Identifying early warning symptoms of dementia

Dr Teh says the more risk factors a person has, the higher their chances of getting dementia.

EVERY year, 10 million new dementia cases are diagnosed, according to the World Health Organisation (WHO).

More than 55 million people worldwide live with a form of dementia and it is the seventh leading cause of death among all diseases.

In Malaysia, 204,000 to 264,000 adults had dementia in 2020, according to the Alzheimer’s Disease Foundation.

This will increase to between 637,500 and 825,000 by 2050.

At the opening ceremony of Malaysian Conference of Psychological Medicine 2022, Sunway Medical Centre, Sunway City, consultant geriatrician Dr Teh Hoon Lang shared that dementia is a general term for conditions where the decline in cognitive function affects daily living.

Alzheimer’s is a brain disease that is the most common cause of dementia.

“There are many factors associated with an increased risk of dementia and these factors can be divided into modifiable and non-modifiable risk factors.

“Non-modifiable risk factors include advancing age, being female and genetic inheritance.

“Certain types of dementia are genetic but having that gene does not mean that person will have dementia.

“Meanwhile, modifiable risk factors include diabetes mellitus, hypertension, obesity, excessive alcohol consumption, smoking, depression, traumatic brain injury, sedentary lifestyle, social isolation, mid-life hearing impairment, lower-education level and air pollution.

“The more risk factors a person has, the higher their chances of getting dementia,” Dr Teh explained.

There are many signs and symptoms of dementia and Alzheimer’s Disease International (ADI) listed 10 warning signs, which are also the early signs and symptoms of dementia:

> Memory loss

> Difficulty performing familiar tasks

> Problems with language

> Disorientation to time and place

> Poor or decreased judgement

> Problems keeping track of things

> Misplacing things

> Changes in mood and behaviour

> Challenges understanding visual and spatial information

> Withdrawal from work or social activities

Dementia is diagnosed based on clinical criteria whereby the doctor takes a detailed history from the patient and caregiver, performs a physical examination, cognitive assessment, functional assessment, as well as runs blood tests and brain imaging.

“Although there is no cure for dementia, there are many measures or strategies to slow down the progress of the disease and provide patients and caregivers a better quality of life,” Dr Teh shared.

There are pharmacological and non-pharmacological aids for dementia.

Good control of comorbidities and regular vaccinations against communicable diseases are also important to protect people with dementia from rapid deterioration if they are infected.

“The most important part of dementia care is to get diagnosed early and obtain professional advice on the management plan.

“Every person with dementia is unique and the approach should be individualised.

“The basic principles of care include understanding the disease pattern and the struggles or difficulty they are facing, providing a supportive environment, maximising their strength and minimising their loss due to cognitive decline,” Dr Teh explained.

Managing and reducing risk factors

In Malaysia, there is a lack of a post-diagnosis support system for people with dementia and their caregivers.

More healthcare professionals and volunteers are needed to support them after diagnosis and a dementia support network between non-governmental organisations, government and private healthcare facilities should be established.

Dr Teh is one of the authors for the latest edition of Clinical Practice Guidelines on Management of Dementia.

She believes it can help young doctors to recognise and diagnose dementia.

The guidelines also emphasise the importance of non-pharmacotherapy for people with dementia like cognitive stimulation therapy.

“This is the area in which we are still lacking trained professionals.

“Non-pharmacological management should be the mainstay of dementia care,” she said.

One of the crucial steps to reduce the risk of dementia is having a good control of cardiovascular risk factors such as diabetes mellitus and hypertension.

Healthy practices such as exercising regularly, reducing alcohol intake and smoking cessation are also important to maintain brain health.

“Start building your cognitive reserve in youth and keep your brain active even after retirement by learning new skills or hobbies and through social interactions,” Dr Teh advised.

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