Early diagnosis enables accurate, timely treatments that slow down the progression of dementia, a chronic condition

Many people believe that a decline in problem solving skills, difficulty with language and changes in behaviour are part and parcel of getting older. However, such regressive symptoms are in fact not a normal part of ageing, and could be a sign of dementia.

According to the Institute of Mental Health, one in 10 people over 60 in Singapore have dementia – an umbrella term to describe a person’s progressive decline in cognitive function.

A multifactorial condition, dementia can be caused by various diseases and modifiable and non-modifiable risk factors. According to the Head of the Tsao Foundation’s Intellectual Disability Service and Resident Physician Physician at Khoo Teck Puat Hospital, Dr Chen Shiling, Alzheimer’s accounts for 60% to 70% of all dementia cases, while vascular dementia is the second most common cause, followed by other types of dementia including frontotemporal dementia, Lewy-body dementia and more.

“Modifiable risk factors for the condition usually involve diabetes, hypertension, binge drinking, depression, physical inactivity, head injuries, smoking and hearing impairment, while non-modifiable factors comprise age, gender and genetics,” she adds.

Who is at risk?

Although dementia is most seen in elderly individuals, the condition affects young people too. In fact, young onset dementia (any confirmed diagnosis below 65) can occur in persons as young as 30, with rates of such cases increasing steadily every year.

“More Singaporeans are diagnosed with young onset dementia (YOD) annually partly due to increasing awareness, among the public and medical community, of this condition,” says Dr Chen.

“According to the National Neuroscience Institute, 245 cases of YOD were recorded in 2019, up 400% in seven years, with YOD often involving a stronger genetic component than dementia in older age groups,” she continues.

How can family members and persons with dementia spot the common and early signs of the condition?

Dr Chen explains that although symptoms may vary depending on the cause, there are seven common signs of dementia people can observe. These include:

  1. Problems with recent memory: Failing to retain recently learned information, forgetting important dates or events, or asking the same questions repeatedly.
  2. Confusion with place and time: Inability to differentiate between day and night, being unsure of their whereabouts or becoming frustrated over unfamiliar or noisy environments.
  3. Problems with visual perception: Difficulty in identifying objects in familiar environments, inability to judge distances/depth correctly or finding simple activities like reading and driving challenging.
  4. Challenges in planning and thinking: Having trouble concentrating, requiring more time to complete familiar tasks, misplacing things or having trouble handling money, paying bills or following instructions, resulting in difficulties with financial transactions.
  5. Challenges with communication: Inability to find the right words to express themselves or name objects, struggling to understand what others are saying or refraining from talking because they don’t know how to continue a conversation.
  6. Changes in mood, behaviour and personality: Exhibiting rapid mood swings, becoming passive and sleeping more than usual, appearing insensitive or rude to others or withdrawing from usual hobbies and activities
  7. Poor judgement: Inability to identify and filter inappropriate or unsafe behaviors such as using crude language, hitting people, or touching a hot kettle.

Such as with other progressive diseases, symptoms of dementia tend to deteriorate over time. To catch the condition early, here are some signs to look out as the condition progresses:

Mild Stage:

  1. Forgetfulness – particularly of recent events
  2. Inability to keep track of time
  3. Confusion/disorientation in less familiar environments
  4. Difficulty handling complex tasks
  5. Increased anxiety and irritability

Moderate stage:

  1. Becoming increasingly forgetful of recent events/current affairs
  2. Getting lost in familiar places
  3. Having trouble communicating with others
  4. Needing reminders with personal care or hygiene
  5. Behavioural changes such as agitation, hallucinations and issues with judgement

Severe stage:

  1. Becoming less aware of the time and place
  2. Having difficulty recognising relatives and friends
  3. Requiring assistance for basic activities such as bathing, dressing and using the loo
  4. Having trouble walking
  5. Increasing challenges with communication and reducing speech
  6. Difficulties swallowing and eating

When and why should persons with symptoms of dementia visit a doctor for a formal diagnosis?

Dr Chen says that it’s imperative that all persons who notice early signs of dementia in themselves or their loved ones get a medical opinion early. In addition to achieving the most appropriate treatments, early diagnosis will provide access to support services which allow them to plan for the future and have the best possible quality of life.

“When it comes to concerns about memory and cognitive function, other factors such as depression and hormonal imbalances could also cause lapses in cognitive function. This is why accurate diagnosis is important for confirming your condition and achieving the most appropriate treatments, regardless of the underlying cause.

“If your diagnosis does confirm true dementia, early diagnosis will be the key in not only achieving the best possible treatments for delaying the progression of the condition, but also promoting timely access to community support services, so that persons with dementia can plan for the future and continue to live well, in spite of their condition.”

Dr Chen Shiling, Head of the Tsao Foundation’s Intellectual Disability Service and Resident Physician Physician at Khoo Teck Puat Hospital

Dr Chen Shiling photo courtesy of Dr Chen Shiling. Featured image by Dreamstime. Trending hashtags: #dementia #dementiaawareness #dementiasupport #alzheimer #alzheimerawareness