Dementia is a term that describes a group of symptoms affecting memory, thinking, and social abilities. It is not a normal part of aging, but a result of various diseases and injuries that damage the brain. Dementia can have a profound impact on the quality of life of the person living with it, as well as their family, caregivers, and society.
In this post, we will explore some of the causes, symptoms, outcomes, and prevention strategies of dementia, with a focus on the situation in Malaysia. We hope that by raising awareness about this topic, we can help reduce the incidence and burden of dementia in our community.
What causes dementia?
Dementia can be caused by different types of brain diseases or injuries. The most common cause of dementia is Alzheimer’s disease, which accounts for 60-70% of cases1. Alzheimer’s disease is characterized by the accumulation of abnormal protein deposits called amyloid plaques and neurofibrillary tangles in the brain, which impair the function and communication of nerve cells.
Other causes of dementia include:
- Vascular dementia: This occurs when blood vessels in the brain are damaged by stroke, high blood pressure, diabetes, or other conditions, leading to reduced blood flow and oxygen to the brain cells.
- Lewy body dementia: This is caused by the presence of abnormal protein clumps called Lewy bodies in the brain, which affect movement, cognition, and behavior.
- Frontotemporal dementia: This is caused by the degeneration of nerve cells in the frontal and temporal lobes of the brain, which control personality, language, and judgment.
- Mixed dementia: This refers to having more than one type of dementia at the same time, such as Alzheimer’s disease and vascular dementia.
- Other rare causes: These include infections, autoimmune diseases, genetic disorders, head injuries, tumors, or toxins that affect the brain.
What are the symptoms of dementia?
The symptoms of dementia vary depending on the cause, severity, and stage of the condition. However, some common symptoms include:
- Memory loss: This is often one of the first signs of dementia. It may affect recent events, names, places, or appointments. It may also cause repetition or misplacing of things.
- Communication difficulties: This may involve problems with finding words, following conversations, or understanding instructions.
- Cognitive impairment: This may affect reasoning, problem-solving, judgment, orientation, or visual perception. It may cause confusion, disorientation, or hallucinations.
- Behavioral changes: This may affect mood, personality, emotions, or motivation. It may cause depression, anxiety, agitation, apathy, or impulsivity.
- Functional decline: This may affect the ability to perform daily activities such as dressing, eating, bathing, or driving. It may also cause poor coordination, balance, or mobility.
What are the outcomes of dementia?
Dementia is a progressive condition that worsens over time. There is no cure for most types of dementia, but some treatments can help manage the symptoms and improve the quality of life. The outcomes of dementia depend on many factors, such as the type and stage of dementia, the age and health of the person, the availability and effectiveness of medical care and support services, and the impact on family and caregivers.
Some possible outcomes of dementia are:
- Disability: Dementia can impair physical, cognitive, emotional, and social functioning, leading to increased dependency and reduced autonomy. People with dementia may need assistance with daily activities, personal care, and decision-making. They may also face barriers in accessing health care, education, employment, or social services.
- Caregiver burden: Dementia can place a heavy burden on family members and caregivers who provide emotional, physical, financial, and social support for people with dementia. Caregivers may experience stress, anxiety, depression, isolation, or burnout. They may also have to cope with changes in roles, relationships, and identity.
- Societal cost: Dementia can have a significant economic impact on society due to direct costs (such as health care and social care) and indirect costs (such as lost productivity and income). In 2019, dementia cost economies globally 1.3 trillion US dollars1. In Malaysia, the estimated annual cost per person with dementia was 8 000 US dollars2.
How common is dementia in Malaysia?
Dementia is a major public health challenge in Malaysia. According to a systematic review by Arulsamy and Shaikh2, dementia accounts for nearly 80% of traumas in Malaysia, with 64% of these cases related to road traffic accidents. The majority of dementia cases are male, less than 40 years old, and from rural areas.
The prevalence of dementia in Malaysia is estimated to be 8.5% among older adults (aged 60 and above)3. This translates to about 260 000 people living with dementia in 20204. This number is projected to increase to 637 500 to 825 000 by 20505, an increase of 312%5. This is due to the aging population, lifestyle and environmental risk factors, and lack of awareness and diagnosis of dementia.
How can dementia be prevented?
The best way to prevent dementia is to reduce the risk factors that can damage the brain. Some prevention strategies are:
- Maintaining a healthy lifestyle: This includes eating a balanced diet, exercising regularly, maintaining a healthy weight, quitting smoking, limiting alcohol intake, and managing chronic conditions such as hypertension, diabetes, or obesity.
- Stimulating the brain: This involves engaging in mentally challenging activities such as reading, learning new skills, playing games, or solving puzzles. It also involves staying socially connected with family, friends, and community.
- Protecting the head: This means wearing a helmet when riding a motorcycle, bicycle, or other vehicles; wearing a seat belt when driving or riding in a car; following traffic rules and regulations; avoiding driving under the influence of alcohol or drugs; and avoiding distractions such as texting or talking on the phone while driving.
- Seeking help: This means seeking professional help for mental health problems such as depression or suicidal thoughts; seeking help for domestic violence or abuse; and seeking help for any signs or symptoms of dementia.
What can I do if I or someone I know has dementia?
If you suspect that you or someone you know has dementia, you should seek medical attention as soon as possible. Early diagnosis and treatment can improve the chances of recovery and reduce the risk of complications. You should also follow the advice of your health care provider and participate in treatment and support programs if recommended. Treatment can help you manage your symptoms and improve your quality of life.
You should also seek support from your family, friends, and community. Living with dementia can be challenging and stressful for both the person and their caregivers. You may experience changes in your roles, relationships, and identity. You may face barriers in accessing health care, education, employment, or social services. You may encounter stigma or discrimination from others. You may feel isolated or hopeless.
Conclusion
Dementia is a serious condition that can affect anyone, regardless of age, gender, or background. It can have devastating effects on individuals and their families, as well as society at large. However, it is not a hopeless situation. With proper medical care, treatment, and support, many people with dementia can live with dignity and respect. By raising awareness about dementia, we can also prevent or reduce its occurrence and burden in our community.
Referrences:
- https://adfm.org.my/dementia-cases-set-to-rise-312-per-cent-by-2050-is-malaysia-prepared/
- https://por.moh.gov.my/moh/resources/Main%20Banner/2021/Jun/Draft_CPG_Management_of_Dementia_%28Third_Edition%29.pdf
- https://www.who.int/westernpacific/news-room/feature-stories/item/supporting-people-living-with-dementia-in-malaysia
- https://www.frontiersin.org/articles/10.3389/fpubh.2021.637484/full
- https://www.aia.com.my/en/what-matters/health-wellness/dementia-alzheimer-and-parkinson-disease.html
- https://www.msn.com/en-us/health/condition/Dementia/hp-Dementia?source=conditioncdx
- https://www.who.int/news-room/fact-sheets/detail/dementia
- https://www.mayoclinic.org/diseases-conditions/dementia/symptoms-causes/syc-20352013
- https://www.dementia.org/causes
- https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/symptoms-causes/syc-20350447
- http://www.moh.gov.my/
- http://www.acadmed.org.my/
- https://www.psychiatry-malaysia.org/