Working that brain – by engaging in debate or number games – may protect you from the severe loss of mental ability associated with dementia.
Being young does not.
A study by a neurologist here is challenging the notion that dementia is an affliction that hits only those above 65: About half the patients being treated for dementia at the National Neuroscience Institute (NNI) are under 65.
Granted, the majority are over 40, but these patients are distinctly "middle-aged" – not what society thinks of as "old".
Dementia refers to the severe loss of mental capacity, including of one’s memory, which affects a person’s ability to live normally. If it happens to someone between the ages of 40 and 65, it affects his ability to hold down a job and be economically active.
Out of 10,000 people aged 40 to 65, seven or eight suffer from "young onset dementia".
NNI’s Dr Nagaendran Kandiah teamed up with Dr L.H. Tan of the National University Hospital to study 186 NNI patients over a nine-month period.
They also found that dementia hit the middle-aged differently compared to the elderly. Among those aged 65 and older, dementia for two in three has its roots in Alzheimer’s disease.
There is now no cure for Alzheimer’s, a disease in which brain cells are progressively destroyed.
In dementia among the middle-aged, however, Alzheimer’s is the cause in only 23 per cent – under a quarter – of patients.
Some non-Alzheimer’s dementia can be treated. One in four dementia patients under 65 can have their loss of memory reversed, said Dr Nagaendran.
Take Madam Ho Lan Hua, 62. Fluid was building up in her brain, causing memory loss and problems with balance. When the fluid was drained, improvement was immediate.
She started having trouble when she was 58. She had several falls because of her problems with balance.
Mentally, she was forgetting things she was told 10 seconds before, said her daughter Ng Lai Peng, a teacher.
She said: "Before we knew it was an illness, we used to get annoyed with her. We blamed her for not paying attention."
After a shunt was put into her head to drain the fluid, Madam Ho’s faculties improved by 50 per cent in the first week.
She is still making progress.
Dementia among the middle-aged can also be caused by Hashimoto’s disease, an auto-immune brain disorder.
Of the more than a dozen dementia patients with this disease studied, half made "significant" improvements with steroid treatment. The rest remained stable, with no further deterioration.
Yet another group of middle-aged dementia patients came by the condition following a stroke. This group needs to take control of their cholesterol, blood pressure and blood sugar levels and avoid a second stroke to arrest their memory loss.
Dementia is set to rise here as the population moves up the age spectrum. Doctors expect the number of people suffering from memory loss to double over the decade. Already, 30,000 people here have it.
Dr Nagaendran noted that dementia is "significantly lower" among the more highly educated, who regularly exercise the brain to stave off mental decline. It is like doing physical exercise to keep the body fit.
The NNI hopes to get a grant with which to develop mentally stimulating computer games for patients. It will also hold a public forum this month, and public screening for dementia at its premises in October.
Dr Nagaendran will present his findings at a two-day symposium for doctors, who need to be able to diagnose dementia early enough so treatment can begin. The symposium starts today at Tan Tock Seng Hospital.