What Is Dementia?

Dementia is a disorder of the brain that is characterised by progressive worsening of memory and intellect (cognitive abilities), orientation and personality. Dementia affects a person's ability to think, reason, remember, learn new information and skills, solve problems, and make judgements. It results in a progressive worsening of the affected person's work, daily activities, and ability to interact socially.

To date there is no cure for dementia but through treatment and medications, it can slow down the progression of the disease.

How Common Is It?

  • The risk of dementia increases with age. In Singapore, about 1 in 10 (amongst the elderly aged 60 years and above) suffers from dementia. This corresponds to approximately 82,000 people with dementia in 2018 and is projected to increase to 152,000 by 2030.

What Are the Signs and Symptoms?

  • Forgetfulness that affects day-to-day function
  • Difficulty in planning or solving problems
  • Confusion of time and place
  • Poor or decreased judgement
  • Difficulty in doing familiar tasks
  • Changes in personality
  • Problem in communicating
  • Misplacing things
  • Withdrawal from social activities or work
  • Changes in mood or behaviour

How to prevent it?

There is no way to prevent it, but it is possible to lower the risk by:

  • Staying physically active
  • Eating healthily
  • Staying mentally active
  • Being socially engaged
  • Taking control of your health

What are the causes and risk factors?

  • High blood pressure
  • High cholesterol
  • Type 2 diabetes
  • Obesity
  • Smoking
  • Stroke


Some of the causes of dementia include:

  • Alzheimer's disease

 Alzheimer's disease is a progressive illness in which the nerve cells of the brain are destroyed, and the brain substance shrinks. The cause of Alzheimer's disease is not fully understood but it's likely a combination of genetic and lifestyle factors.

  • Vascular Dementia

Vascular dementia is caused by reduced supply of blood to the brain due to damaged blood vessels, depriving brain cells of vital oxygen and nutrients. There are many factors that can increase the chances of damage to blood vessels in your brain and may be preventable. 


Diagnosis

  • Interview: Doctor will ask the affected person, family members, or caregivers for symptoms
  • Assessments: A cognitive and language ability test
  • Blood test: Sample will be tested for vitamin deficiency, thyroid function, liver function
  • Brain imaging: Neuroimaging tests such as Computed Tomography (CT) scan or Magnetic Resonance Imaging (MRI) of the brain


Treatments

  • Medications to slow down the progression of dementia
  • Counselling, behavioural therapies, and education to improve care for patients and their families


Social support and support for caregivers

Support for the person with dementia as well as the family members and caregivers are important as it allows appropriate care to be provided. These support services include:

  • Education sessions on dementia and caregiver skills
  • Individual and family counselling
  • Regular caregiver support group meetings
  • Sessions with healthcare professionals and counsellors who can provide support and help with crises and the changing nature of the affected person's symptoms
  • Respite care for the affected person
  • Web-based learning, on-line discussions

The attending doctor or healthcare professional may also refer family members or caregivers to community resources to meet various care needs.

For more information you can call:

  • Dementia Singapore for caregivers' support and dementia care services – 6377 0700
  • Singapore Association of Mental Health (SAMH) for general enquiries on rehabilitative and outreach services – 1800 283 7019
  • Institute of Mental Health (IMH) for general enquires on clinical services and psychiatric care – 6389 2000

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References:
  1. Subramaniam. M, et. al. Prevalence of Dementia in People Aged 60 years and above: Results from the WiSE Study, 2015, Journal of Alzheimer’s Disease 45 (2015) 1127-1138
  2. Baumgart, M., Synder, H. M., Carrilo, M.C., Fazio. M., Kim, H., & Johns, H. (2015). Summary of the evidence on modifiable risk factors for cognitive decline and dementia: A population-based perspective. Alzheimer & Dementia, 11, 718-726.  https://www.sciencedirect.com/science/article/pii/S1552526015001971
  3. How to reduce your risk of dementia? (2018). Alzheimer’s Society  https://www.alzheimers.org.uk/about-dementia/risk-factors-and-prevention/how-reduce-your-risk-dementia   
  4. Tests for diagnosis of dementia. (2020). National Health Service. https://www.nhs.uk/conditions/dementia/diagnosis-tests/
  5. What are the treatments for dementia? (2020). National Health Service. https://www.nhs.uk/conditions/dementia/treatment/ 
  6. Alzheimer’s and Dementia Care: Help for Family Caregivers. (2021). HelpGuide. https://www.helpguide.org/articles/alzheimers-dementia-aging/tips-for-alzheimers-caregivers.htm 
  7. Dementia. (2019). National Neuroscience Institute Singapore. https://www.nni.com.sg/patient-care/conditions-treatments/dementia  
  8. Dementia – early signs. (2021). Better Health Channel. https://www.betterhealth.vic.gov.au/health/ConditionsAndTreatments/dementia-early-signs
  9. 10 Early Signs and Symptoms of Alzheimer’s. (2021). Alzheimer’s Association. https://www.alz.org/alzheimers-dementia/10_signs