What is dementia? There are various types of dementia – Alzheimer’s, vascular and etc.
Symptoms of dementia may include:
- Memory impairment e.g. losing things and forgetting recent events
- Difficulties in language ability e.g. losing appropriate language usage
- Difficulties in carrying out movements-related activities despite intact motor/strength function
- Failure to recognize or identify objects despite intact sensory function
- Disturbances in executive functioning (e.g. planning and organizing) and etc.
There may also
be changes in the person’s personality, resulting in significant
behavioural changes. These contribute to the behavioural and
psychological symptoms of dementia (BPSD).
Causes of Dementia:
Genetic contributions with loss
of specific brain cells (cholinergic neurons), brain cell changes
(deposits of Lewy Bodies), stroke and etc.
Illness Progression:
Dementia is a
neuro-progressive illness. In the initial stage, as symptoms are
generally mild, family members and the patient may dismiss the symptoms,
e.g. assuming forgetfulness as part of “normal aging”. Nonetheless, the
patient/family may start to feel distressed and worried.
As the illness
progresses, the symptoms become more obvious and worrisome. Assistance
with Activities of Daily Living (ADL) such as dressing, toileting, and
eating may be needed. The patients are often significantly forgetful.
They may have repetitive speech such as asking the same questions over
and over again.
Some may also
develop hallucinations (e.g. hearing voices talking to/about them) or
delusions (e.g. wrongly believing that others have stolen their
misplaced things). They may be irritable and no longer able to recognize
their loved ones. They are also more susceptible to depression and
other medical illnesses e.g. infection, stroke and etc.
Treatment for Dementia:
Medications - there
are medications to help decrease the rate of decline in dementia. In
addition, treatment can also help control the associated symptoms, e.g.
irritable mood, depression, insomnia and hallucinations/delusions.
There are
various types of medications which can modulate the brain’s cells
functioning. These include cholinesterase inhibitors and NMDA receptor
antagonist. Some of these medications may be taken orally and/or via a
convenient skin-patch route.
Other treatment modalities for dementia are also equally important to ensure a holistic and comprehensive approach to managing dementia. These include:
- Behavioral management
- Caregiver training
- Environmental modulations
- Reality orientation
- Reminiscence Therapy
