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Dementia

Dementia is a disease of decline in brain function due to neurological pathology. Patient’s memory, comprehension, language, learning capacity, calculation and judgement would be affected. Some also present with emotional, behavioural or sensory problems. According to Mental Health Review Report (2017), with the gloomiest estimates putting our demented population at 100 000, representing almost one-tenth of the elderly population.

Causes of dementia

  1. Alzheimer's Disease: Most common cause of dementia. Accounted for nearly 65% of dementia in Hong Kong Chinese elderly
  2. Vascular Dementia: 2nd common cause of dementia. Accounted for around 30% of dementia in Hong Kong Chinese elderly
  3. Others (Parkinson’s disease dementia, Hypothyroidism, Vitamin B12 deficiency etc.)

Stages of dementia and common presentations

  1. Early stage - Become forgetful, especially regarding things that just happened, have difficulty carrying out complex household tasks, may show mood changes including depression and anxiety.
  2. Middle stage – Become more forgetful, especially of recent events and people’s name, unable to live alone safely without considerable support. Behaviour changes may include wandering, repeated questioning etc.
  3. Late stage - Cannot recognise relatives, may become double incontinent and there may be behaviour changes including aggression towards carer and agitation.

10 warning signs of dementia

  1. Recent memory loss that disrupt daily life
  2. Challenges in planning or solving problems 
  3. Difficulty completing familiar tasks
  4. Confusion with time and place
  5. Trouble understanding visual images and spatial relationships
  6. New Problems with words in speaking or writing
  7. Misplacing things and losing the ability to retrace steps
  8. Impaired judgement
  9. Withdrawal from work or social activities
  10. Change in mood and personality

Management

  1. Seek early medical advice and treatment if there is suspicion of dementia.
  2. Medication can improve memory and relieve symptoms. Treatment can also manage behavioural problems but there is no definite cure for dementia.
  3. Non pharmacological interventions such as Reality Orientation and Reminiscence Therapy were also shown to be effective for people with dementia.
  4. Carers of demented patient can attend health talks, support groups etc. to acquire caring skills through sharing and alleviating the anxiety and stress.

Prevention

  1. Healthy lifestyle
    • Physically active
    • No smoking and no alcohol
    • Balanced diet
    • Take part in intellectual and leisure activities
  2. Early diagnosis and control of chronic disease like diabetes mellitus, hypertension and stroke

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