions. Treatment in the early stages can slow down degeneration. Medical and social welfare sectors agree that non-pharmacological interventions should be attempted before medication is prescribed to control emotions or distressing behaviour.

Non-pharmacological Intervention

Psychosocial Activities

Improve communication and emotional well-being through socialising activities to maintain meaningful human relationships

Intelligent Stimulation Training

Improve focus, memory and skills with numbers, languages and problem-solving

Reality Orientation

Guide and remind the people with dementia to recognise things around them, including current date, time and location, to instill a sense of security and keep emotions stable

Reminiscence Therapy

Recount stories from the past to make the people with dementia feel assured and supported, and reinforce long-term memory

Art/Music Therapy

Help the people with dementia relax and express their feelings through art and music, and boost their sense of satisfaction and confidence

Other Means

Calligraphy, multisensory stimulation therapy, aromatherapy, pet therapy and horticulture therapy 

Pharmacological Intervention

Drugs for people with Alzheimer's disease
  • Acetylcholinesterase Inhibitors or Cholinesterase Inhibitors, such as Donepezil (Aricept®), Rivastigmine (Exelon®) and Galantamine (Reminyl®)
  • N-Methyl-D-Aspartate (NMDA) Receptor Antagonists, such as Memantine (Namenda®, Ebixa®)
Drugs for improving behaviour or
psychological symptoms
  • Anticonvulsants or Mood-Stabilizers
  • Antipsychotics
  • Antidepressants
  • Anxiolytics
  • Hypnotics
Drugs for non-Alzheimer's disease
  • Antihypertensive drugs, diabetic and heart disease medications (for people at high risk of vascular dementia)
  • Antiplatelet drugs and anticoagulants (for people with vascular dementia to lower the chance of recurrent stroke)
  • Vitamins and supplements (for people with dementia related to vitamin B deficiency)
The information stated above is for reference only. Please consult your physician if you have any questions, and do not self-medicate to avoid adverse reactions.