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Heed the warning signs of dementia

  Tuesday, 17 l 08 l 2010 Source:  The Straits Times   
By: Kimberley Koh

Be aware of the behavioral changes in a person which affect daily life and seek medical treatment early, experts tell Kimberley Koh

CASE #1: An elderly woman misplaced her money but mistakenly thought her maid had stolen it. She tried to assault the maid and threatened to call the police.

Case #2: A homemaker bought more fish than she needed and left them in the chiller instead of the freezer of her refrigerator. The fish became bad after a few weeks.

Case #3: A wife thought her husband was her father and addressed him as “papa”.

dementiaThese are true examples of how dementia can affect individuals and the people around them, says Dr Joshua Kua, who heads the department of geriatric psychiatry at the Institute of Mental Health.

Affected individuals can suffer from declining memory in the early stage leading to impaired function, but many people attribute it to normal ageing, he notes.

“Memory problem is one of the symptoms of dementia, and this is particularly true for Alzheimer’s dementia,” adds the senior consultant psychiatrist who is also project director of the Aged Community Assessment and
Treatment Service.

Another common sign of dementia is increasing difficulty in doing routine tasks such as going to the market, doing household chores and cooking, notes Dr Kua.

He cites the case of a housewife who forgets what she needs when she is in the market. “At times, she would buy things she did not require or bought too many of certain items,” he says.

Dementia patients are also confused about time and space. Says Dr Kua: “Some would think that it is night even though it is bright and sunny outside. The confusion is more pronounced when they are in unfamiliar places.”

Difficulty in communicating is another symptom, although in the early stages it may be subtle, he adds. “Some have ‘word finding’ difficulties, which gradually become more concrete, and they are less able to understand or use abstract language.”

Withdrawal from work and social activities may initially be seen as the individual becoming lazy or depressed,
says Dr Kua.

If you or your loved one has such experiences, it’s time to see a doctor.

Dr Norhisham Bin Main, an associate consultant with the department of geriatric medicine at Khoo Teck Puat Hospital, says: “The extent to which the warning signs affect the individual has implications on the severity of the dementia.”

Those living with or caring for the older folks are best placed to spot these warning signs, he adds. “Caregivers living with the affected person will notice the day-to-day changes that occur.”

When a doctor examines the affected individual, the caregiver should be present and provide collaborative information.

Explains Dr Norhisham: “An accurate diagnosis is important so that potentially treatable conditions causing cognitive impairments can be identified and treated appropriately.”

Polyclinic and family doctors can do the initial evaluation, he says.

The individual can then be referred to a hospital’s memory clinic for the diagnosis and management of dementia.

The treatment is multi-faceted and may include medication to stabilise the symptoms, education and support
for the affected individual and the caregiver.

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