As the number of aging adults increase in Singapore, so does the number of people who are at risk of dementia. We all know aging is the stage of our life where we encounter health issues. Memory loss and dementia are among the most prominent ones that affect seniors. Sometimes it's inevitable but not considered normal. Having dementia puts every senior's health and safety at risk so it's extremely important to provide the best kind of care to handle it.
But before anything else, we must first know and understand dementia, particularly its early signs and the 7 stages. This way, we and our aging loved ones can become prepared.
What is dementia?
Dementia is a degenerative and progressive disease that affects a person's cognitive abilities. This is typically caused by damaged protein structures in the brain, unusual protein growth around the brain cells, or disrupted connection between brain cells. It is something that develops over time and is more common among older adults but for some, it can start as early as 40 years old. This is referred to as early-onset dementia.
Is dementia different from Alzheimer's disease?
Dementia and Alzheimer's disease are often used interchangeably, but they're not exactly the same thing. Dementia is more of an umbrella term used to define all kinds of diseases that affect memory, thinking, perception, problem-solving, and language. Alzheimer's, on the other hand, is a type of dementia that involves memory loss and a continuous decline in thinking.
Dementia in Singapore
According to records, 5.2 percent of Singaporeans aged 60 years and up are affected by dementia. Singapore's Ministry of Health and Health Promotion Board projected that by this year, 53,000 Singaporeans would develop dementia and they're expected to increase up to 187,000 by the year 2050. It's indeed an alarming concern but the Singaporean government ensures that various programs are in place for the elderly with dementia. Dementia may never be cured completely but there are lots of treatment that can be done to reduce its progression, with personal and nursing care being one of the steps taken.
What are dementia symptoms?
Signs of dementia you should look out for
Dementia can affect each person differently. It depends on what part of the brain is damaged and the personality of the patient should also be taken into consideration. When it comes to dementia, memory loss is one of the most common symptoms. However, there are other symptoms of dementia that we need to remember:
Don't we just love to tease our parents or other aging adults whenever they forget something small? We often tell them, "it's because you're getting old". That is not necessarily untrue for memory loss is common among aging adults. It's different from everyday forgetfulness because dementia is something more severe and can affect their day-to-day activities. This may include forgetting the names of people they've known for years or not being able to recall if they already ate that day.
Disorientation with time and environment
Sometimes, we encounter losing track of time or even forgetting what day of the week it is. But when it comes to people with dementia, they get easily confused or disoriented with time and place. This is why some seniors get lost because they couldn't remember where they are or how they can return home. This is a very concerning problem since it poses a threat to their safety.
Difficulty performing familiar or basic tasks
Dementia cases can cause a person to struggle with even the most basic tasks. Things like eating, taking medications, or even simply putting a shirt on properly can become challenging for people with dementia.
Problems with speech or communication
A person with dementia usually struggles with finding the right words to say. They might forget simple words or replace what they want to say with an unusual word or phrase just to get their point across.
Personality changes or mood swings
Symptoms of dementia include rapid mood swings or changes in one's personality. People with dementia may find difficulty in controlling emotions. They might suddenly become too emotional or unusually emotionless. There are also changes in their personality like if they used to be so patient, they can become someone who's easily irritable.
Poor judgment skills
People who experience a decline in their cognitive and thinking skills experience lapses in judgment and decision-making. They lose the ability to make rational decisions and often make choices that sometimes have no sense.
In line with short-term memory loss or just memory problems in general often experience misplacing their things. They couldn't remember where was the last place they left an object. They may have difficulty retracing their steps.
Losing interest in work or social activities
One of the signs of dementia is withdrawal from work or social activities. They often stay away from activities that involve social interaction and instead indulge in passive ones like watching television or sleeping for a long time. They also stop doing the things they used to love to do in their daily life.
Difficulty in planning and problem-solving
One of the dementia symptoms is the lack of ability to plan and solve problems. People living with dementia find it difficult to make plans and stick to them.
How to diagnose dementia?
You can't rely on one single test when it comes to the diagnosis of dementia. There are a lot of medical assessments made available to determine whether or not you or your loved one has this condition. Furthermore, dementia is also not diagnosed as a singular disease but is typically classified into various types depending on the cause. The diagnosis of the stages of dementia is also determined depending on the severity.
Cognitive and Neuropsychological tests
These tests serve the purpose of assessing a person's memory, thinking skills, language skills, reasoning skills, judgment skills, as well as orientation. This will find out how your brain health affects your behavior and thinking, and analyzing the overall relationship between brain and behavior.
If you or a family member is experiencing symptoms of dementia or have complaints about your memory or cognitive abilities, then taking this test would be necessary.
Possible causes of dementia are tumors and strokes in the brain. Fortunately, brain scans can help detect them. Most common scans include the following:
- Positron Emission Tomography (PET) scans - imaging tests that use radiation to produce images showing your brain activity
- Computed Tomography (CT) scans - uses computers and x-ray machines to produce cross-sectional images of your brain and other parts of the body
- Magnetic Resonance Imaging (MRI) scans - a painless test that uses strong radio waves and magnetic fields to create detailed images of your brain and other body parts
It's uncommon but still possible for dementia to be passed on through genetic means. Genetic tests are meant to identify if people are at risk of dementia. So, if you have a family member that's been diagnosed with dementia, it would be best for you to take a genetic test.
Lab tests may be necessary when it comes to a physical examination. This is to look for any signs of medical problems that can cause dementia. Tests include blood tests, thyroid hormone tests, and lumbar punctures which will enable doctors to assess the levels of various chemicals, vitamins, and hormones in the body. By taking these tests, they can rule out other causes of dementia-like symptoms.
Other laboratory tests may include:
- Chemistry screens to check kidney's functions and electrolyte levels in the blood
- Glucose test to check blood sugar level
- Toxicology screen to examine urine, blood, and hair for drugs
- Lead tests to identify heavy metals in the blood
- HIV testing for AIDS
This method of diagnosis involves evaluating the mental health conditions like depression, anxiety, bipolar disorder, schizophrenia, amongst others. It's useful for persons with dementia because it can also help diagnose any problems affiliated with memory, behavior, and thought processes.
What are the types of dementia?
When it comes to dementia, the most famous classification would be Alzheimer's disease. In fact, these two terms are often used interchangeably. But the thing is, there are plenty of other dementia types that other people aren't aware of. Would you believe there are 400 of them all in all?
But in the meantime, here are the 10 most common types of dementia below:
1. Alzheimer's disease
Alzheimer's disease is the most common form of dementia. It is characterized by brain cell death and makes up 60% to 80% of all dementia cases. Older adults are more prone to this particular disease. Early signs of Alzheimer's include depression, confusion, mood changes, short-term memory loss, and trouble with walking and speaking.
2. Parkinson's disease
Parkinson's disease may lead to dementia at its advanced stages. Early symptoms of this include difficulty with reasoning and judgment. This can eventually lead to confusion, hallucinations, speech difficulties, and paranoia as the condition worsens.
3. Frontotemporal dementia
Also known as Pick's disease, this is actually a term used to define several types of dementia that affects the front and side of the brain. These are the parts that control our language and behavior. It can affect people as early as 45 years old. The symptoms include loss of motivation, developing compulsive behavior, and forgetting the meaning of common or basic words.
4. Vascular dementia
This is considered to be the second most common type of dementia. It compromises 20% of all dementia cases and is due to the lack of blood flow that goes to the brain. Older adults are more susceptible to this condition and may be connected to stroke. The symptoms may appear out of the blue or progressively, depending on what caused it.
Confusion and disorientation are the symptoms during the early stages. In later stages, patients may experience trouble concentrating and completing tasks.
5. Lewy Body dementia
Lewy bodies pertain to the small, round clumps of protein that form up inside the brain cells. This may cause interference with neural signals and communication. This particular type of dementia causes memory loss, visual hallucination, disorientation, and difficulty sleeping at night.
6. Creutzfeldt-Jakob disease
This is the least common form of dementia, with only 1 in 1 million people being diagnosed with this condition. Although it's rare, it progresses at a rapid pace and people with this condition often die within a year of its diagnosis. Its symptoms involve memory loss, confusion, depression, and agitation. Muscle-twitching and stiffness are also other signs of this disease.
7. Wernicke-Korsakoff syndrome
Although Wernicke's disease and Korsakoff syndrome are two separate but linked conditions, they are often grouped together. This is typically not a type of dementia but it shares similar symptoms.
The Wernicke disease is caused by a vitamin B-1 deficiency, which leads to bleeding in the brain's lower sections. This vitamin deficiency stems from malnutrition or chronic infections but it's commonly caused by alcoholism. If left untreated, it can lead to physical symptoms such as loss of muscle coordination and having double vision. This happens as symptoms of Korsakoff syndrome appear which includes difficulty in information-processing, remembering things, and learning new skills.
8. Huntington's disease
This is a genetic type of dementia that is more common among younger adults. This condition may cause dementia and impaired movement because of the premature breakdown of the brain's nerve cells.
Huntington's disease has two types: one is juvenile while the other is adult-onset. Symptoms of juvenile often appear during the childhood or adolescence of the patient whilst the adult-onset symptoms occur at ages '30s to '40s.
Physical symptoms include difficulty in walking, jerking, and trouble swallowing. Meanwhile, dementia-related symptoms include problems with impulse control, difficulty focusing on tasks, and trouble with speaking.
9. Normal Pressure Hydrocephalus (NPH)
This is a condition that leads to dementia symptoms because of the build-up of fluids in the brain's ventricles. Probable causes of this condition are injuries, bleeding, brain tumor, infection, and previous brain surgeries.
People with this disease may experience forgetfulness, poor balance, depression, mood swings, frequent falls, or loss of bladder control.
10. Mixed dementia
Mixed dementia is when a person has more than one type of dementia. This is relatively common but some people who have it are unaware of it. The most common is the combination of vascular dementia and Alzheimer's disease. Symptoms may vary depending on the combination, but the most common ones are difficulty in speaking and walking.
The 7 stages of dementia
When it comes to measuring the progression of dementia, various scales and methods are being used. However, the most prominent scale is that of the Global Deterioration Scale for Assessment of Primary Degenerative Dementia (GDS), also referred to as the Reisberg Scale.
This scale states that there are 7 stages of dementia that are further categorized into 4 levels namely: no dementia, early-stage dementia, mid-stage dementia, and late-stage dementia.
No dementia level
Stage 1: No cognitive decline
Stage 1 is when there are no signs of dementia based on the doctor's clinical interview and assessment. Subjects are mentally healthy and are able to function in a normal manner. No symptoms are present to indicate any behavioral problems, memory loss, or other factors that are related to dementia.
Stage 2: Very mild cognitive decline
This stage is when the individuals are experiencing mild forgetfulness. This is considered a normal sign of aging among seniors. Most common symptoms include misplacing things or forgetting names.
Stage 3: Mild cognitive decline
This is the last stage of this category. Compared to stage 2, the symptoms are more severe and include a wider range of signs such as mild difficulty in concentration, poor work performance, verbal repetition, and having trouble with speech or getting easily confused in directions. Average duration of this stage runs from two to seven years.
Early-stage dementia level
Stage 4: Moderate cognitive decline
This category of dementia only contains one stage which is moderate cognitive decline. Signs of stage 4 dementia can be determined through various medical examinations. The average duration of this stage is 4 years. People who are at this stage of dementia may experience or develop the following symptoms:
- Misplacing things more often
- Increased difficulty in concentrating on tasks
- Losing track of day and time
- Forgetting names of people
- Forgetting recent events
- Withdrawal from social interaction or activities
- Inability to manage finances
- Inability to travel alone
Mid-stage dementia level
Stage 5: Moderately severe cognitive decline
This stage of dementia is particularly crucial because this means that the individuals can no longer perform activities of daily living (ADLs) by themselves. They now require some level of assistance to tend to their basic needs such as feeding, dressing, bathing, and others. Here, the symptoms are easier to identify and there is greater memory deficiency.
Stage 6: Severe cognitive decline
At this point, individuals deeply struggle with communication and they can no longer perform ADLs without any form of help or assistance. The symptoms at this stage is worse compared to the previous stage and it includes:
- Forgetting both past and recent events
- Forgetting names of family members
- Increased unawareness of surroundings
- Heightened sleeping problems and disturbances
- Struggling to count down from ten
- Increased irritability and aggression
- Loss of bladder control
- Emotional and personality changes
Stage 7: Very severe cognitive decline (late dementia)
This is the very last and most crucial of all stages. This is where all the verbal abilities have been lost. Other symptoms of this stage involve:
- Inability to walk
- Difficulty in eating and swallowing
- Significant weight gain or weight loss
- Loss of urinary control
- Loss of motor skills
- Loss of speech
- Having restlessness and outbursts
How to care for the elderly with dementia
Caring for seniors who have dementia is a challenging task to do but it will significantly help them experience a better quality of life. Here are ways you can care for your family members or loved ones who have memory impairment:
Seek counseling and support
This health condition can cause a lot of stress and emotional toll on the patient and caregiver. It's important to get the necessary support to provide you with strength and guidance during this journey. For instance, you can join support groups or arrange visits with a counselor.
You also need to seek professional help to deal with the more complicated aspects of dementia. Keep in touch with a primary doctor and even memory care homes who are experts on the matter.
Developing a routine
Persons with dementia usually have anxiety and restlessness so planning a routine may help them feel at ease. Help your loved ones establish a healthy routine to let them have something to look forward to every day. This can also keep their mind and body active.
Plan ahead of time
As this condition progresses, so do the needs of your loved one. It's extremely essential to become prepared so you can deal with the challenges better. Knowing what to anticipate lessens the stress factors.
Adjust your way of communicating
It's highly possible that somewhere along the way, the sick person might struggle with speaking or finding the right words to say as they communicate. When it happens, avoid getting frustrated or impatient. Practice speaking slowly and gently so as not to frighten or stress out the patient even more. Being affectionate will help make them feel comfortable and reduce their confusion.
When it comes to dementia, you need to learn and understand everything for you to provide the best kind of care for your loved ones. It's not a normal condition that's easy to face, so having the right knowledge, going through the right methods, and seeking support from the right people will significantly reduce the difficulties brought about by it.
If you need help in providing the right care, support, and assistance for your loved ones even at the early stages of their memory problems, you can turn to a nursing home alternative like Red Crowns Senior Living. Here, your loved one can receive all the medical treatment and personal nursing care that they need as they go through this health condition.