Dementia is a term that describes a group of symptoms associated with a loss of memory or other thinking skills. Alzheimer’s disease accounts for 60-80% of all dementia cases, but there are other common types of dementia. This guide will help you better understand the different types of dementia, along with their signs, symptoms, causes, and treatments.
"The government’s strategy for dementia not only focuses on those already diagnosed with dementia but also on outreach efforts to increase awareness and early detection."
Ministry Of Health, Singaopre
Background
1 in 10 Singaporeans over the age of 60 has dementia. Neurological diseases such as dementia are the fifth leading cause of disability in Singapore. Singapore government’s strategy against dementia focuses not only on people already diagnosed with dementia but also on outreach to increase awareness and early detection. [1, MOH-SG]
Alzheimer’s disease (AD) AD is the most common form of dementia. Changes in the brain occur gradually. Signs include short-term memory, altered judgment, reasoning, and inability to perform daily tasks.
Vascular dementia (VaD) VaD is associated with stroke and is potentially preventable. Insufficient blood flow to the brain causes focal damage to brain areas involved in attention, planning, and action.
Common early signs include: [3, University of Queensland]
Dementia Symptoms at Different Stages include:
Dementia typically progresses slowly in three stages: early, middle and late (sometimes referred to as mild, moderate, and severe in a medical context). [4,dementia.org.au]
Early dementia
Often this phase is only apparent in hindsight. At the time, it may be missed or put down to old age or overwork. The onset of dementia is usually very gradual, and it is often impossible to identify the exact time it began. The person may:
Appear more apathetic, with less sparkle.
Lose interest in hobbies and activities.
Be unwilling to try new things.
Be unable to adapt to change.
Show poor judgment and make poor decisions.
Be slower to grasp complex ideas and take longer with routine jobs.
Blame others for “stealing” lost items.
Become more self-centered and less concerned with others and their feelings.
Become more forgetful of details of recent events.
Be more likely to repeat themselves or lose the thread of their conversation.
Be more irritable or upset if they fail at something.
Have difficulty handling money. [4,dementia.org.au]
Moderate dementia
At this stage, the problems are more apparent and disabling. The person may:
Be more forgetful of recent events. Memory for the distant past generally seems better, but some details may be forgotten or confused.
Be confused regarding time and place
Become lost if away from familiar surroundings
Forget names of family or friends, or confuse one family member with another.
Forget saucepans and kettles on the stove. May leave gas unlit.
Wander around streets, perhaps at night, sometimes becoming lost.
Behave inappropriately, for example going outdoors in nightwear.
See or hear things that are not there.
It becomes very repetitive.
Be neglectful of hygiene or eating.
Become angry, upset, or distressed through frustration. [4,dementia.org.au]
Advanced dementia
At this third and final stage, the person is severely disabled and needs total care. The person may:
Be unable to remember occurrences for even a few minutes, for instance, forgetting that they have just had a meal.
Lose their ability to understand or use speech.
Be incontinent.
Show no recognition of friends and family.
Need help with eating, washing, bathing, toileting, and dressing.
Fail to recognize everyday objects.
Be disturbed at night.
Be restless, perhaps looking for a long-dead relative.
Be aggressive, especially when feeling threatened or closed in.
Have difficulty walking, eventually perhaps becoming confined to a wheelchair.
Have uncontrolled movements.
Have permanent immobility, and in the final weeks or months, the person will be bedridden. [4,dementia.org.au]
"Forget Us Not"
is an independent initiative that aims to improve awareness and understanding of dementia and build dementia-friendly communities in Singapore
Dementia Care (Singapore):
Can dementia be prevented?
Lifestyle and home remedies. Dementia symptoms and behavior problems will progress over time. Caregivers and care partners might try the following suggestions: [5, Stanford Medicine]
People with stroke-related dementia may be able to prevent future deterioration of dementia by lowering their risk of heart disease and stroke. Even without these known risks, overall health can benefit from these strategies: [6. healthhub.sg]
Encourage exercise. Staying fit and spending quality time with family and friends contribute to health and well-being. Keeping the body and mind active reduces the risk of dementia. During the week, moderate physical activity for at least 150 minutes. Choose an appropriate action for your age and physical condition, and start at a comfortable level.
Be Socially Engaged. Build and maintain relationships. It’s always possible to make genuine friendships. Be friendly to your neighbors by smiling and saying hello. Join the Tai Chi session on the weekends. Play with your grandchildren and teach them what they love. It’s an afternoon of painting, cooking, and chatting over tea.
Mentally Active. Play more. Stimulate your mind through reading. Go to the library and borrow books and magazines. Enjoy card games, board games, and Sudoku in your spare time. Learn new skills. If you’ve never played an instrument before, it’s time to start. On weekends, you can also learn further dance steps and foreign languages. Are you tired of making the same dish over and over? Try new recipes and share cooking secrets with your friends. Visiting newly opened food courts and restaurants with family and friends is also fun.
Take Control of Your Health. Manage chronic conditions such as diabetes and high blood pressure, and get regular checkups. A strong and healthy heart supplies enough blood to the brain. This will keeps the brain well-fed and healthy. Keep your blood pressure, blood sugar, and cholesterol levels within acceptable limits. If you are on medication, take it faithfully and seek treatment early to avoid possible complications from these conditions. Maintain your ideal weight. Maintaining an average body mass index (BMI) helps control blood pressure and cholesterol levels. No smoking. Smoking is associated with heart disease and may increase the risk of dementia.
Dementia Treatment
Several dementia symptoms and behavior problems might be treated initially using nondrug approaches, such as:
Therapy:
These approaches can help your loved ones improve their memory and thinking skills. Or at least bring joy and brighten your day. Whatever they do, ensure it benefits their quality of life and doesn’t make them feel frustrated or overwhelmed.
Reminiscence stimulation therapy includes conversations with a loved one about their hometown, school days, work life, and favorite hobbies. It can be done individually or in groups as part of an organized treatment. The person doing the session can refer to your loved one’s past music, photos and valuables.
Cognitive stimulation therapy (CST) is a structured program for groups of people with mild to moderate dementia. At meetings, groups engage in spiritually engaging activities such as talking about current affairs, singing, puns, and cooking recipes.
Lifestyle Changes. Be active in physical
activities such as walking, dancing, and gardening. Studies show that exercise can delay symptoms of dementia, such as thought disorders, and reduce anxiety and depression. Prioritize a good night’s sleep and encourage a quiet routine. Avoid caffeinated tea and coffee, especially in the evening, and limit afternoon naps. A healthy diet, as what your loved ones eat affects their health, including their brains, so watch your food. A good diet can even slow the progression of dementia.
Medications:
There is no medicine that cures dementia. However, some may temporarily help with some symptoms. Doctors may also prescribe other drugs to treat problems caused by dementia, such as depression, sleep disturbances, and irritability. [7, webmd]
General Helpline:
for Dementia Support: For more information, you can call. [8. healthhub.sg]
HPB Dementia Infoline: 1800 223 1123. For general inquiries on dementia
Institute of Mental Health (IMH): 6389 2000. For general inquiries on clinical services and psychiatric care.
Samaritans of Singapore (SOS): 1800 221 4444. Emotional support for anyone in.
Dementia Singapore: 6377 0700. For caregiver support and dementia care services.
Singapore Association of Mental Health (SAMH): 1800 283 7019. For general inquiries on rehabilitative and outreach services
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