Dementia is the medical term used to describe a group of symptoms consisting of memory loss, impaired judgment, disorientation and behavioral changes, which are of sufficient severity to cause loss of function.
Dementia is not part of normal aging, although the elderly are more susceptible to becoming demented. Dementia occurs because there is degeneration of brain function, which eventually affects social or occupational activities (e.g. work, hobbies, shopping, cooking, dressing, eating, bathing, and toileting).
- Recent memory loss that affects job performance
- Difficulty performing familiar tasks
- Problems with language
- Disorientation to time and place
- Poor or decreased judgment
- Problems with abstract thinking
- Misplacing things
- Changes in personality
- Loss of initiative
- Changes in mood or behavior
(Adapted from °Someone to Stand by You": A guide for caregivers affected by Alzheimer's disease or a related dementia. Alzheimer's disease Association: Los Angeles, Riverside and San Bernardino Counties)
There are many conditions which may cause dementia, including:
- Degenerative diseases
- Alzheimer's Disease
- Lewy body dementia
- Fronto-temporal dementia
- Cerebrovascular disease
- Infectious disease
- Normal pressure hydrocephalus
- Brain tumors
- Autoimmune disorders
- Metabolic disorders
- Electrolyte imbalance
- Thyroid problems
- Vitamin B12 deficiency
Increasing age, cardiovascular factors such as hypertension, and more rarely, genetic factors, contribute towards the risk of dementia.
Individuals who should be screened and evaluated for dementia include those with progressive cognitive or behavioural complaints suggestive of dementia, as well as patients who arouse the physician's or caregiver's suspicion of cognitive impairment despite absence of complaints.
Clinical assessment for dementia should include:
- a focused history of relevant medical, psychiatric, social and medication history, together with a detailed description of cognitive and behavioural symptoms, preferably from a reliable informant as well as the patient.
- a focused physical examination with emphasis on detecting causes of delirium and neurological signs.
- Functional and mental status examination.
- Diagnostic tests to rule out metabolic and structural causes of dementia, which should include full blood count, serum electrolytes (including calcium), glucose, liver function tests, thyroid function tests, Vitamin B12 & folate levels, syphilis serology and neuroimaging.
- Evaluation of social and care issues
Early diagnosis of dementia may be of help to patients and their families in providing appropriate investigations, treatment and counseling for long-term management.
Some causes of dementia are potentially reversible. However, there is presently no cure for the common causes of dementia such as Alzheimer's Disease and Vascular Dementia. Nevertheless, there are medications available to alleviate symptoms and enhance quality of life.
Apart from medications, there are also behavioural therapies, counseling and education to improve care for patients with dementia and their families.
Patients may also benefit from advice on appropriate care facilities and legal issues.
Many new treatments are being developed for the prevention and treatment of dementia. There are ongoing clinical trials and other research efforts in Singapore.
A multi-disciplinary dementia assessment and management service is available at the NNI Neurodegenerative Diseases Clinic (at Singapore General Hospital).
NNI Neurodegenerative Diseases Clinic
Tel: (65) 6321 4744
Disclaimer: This brochure is meant to be a guide only.