Losing your true self

Move to raise awareness that dementia is an illness rather than a part of old age.

Losing memory and cognitive function can mean losing the essence of what makes a person who they are.

While some memory loss can be expected with ageing, a gradual deterioration in communication, learning and remembering friends and family members can be a sign of dementia.

The crippling syndrome, which encompasses a range of symptoms including a decline in memory and thinking skills, can negatively impact a person’s ability to perform their daily activities.

The World Health Organisation (WHO) noted that dementia is one of the major causes of disability and dependency among older people worldwide, with physical, psychological, social and economic impact on caregivers, families and the society. 

Despite this, Universiti Malaya Medical Centre’s Assoc Prof Dr Tan Maw Pin said awareness was still poor in Malaysia, posing challenges in treating those with the illness promptly.

“We tend to diagnose dementia very late in Malaysia, as family members will gradually take on each task for the older person including personal care and feeding, without recognising it is part of the illness,” she explained.

“They only seek medical help earlier if the older person displays behavioural problems such as wandering and aggression.”

Some of these symptoms are attributed to old age, while difficult behaviours such as paranoia are often blamed on the individual, with family members failing to realise the tell-tale sign of dementia.

Dr Tan, who works in the geriatric medicine department, noted that this often leads to tension between family members.

“I have seen children cut off all communications with their parent as a result of paranoid behaviour, which was subsequently diagnosed as dementia.”

She said there are two types of dementia – one hereditary, the other lifestyle-based.

“Children of affected individuals have a 50% chance of getting the illness.”

Dr Tan said, dementia shared common risk factors with heart disease, diabetes, stroke, high cholesterol, among others.

“Prevention is therefore no different - eat healthily and exercise the mind and body regularly,” she said.

Caregivers can seek help from geriatricians, neurologists and psychiatrists, who are treating dementia.

However, she said, the waiting list in some hospitals can be long as there are not enough doctors specialising in the field to treat and manage dementia.

A review article in the Asean Journal of Psychiatry in 2011 titled ‘Dementia in Malaysia: Issues and Challenges’ by Azlina Wati Nikmat, Graeme Hawthorne and S. Hassan Ahmad Al-Mashoor highlights a lack of psychiatrists in Malaysia, with a ratio around 0.05 to 0.60 per 100 000 population. 

To date, there is no known cure to the illness. However, the emergence of complementary treatment is comforting to caretakers, who need not be passive bystanders to the debilitating effects of dementia in their loved ones.

“Some studies showed the standardised ginkgo biloba extract such as EGb761 is helpful to improve memory performance for those with dementia and help maintain their functionality,” said a spokesman for LF Asia (M) Sdn Bhd, the official distributor for Dr Willmar Schwabe Pharmaceuticals’ products in Malaysia.

LF Asia is owned by Li & Fung Company, a Hong Kong-based multinational healthcare distributor, consumer goods design, development, sourcing and logistics group. In Malaysia, they are also the distributor of ginkgo biloba extract, EGb761.

The company distributes EGb761, which is a unique and patented standardised ginkgo biloba extract that neutralises free radicals and increases blood circulation.

Dr Tan notes that supplements containing ginkgo biloba extract EGb761 has been known to be an alternative treatment and cost-effective in the long run to help those with dementia, helping to reduce the burden of caregivers.

While it is not a substitute for synthetic medication, Dr Tan explained that EGb761 can help to slow down the process of dementia, but not the actual pathological deterioration in the brain.

However, caregivers and patients must consult their doctor for a prescription.

“With dementia patients surviving up to 10 years after they have been diagnosed of the illness, the burden of caring them can put a strain to the families’ resources, more so with family sizes getting smaller,” said Dr Tan.

Often, both husband and wife are required to work to provide for their family and dementia patients can exhibit disruptive behaviour, adding further challenges to their daily life.

“Our main battle currently is with people actually recognising that dementia is an illness rather than a part of old age.

“Raising an awareness is our priority at the moment,” she said, adding that people should get themselves checked out if they notice problems with forgetfulness in themselves or their loved ones.
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