The early signs of dementia

Woman looking into distance whilst thinking

According to the 2013 Well-being of the Singapore Elderly (WiSE) study, 1 in 10 persons in Singapore aged 60 years and above has dementia, which according to the WHO definition, is a “syndrome in which there is deterioration in memory, thinking, behaviour and the ability to perform everyday activities”.

To suggest that someone with dementia “may” have memory loss, is misleading. Dementia is a condition in which people with dementia encounter problems with memory. But it is of course worth noting that the “symptoms of dementia are not limited to forgetfulness and memory loss“, as the author of this 2015 Institute of Policy Studies (IPS) Commons article points out. The ability to plan and make decisions, as well as solve problems, are other cognitive difficulties faced by someone with dementia.

Recent research efforts offer relatively quicker ways for clinicians to diagnose dementia and identify individuals at risk for dementia. According to a recent study published in 2015, researchers have developed a brief questionnaire, known as the QDRS comprising 10 items, which can accurately identify if someone has very mild, mild, moderate, or severe dementia. And a 2014 study has found a time-efficient method for identifying those at risk for dementia — through their ability to track a moving target with a computer mouse which moves in the opposite direction to what they see on the screen. Those diagnosed with Mild Cognitive Impairment (MCI) (and who are at risk for dementia) made many more errors than the control group. A more recent study also points to the tendency for those with amyloid plaques associated with dementia to have walk at a slower pace compared to healthy peers.

But you’re concerned that you may be developing dementia. Or you’re concerned about someone you know being at risk for dementia…

So here are 3 questions to answer:

1. Have you noticed any of these early warning signs?

The local Health Promotion Board has a print-friendly fact sheet, while the local Alzheimer’s Disease Association offers a checklist and describes the stages of dementia. No? Move on to Question 2!

2. Are you aware that you have difficulties remembering things?

recent study which tracked over 2,000 individuals for 10 years reported that awareness of memory problems is a good clue as to whether they have dementia or not. In this study, those who were eventually diagnosed with dementia stopped being aware of their memory problems about 2.5 years before showing signs of dementia. So being aware that you have memory problems is actually a good thing. But read on…

3. How often do you have problems remembering things?

The US Alzheimer’s Association distinguishes behaviours which are characteristic of dementia from behaviours associated with healthy ageing in their list of early warning signs. Forgetting the names of things and/or the names of people is something that happens to most of us. Some of us experience the tip-of-the-tongue phenomenon quite often in fact. We can also be prone to forgetting appointments. But we’re usually able to retrieve these words and/or names later on, and we typically realise that we missed an appointment at a later time.

But a 2014 study also found that those who reported a change (more difficulties) in their ability to remember things were much more likely to subsequently develop dementia. So if you’re concerned that you might have cognitive issues, you can take an online assessment — Self-Administered Gerocognitive Exam or the SAGE test. But it’s also important that you consult with a medical professional if memory and thinking problems are a concern for you. 

Did you know?

IMG_2873

A recent study found that there are more younger people with Type 2 diabetes mellitus in Singapore than other countries in Asia. According to the same study, as many as 3 in 10 people have diabetes before the age of 40 years.

Even though diabetes is a condition that’s been known to us since the days when the Egyptians wrote about a “thirsty disease” on papyrus, it’s not always a well-understood condition. What do you know about diabetes? Try this quiz!

True or False?

1. If you have Type 2 diabetes, your body is unable to produce insulin.

2. Type 2 diabetes is more common than Type 1 diabetes.

3. Exercise helps insulin work better for those who have Type 2 diabetes.

4. The risk of developing heart disease for people with diabetes is the same as for those who don’t have diabetes.

5. About 1 in 10 people with diabetes will eventually develop kidney disease.

6. Blurred vision can be a sign of diabetes.

7. The only way for people with diabetes to control blood sugar levels is to take oral medications and/or have insulin injections.

8. Healing from cuts and sores can take longer for those with diabetes.

Find out the answers tomorrow for a healthy World Diabetes Day!

Source: https://www.singhealth.com.sg/…/…/Diabetes-Mellitus.aspx

Signs of cognitive decline that we should worry about

Aging successfully

It was recently reported that tip-of-the-tongue phenomena isn’t something that we need to worry excessively about.

It appears that older people have the experience of not being able to identify someone famous or find the name of something more frequently than younger people (“Tip-of-the-Tongue Moments May be Benign“, American Psychological Science, 16 Oct 2013). But it has been found to be unrelated to cognitive changes associated with onset of dementia, suggesting that we shouldn’t be too concerned when we can’t name an actor in the midst of our frenetic discussion of the current k-drama series during family reunion dinners.

In contrast, there are other signs which we should be paying attention to. The Agency for Healthcare Research and Quality (US) for example lists a number of symptoms which might indicate dementia, which include experiencing increased difficulty remembering recent conversations and appointments, performing complex tasks which involve a number of steps, orienting and finding one’s way to familiar places. The Alzheimer’s Association (US) lists 10 symptoms which distinguishes the signs that someone may have Alzheimer’s from that of typical age-related cognitive changes. Given that dementia is a progressive condition, where there is “deterioration in memory, thinking, behaviour and the ability to perform everyday activities” (WHO), these early stage signs serve as a useful guide. The tendency to confuse time and place, resulting in one going to an appointment at the wrong time or at the wrong place, is another such sign – mentioned here by the Health Promotion Board.

There is also much talk about a scan which may determine if one’s cognitive difficulties are caused by Alzheimer’s disease (“Alzheimer’s Anxiety“, NY Times, 16 Nov 2013). But perhaps more pressing for most of us is the issue of whether we’re experiencing cognitive difficulties which warrant a closer look. And the answer to that might just be in a 12-question pen-and-paper questionnaire (known as the SAGE) which has been found useful for discerning cognitive decline, and for which validity research findings were recently published in the Journal of Neuropsychiatry and Clinical Neurosciences and reported in this article in Forbes (14 Jan 2014).