DEMENTIA
My father is a 56-year-old man with underlying diabetes mellitus, hypertension, and dyslipidemia, all currently well controlled. He had a left lacunar ischemic stroke (multifocal infarcts) about two years ago. He continues to smoke.Over the past 10 years, he has had progressive behavioural and cognitive changes. These began with child-like behaviour and difficulty remembering birthdays, followed by forgetting familiar routes and people. He often pretends to recognise people to mask the memory loss.In the last few years, his behaviour has significantly worsened. He has developed loss of social manners, inappropriate public behaviour, repetitive actions, sweet cravings, disinhibited or inappropriate speech, and hypersexual behaviours, including inappropriate touching of family members and children, sometimes giving them money afterward. These behaviours are very different from his previous personality. An MMSE done last year was normal, but his behavioural symptoms have continued to deteriorate.We are worried about some neurocognitive disorder or frontal lobe atrophy. And currently this situation is difficult to manage as it is difficult to control him. We would like to know proper diagnosis and ready to seek immediate management

Answer:

Dear Sir/Madam,

We extend our sincere gratitude for choosing Pantai Hospital Malaysia for your healthcare requirements.

We understand that the behavioural and cognitive changes you have described are distressing for both your father and the family, and we appreciate your concern in seeking timely medical attention.

Based on the history you have shared—including progressive behavioural changes over several years, loss of social inhibition, personality changes, hypersexual behaviour, repetitive actions, dietary changes, and a background of vascular risk factors and prior ischemic stroke—these symptoms require urgent specialist assessment.

We strongly recommend that your father be reviewed as soon as possible by a Neurologist. The specialist assessment may include:

·       Detailed neurological and cognitive evaluation

·       Neuropsychological testing

·       Brain imaging (such as MRI of the brain)

·       Blood investigations to exclude reversible causes

·       Review of current medications and risk factors

If his behaviour is becoming unsafe to himself or others, or if it is increasingly difficult for the family to manage, urgent presentation to the Emergency Department is recommended for expedited assessment.


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Last Edited: 07 Mar 2026
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