What You Need to Know About Dementia

This article was contributed by Dr Raymond Ong Khar Fei, Consultant Geriatrician at Pantai Hospital Klang.
To book an appointment or learn more about Dr Raymond Ong Khar Fei and his clinic, click here.

What is Dementia?

Answer: Dementia is an acquired brain dysfunction causing cognitive impairment and functional decline which is usually insidious in onset and progressive in nature

What are subtypes of Dementia?

Answer: Most common to less common- Alzheimer’s Dementia (Majority) > Vascular Dementia > Rare (Parkinson Disease Dementia, Lewy Body Dementia, Frontotemporal lobe Dementia)

What are the MOLECULAR-PATHOLOGIC Causes of Alzheimer’s Dementia?

Answer: Characterized by progressive loss of synapses and neurons with Abnormal protein deposition of ᵦ amyloid and Tau protein.

What are the early signs and symptoms of Alzheimer’s disease?

Answer:
Early symptoms may include:
Memory loss that disrupts daily life- Difficulty with familiar tasks like cooking, managing finances, or driving.
These symptoms can be subtle at first, but they worsen as the disease progresses.
Patient with Dementia also will affect Mood or changes in behaviour, including withdrawal from social activities.

Who is at risk of Dementia?

Answer:

Several risk factors have been identified:

• Age: Increasing age is the strongest risk factor for dementia
• Genetics: Certain genes, like APOE-e4, are linked to a higher risk of Alzheimer’s.
• Medical risk factors: Cardiovascular disease, Stroke, Obstructive sleep apnoea, Uncontrolled Diabetes, uncontrolled Hypertension
• Family history: People with a close family member who has Alzheimer’s may be at higher risk.
• History of Head injury
• Lifestyle and environment Risk factor- Heavy smoking and Heavy alcohol consumption

How is Alzheimer’s disease diagnosed?

Answer: There is no single test to diagnose Alzheimer’s. The diagnosis involves Clinical (Detailed History, Physical examination, Cognitive testing and other assessments) + Imaging (MRI brain, PET scan) + Biomarkers

Can Dementia be treated?

Answer:

While there is no cure for dementia, but there are steps you can take to reduce the risk and slow down the progress of the disease.

• Mental exercise
• Physical activity
• Healthy diet
• Social engagement
• Management of chronic conditions like diabetes, hypertension, and high cholesterol.

What are the management options for Alzheimer’s disease?

Answer:

Nonpharmacological therapy > Pharmacological therapy

AIM to

• Preserve function and independence of the person with dementia as much and as long as possible
• Reduce carer stress
• Maintain person and carer quality of life

Management includes- Geriatricians + Multidisciplinary (Nurse, Occupational therapist, Physiotherapist, Neuropsychologist, Speech and language therapist, pharmacist, Dietitian, Social worker, doctor)

What is the difference between Alzheimer's disease and normal aging?

Answer:

While some memory loss is a normal part of aging, Alzheimer’s disease involves significant cognitive decline that interferes with daily life.

Can Alzheimer’s disease affect younger people?

Answer:

Yes, although Alzheimer’s disease is most common in older adults, there is a form called Early-Onset Alzheimer’s that affects individuals under 65, and sometimes even in their 40s or 50s. Early-onset Alzheimer’s tends to progress more rapidly than the late-onset form.

How does Alzheimer’s impact daily life, and what can families do to prepare?

Answer:

Alzheimer’s can severely affect an individual’s ability to manage daily tasks.

Families should:

• Start making financial and legal arrangements early on, such as power of attorney or living wills.
• Create a safe environment that minimizes risks of falls and accidents.
• Seek support groups for families to navigate the challenges of caregiving.
• Be patient and understanding, and allow the person with Alzheimer’s to maintain as much independence as possible.