Dementia
About Dementia
Dementia is a disease that impacts brain functions. Patients would experience a significant and ongoing decline in cognitive abilities, including memory, judgment, and language ability, with no course of action to reverse the condition or cure the disease. According to statistics from the Hong Kong Hospital Authority, about 5-8 out of every 100 elderly people over 65 years old suffer from this disease; and among the elderly over 80 years old, 20-30% of them suffer from dementia to varying degrees.
Dementia is a syndrome that can be caused by multiple brain diseases for which pathological changes will start to occur in the brain cells of patients. Common subtypes include:
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Alzheimer's disease： The most common type of dementia. A neurodegenerative disease where patients suffer from a progressive decline in cognitive ability, while the cause remains unknown.
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Cerebrovascular dementia：The second most common type of dementia. A kind of brain damage caused by stroke or other vascular diseases. The cognitive abilities of patients would display regressive decline, which means that every time a patient has a stroke, the brain function will have further degeneration.
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Other diseases：Includes dementia with Lewy bodies, frontotemporal dementia, hypothyroidism, neurosyphilis, alcohol-related cognitive impairment, and lack of vitamin B12, etc.
Risk Factor
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Age：Individuals aged 65 or above are more likely to suffer from dementia. The older the age, the higher the risk.
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Gender：Women are generally more likely to develop dementia than men.
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Lifestyle：People with high blood pressure, high cholesterol and diabetes may have a greater risk of developing dementia.
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Heredity factors：If an individual’s immediate family members suffer from dementia, the chance of developing the disease will also increase.
Symptoms at the Initial Stage
- Decline in memory, affecting daily life
- Feeling incapable of familiar daily business
- Inability to clearly remember time, date and people
- Placing objects in inappropriate places
- Impaired judgment
- Inability to understand relatively abstract things
- Emotional problems
- Difficulties in language expression or comprehension
- Personality change, or even abnormal behaviours
- Loss of initiative in daily actions
Evaluation and Diagnosis
Cognitive health assessment：Through simple and fast behavioural assessment and intelligence test, a patient's performance is assessed in various cognitive fields, including concentration, attention and working memory, executive functions, language ability, visuospatial ability, abstract reasoning, orientation to time and space, etc. It is an effective assessment for identifying early dementia. Patients are also evaluated in terms of their behaviour, psychological symptoms and emotions, which would help doctors to fully understand the their performance and conditions in all aspects.
Blood test：It helps to rule out the possibility of other diseases, including thyroid disease or lack of vitamin B12.
Brain MRI：To check for atrophy, blood clots or tumours in the brain.
>PET scan：With this type of examination, a small amount of radioactive tracer will be injected into the patient’s body to visualize the activity of the brain. It helps to measure the accumulation of beta-amyloid plaques and the glucose metabolism in the brain, and facilitates the diagnosis and assessment of the diseases, as well as the evaluation of drug treatment in patients.
Treatment Methods
Medication：Drugs for the treatment of dementia are generally divided into two categories, including drugs that delay the symptoms, and drugs that help with dementia related behavioral and emotional problems (such as insomnia, depression, anxiety, or hallucinations, etc.).
Memory and cognitive training：Non-drug therapy is conducted through reality orientation, concentration training, reminiscence therapy, multi-sensory therapy, music therapy, artistic creation and other psycho-behavioral therapy. It strengthens the patient’s living skills, postpones cognitive decline and improves psychological and emotional problems, to enhance the quality of life of patients with a multidimensional approach.
Nutrition counselling：The cultivation of healthy eating habits, can not only help regulate high blood pressure, cholesterol and diabetes, but also promote brain health to help slow down the development of the disease.
Physiotherapy：Training such as aerobic exercises, muscle strengthening exercises, balance training and hand-eye coordination drills can help strengthen the movement and coordination of the patient’s limbs and slow down degeneration. It can also reduce the chance of falls and injuries.
