Dealing with dementia

by | November 14, 2010

Dementia is not a normal part of ageing. It is an illness that affects the brain and leads to a decline in the brain’s ability to work properly. Dementia affects memory, judgment, language, planning and behaviour.

BY: Sng Yan Ling


Dementia happens when you brain starts to lose its functions progressively. Although it can strike anyone, the illness is more common among older adults especially those above 65 years old. There are various types of dementia, of which the two most common types are Alzheimer’s disease and vascular dementia. There is no known cause for Alzheimer’s disease but genetics and lifestyle are thought to play a role, particularly for vascular dementia which is caused by small strokes that affect blood circulation to the brain. By reducing your cardiovascular risk factors, you lower your vulnerability to it.

In Singapore, there are about 22,000 people, aged 60 and above, currently living with dementia. This figure is expected to grow, as the risk of the disease rises with age, coupled with Singapore’s ageing population.


The fight against dementia

Dementia usually presents itself in stages, accompanied by discernable signs and symptoms which will progressively worsen over time and affect the patient’s ability to live and function safely and independently.

It is important to seek professional assistance early so that the individual and their caregiver can take the necessary measures to manage dementia. Whilst there is no known cure, certain medications can alleviate its symptoms and may work best when coupled with psychosocial interventions especially in the early stages.

Knowing when a loved one has dementia and understanding what it is can make a huge difference. Both the person with dementia and caregiver are now able to understand that a decline in cognitive ability and change in personality are signs of dementia and seek help to alleviate them. In the early stage, simple measures such as keeping lists, labelling items to aid recall and post-it notes can be used to organise a demented person’s routine. 

An early diagnosis also allows more time for caregivers to learn how to cope with caring for someone with dementia and for the individual to plan ahead in terms of managing their finances and learning about long-term care options.

As such, recognising the warning signs of dementia and knowing the preventive and protective factors can help reduce the risk or delay the onset of dementia. These factors include staying physically and mentally active, eating healthily, quitting unhealthy lifestyle habits such as smoking, and being socially engaged.


Warning signs of dementia

Here is a list of top 10 warning signs to look out for:

1.    Memory loss that affects day-to-day function
2.    Difficulty doing familiar tasks
3.    Confusion about time and place 
4.    Problems communicating
5.    Difficulty planning or solving problems 
6.    Poor or decreased judgment
7.    Misplacing things
8.    Changes in mood or behaviour
9.    Changes in personality
10.    Withdrawal from work or social activities

To illustrate, someone suffering from dementia in the initial stage/s may be aware of frequent memory lapses or slightly impaired cognitive functions such as the declining ability to do mental calculations. This may be commonly mistaken for old age, fatigue or stress.

As dementia progresses, memory lapses and a general state of confusion becomes more pronounced. Recent events and familiar faces may be forgotten. At this stage, family members and close friends can sometimes detect a change in personality, mood and behaviour.

In the advanced stages, dementia patients often find it hard to accomplish even the most common day-to-day tasks that are often take for granted. This can be attributed to the severe loss in cognitive abilities which significantly impacts one’s ability to function normally.

This means that someone suffering from advanced-stage dementia may exhibit childlike behaviour and may require help with tying their shoelaces, cleaning themselves, or even finding their way home. Exacerbated by difficulty communicating and an overall decline in problem-solving capacity, tasks that were once familiar and accomplished as a matter of routine are transformed into a tedious daily struggle for both the individual and the caregiver as well.


Are you at risk of dementia?

Most of us who are not anywhere near the age of 65 may not think about dementia, unless we know or live with someone who has the disease. It is important to know that dementia is the result of changes in the brain, which can happen many years before the symptoms start to show. So even if you are in your 40s or 50s, you should make an effort to keep your brain healthy as you age. A healthy lifestyle and good management of any chronic disease (such as diabetes or hypertension) can possibly reduce your risk of dementia. An ounce of the proverbial prevention is worth much more than a pound of cure.

Health professionals recommend keeping an active social life, as it increases one’s level of engagement and satisfaction in life. One can also choose to stay connected by picking up new educational courses such as learning new IT skills or participating in recreational activities like ballroom or line-dancing.

In addition, regular exercise coupled with a healthy diet can work wonders. Foods high in vitamin B12, vitamin E and omega-3 fatty acids have been shown to reduce the risk of dementia and slow its progress.

It is important to cultivate a healthy diet and regular exercise while one is still young – such measures should be a lifelong endeavour and not something exclusive to old age.


Seeking help & raising awareness

While routine screening is not necessary, individuals with progressive cognitive or behavioural complaints indicative of dementia should undergo screening.

The Alzheimer’s Disease Association (ADA) (Singapore), a voluntary welfare organisation, provides information and support for people with dementia and their caregivers. At present, ADA manages four daycare centres located in Bukit Batok, Jurong Point, Toa Payoh and Tampines.

Recently, the Health Promotion Board (HPB) launched a campaign to raise awareness of the key signs of dementia, encourage early detection and destigmatise the condition. To promote a better understanding of the disease amongst Singaporeans, HPB also commissioned renowned local director Royston Tan to produce a short film on dementia. Titled “Ah Kong”, the six-minute film tells a poignant story about confusion of time and place and aims to de-stigmatise the condition by helping the general public understand and empathise with people suffering from dementia. The full-length version of the film is available for viewing on YouTube.

In addition, HPB will be collaborating with Changi General Hospital (CGH) and the Alzheimer’s Disease Association (ADA) (Singapore) on a new programme called DemACT-HOME, which serves to empower eldercare workers (and family caregivers) in the community to engage persons with dementia at home with meaningful activities. The programme comprises of an assessment, training, supervision and a unique activity toolkit to promote cognitive and psychosocial functioning and well-being. DemACT-HOME intends to support the caregiving capacity for seniors with dementia, enable ageing and care in place and in the long run, delay the necessity for institutional care.  


Sng Yan Ling is a psychologist and deputy director, Mental Health Education, at Health Promotion Board (HPB). For more information on HPB, go to its website. 

(PICTURES COURTESY: Health Promotion Board)



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