Keeping active, having a balanced diet and staying healthy may keep dementia at bay.
DEMENTIA is an umbrella term to describe the symptoms of a large group of illnesses that can result in loss of memory, orientation and social skills as well as cause changes in personality, behaviour and mood which are severe enough to affect daily function. However, having memory loss alone does not mean one has dementia, said Dr Chin Ai-Vyrn, who is an Associate Professor at the geriatric division of Universiti Malaya Medical Centre (UMMC) in Kuala Lumpur.
“Dementia indicates issues with at least two brain functions, such as memory loss and language difficulties, or impaired judgment, that are significant enough to cause problems with the ability to perform some daily activities. Symptoms vary, depending on the cause and the area of the brain affected,” explained Dr Chin, 46, in a recent interview.
While some types of dementia such as those caused by nutritional deficiencies and endocrine abnormalities can be reversed, most cases are progressive and worsen over time. There are four main types of progressive dementia – Alzheimer’s disease, vascular dementia, Lewy body dementia and Frontotemporal dementia. These four types make up about 90% of all cases.
Research findings published in the Annals Of Internal Medicine in February showed that physically fit midlifers were nearly 40% less likely to develop dementia or Alzheimer’s disease by the time they were 65 years old, compared with their counterparts who were less active.
Changes in physical activity in midlife may lead to improved fitness levels, resulting in less all-cause dementia with ageing.
Another study from the Journal Of Neurology found that exercise helped minimise arterial plaque build-up, and this was linked to improved performances on memory and mental acuity tests, reports huffingtonpost.com.
“Some studies also show that sticking to a Mediterranean type of diet (which emphasises healthy fats, vegetables, fish and fruits) may help reduce dementia. Reducing alcohol intake and not smoking is good for the brain, too,” added Dr Chin, who graduated from the Royal College of Surgeons in Ireland in 1993 and was the lead clinical Fellow at the Mercer’s Institute memory clinic in Ireland prior to returning to Malaysia in 2007.
Besides a healthy lifestyle, a well-balanced diet and regular exercise are important, too. “Regular exercise is important as it helps in many ways. It can improve cardiovascular status, functional ability and reduce fracture risk. In the long run, it can reduce the risk of developing dementia,” said Dr Chin.
He said it is equally important to keep the mind active. “Retirees should take up activities that are cognitively stimulating. Mental games like mahjong, sudoku or chess and hobbies like reading, sewing or something outdoors like gardening provide cognitive stimulation and may reduce dementia risk. Learning something new, as long as it’s enjoyable and not causing additional stress, is good,” he explained.
UMMC’s geriatrics division, formed in 1998, runs outpatient clinics in three specialised areas – memory, falls and general geriatric medicine (which caters to patients 65 years old and above). The memory clinic, the first in a university hospital, specialises in the early diagnosis and treatment of dementia.
The memory clinic accepts only patients with referrals and the waiting period is usually about three months. The clinic operates every Thursday afternoon. On average, Dr Chin and his colleagues – including geriatricians Prof Dr Philip Poi, Associate Professor Dr Shahrul Bahyah Kamaruzzaman and psychogeriatrician Dr Chong Lu Ann, together with allied health professionals – see around 20 patients (four to five per specialist) every week.
Their patients’ levels of dementia range from mild to severe. Over the last 12 months alone, over 250 patients with dementia have walked through the doors of UMMC’s memory clinic.
Every new patient undergoes a brief neuro-cognitive test and a functional assessment before seeing the specialist, who then takes a history and performs a physical examination. The patient’s family is often asked to attend to provide additional information. Further investigations, such as blood tests or brain scans, are arranged as appropriate. Patients are then given feedback on the results of the assessment at a subsequent visit. Being seen by a specialist in dementia is important as studies show that the diagnosis is accurate in over 90% of cases.
Since there is no specific test to diagnose dementia like Alzheimer’s disease, the patient’s history, physical examination and information from caregivers are key to determine the diagnosis. Dr Chin explained that early accurate diagnosis is vital to help manage the patient’s medical concerns.
“We also look into other areas, including safety, legal aspects (to ascertain if the patient is able to make decisions), care and medication. It’s important to start planning for services and support as early as possible. Patients referred have different degrees of dementia, ranging from mild to moderate to severe.
“Currently, 30% of people over 80 years will have a dementing condition. If nothing is done, the potential numbers are scary. It is vital for us to take care of our health and start taking steps to keep our brains active as we age,” said Dr Chin.