Dementia

What is Dementia?

Dementia is an umbrella term used to decribe a set of symptoms caused by a combination of neurological disorders, such as Alzheimer's disease. It is not a specific disease and currently has no cure. Someone is considered to have dementia when their memory and cognitive function are adversely affected by brain diseases, severe enough to impair daily life and independent function. Dementia also affect behaviour, feelings and relationships.   

Dementia may affect anybody but it is typically more common in adults above the age of 65 years old. In Singapore, approximately 1 in 11 older adults develop dementia. 

Types of Dementia

Alzheimer's Disease

Alzheimer's disease account for 60-80% of dementia cases and occurs due to an abnormal build-up of proteins, known as tau tangles and amyloid plaques, that damage healthy brain cells and cause them to die over time. In its advanced stages, loss of brain function due to Alzheimer's disease can cause dehydration, poor nutrition or infection. 

Vascular Dementia

Vascular dementia is the second most common form of dementia and is caused by microscopic bleeding and blood vessel blockage in the brain which eventually kills brain cells. This may happen due to stroke, when the blood supply to the brain is suddenly cut off or possibly to underlying conditions too, such as high blood pressue or diabetes, or lifestyle factors such as smoking or being overweight.

Lewy Body Dementia

Lewy Body Dementia (LBD) happens when protein deposits called Lewy bodies develop in nerve cells in the brain. The protein deposits affect brain region involved in thinking, memory and movement. There are two forms of LBD that causes cognitive symptoms, dementia with Lewy bodies and Parkinson's disease dementia. 

What are the symptoms of Dementia?

Signs of dementia may vary greatly. Some symptoms of dementia include:

• Noticeable memory loss
• Difficulty completing familiar tasks
• Loss of interest in work or social activities
• Confusion about time and place
• Changes in personality
• Trouble performing complex tasks
• Problems with reasoning or problem-solving

Dementia symptoms are progressive, with signs of cognitive impairment starting out slow and gradually getting worse over time, leading to dementia. 

What are the risk factors of Dementia?

There has been several risk factors identified that affects your likelihood of developing dementia, including:

• Age: Your risk of dementia goes up significantly with age. 
• Family history: Someone with a family history of Alzheimer's disease are generally considered to be at a heightened risk of developing the disease. However, many without a family history have been known to get it too. 
• Smoking & Alcohol use: Studies have found that smoking significantly increases your risk of mental decline and dementia. Drinking large amounts of alcohol has also bene linked to an increased risk of dementia.
• Underlying conditions: High cholesterol or diabetes are some conditions that may increase your risk for both Alzheimer's disease and vascular dementia. 
• Atherosclerosis: Atherosclerosis is the buildup of plaque (fatty deposits, cholesterol and other matter) in the inner lining of your arteries. Atherosclerosis results in a blockage in the delivery of blood to the brain, and may result in a stroke. Atherosclerosis is a major risk factor for vascular dementia. 
• Mild cognitive impairment: Why not everyone with mild cognitive impairment develop dementia, people with this condition have an increased risk of dementia compared to others. 

How do you prevent Dementia?

There is no definitive way to prevent dementia but there are steps you can take to lower your risk of developing the condition:

• Keep your mind active: Mentally-stimulating activities may delay the onset of dementia and decrease its effects. You can consider activities such as doing sudoku or other puzzles, playing word games, and reading. 
• Be physically and socially active: Regular physical activity may delay the onset of dementia and being socially active helps to prevent solitude and social isolation which is linked to a greater risk of cognitive decline.
• Quit smoking: Studies have shown that smoking may increase the risk of dementia and blood vessel conditions. Hence qutting may improve your health and improve your risk of dementia.
• Manage cardiovascular risk factors: Pay attention to cardiovascular conditions you may be suffering from, including high cholesterol or high blood pressure. 
• Take care of your mental health: Depression has been linked to an increased risk of developing dementia. Seek professional help to manage your depression or anxiety to reduce your risk of the condition.
• Get good-quality sleep: Studies have shown that people who sleep less than six hours per night in their 50s and 60s were more likely to develop dementia later in life.
• Treat hearing loss: Hearing loss is associated with a greater chance of cognitive decline. Early treatment of hearing loss, such as with hearing aids, may help decrease the risk.

How do you diagnose Dementia?

Imaging Tests
Imaging tests are done with MRI or CT scan to check for evidence of stroke, bleeding, tumors, or fluid buildup in the brain.

Neurocognitive Test
These tests assess your thinking ability. A number of tests are conducted to evaluate abilities related to memory, thinking, problem-solving, reasoning, judgement and language.