What Do You Know about Alzheimer’s Disease? Find Out from a Geriatrician!

WORDS LIM TECK CHOON

FEATURED EXPERT
DR TEH HOON LANG
Consultant Geriatrician
Sunway Medical Centre

21 September is World Alzheimer’s Day. We’re pleased and really appreciative of the fact that, in conjunction with this day, Dr Teh Hoon Lang has graciously shared her insight on Alzheimer’s disease with us.

IS DEMENTIA THE SAME THING AS ALZHEIMER’S DISEASE?

Dr Teh explains that:

  • Dementia is a complex brain function impairment set that interferes with daily life.
  • Alzheimer’s disease is a common type of dementia.
  • It is a progressive brain disorder characterized by the buildup of abnormal proteins in the brain.
  • This buildup will lead to a gradual decline of memory, thinking, and reasoning skills.
  • This condition will get worse over time.
An overview of Alzheimer’s disease. Click on the image to view a larger, clearer version.
  • According to some studies, over 8.5% of Malaysians aged 60 and above have dementia, with a higher prevalence among women.
  • However, note that Alzheimer’s disease and other forms of dementia can also occur to people at a younger age. They should not be considered as merely ‘old people’s disease’.
WE SHOULD BE VIGILANT & KEEP AN EYE OUT FOR EARLY SIGNS

According to Dr Teh, symptoms of dementia can be mild and hence overlooked.

“Many people may assume these symptoms as part of the normal ageing process,” she adds.

COMMON EARLY SIGNS OF DEMENTIA (OF WHICH ALZHEIMER’S DISEASE IS ONE TYPE)
  • Recent memory loss, such as being unable to recall recent events or appointments.
  • Difficulties in planning and carrying out tasks or solving problems such as following a recipe, managing their finances, or managing their own medicines.
  • Difficulty in completing familiar tasks such as cooking, driving or using appliances.
  • Confusion about time and/or place—they may lose track of the date, time, or where they are. They may also get lost in familiar places.
  • Trouble understanding visual images and spatial relationships. This can manifest as difficulties in understanding maps, following directions, judging distances, determining the size of objects, etc.
  • Problems with languages, such as difficulty finding the right words or using the wrong words during a conversation.
  • Frequently misplacing things and losing the ability to retrace steps.
  • Decreased or poor judgement. They may make poor decisions, such as giving away large sums of money or insisting on driving when they are no longer fit to drive.
  • Withdrawal from work or social activities that they used to enjoy. They may also become isolated and avoid interacting with others.
  • Changes in mood or personality such as becoming depressed, anxious, or irritable. They may also experience personality changes, such as becoming more passive or withdrawn.
CERTAIN FACTORS CAN INCREASE ONE’S RISK OF DEVELOPING ALZHEIMER’S DISEASE & OTHER FORMS OF DEMENTIA

Dr Teh shares that common risk factors include:

  • Sedentary living—not getting regular physical activity.
  • Smoking and/or excessive alcohol consumption.
  • History of head injuries.
  • Infrequent social contact and isolation. This can lead to depression, a risk factor. Thus, we, especially the elderly, are encouraged to stay socially active no matter our age.
  • Less or low levels of education in early life, as this can affect cognitive reserve—the ability of the brain to maintain our cognitive function and withstand deterioration and damage.
  • Obesity, especially during one’s mid-life.
  • High blood pressure or hypertension.
  • Diabetes, primarily type 2 diabetes.
  • Hearing impairment or individuals with hearing loss. Hearing aids may help reduce this risk.
WHY EARLY DETECTION IS CRUCIAL

Any damage to the brain is irreversible; there is no way to treat or undo the damage.

“It is important to see a doctor for an assessment as soon as possible, as early diagnosis and treatment can help to prevent or delay irreversible brain damage,” Dr Teh states.

HOW ABOUT SCREENING FOR ALZHEIMER’S DISEASE?

“According to guidelines, routine cognitive screening isn’t recommended for everyone, it’s only recommended to screen people at risk,” Dr Teh shares.

She adds, “However cognitive screening is not 100% accurate, hence, it’s crucial to educate the public about the early warning signs of dementia.”

Furthermore, some conditions may resemble dementia, such as vitamin B12 deficiency and hypothyroidism, and these can be reversed by early treatment.

INNOVATIONS OF THE PHARMACEUTICAL INDUSTRY IN DEVELOPING A TREATMENT FOR ALZHEIMER’S DISEASE

In other news, the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) has released a video highlighting the challenges and advances made by the pharmaceutical industry in finding means to slow the progression of Alzheimer’s disease. Have a look!

For more information, visit the IFMPA (link opens in a new tab).

Some Facts to Help You Understand Better What Dementia Is

WORDS LIM TECK CHOON

FEATURED EXPERT
DR TEH HOON LANG
Consultant Geriatrician
Sunway Medical Centre

The World Health Organization reveals that about 10,000,000—that’s ten million—new cases of dementia are diagnosed every year.

In Malaysia, the Alzheimer’s Disease Foundation shares that 204,000 to 264,000 adults were diagnosed with dementia in 2020, and they expect the numbers to rise to between 637,500 and 825,000 by 2050.

DEMENTIA IS ACTUALLY A GENERAL TERM THAT COVERS CONDITIONS IN WHICH ONE EXPERIENCES SIGNIFICANT DECLINE IN COGNITIVE FUNCTION

Consultant geriatrician Dr Teh Hoon Lang explains that the decline should be significant enough to affect one’s thinking, memory, and social skills until it impedes their ability to carry out their usual day-to-day routines.

DEMENTIA IS A TERM THAT INCLUDE A NUMBER OF CONDITIONS INCLUDING
  • Alzheimer’s disease, the most common one
  • Frontotemporal dementia, a rare form that usually develops in people younger than 60
  • Lewy body dementia
  • Vascular dementia, caused by blood vessel damage that interrupts blood and oxygen flow to the brain
  • Mixed dementia, a combination of two or more types of dementia
THERE ARE MANY FACTORS THAT CAN INCREASE ONE’S RISK OF DEMENTIA

“These factors can be divided into modifiable and non-modifiable risk factors,” Dr Teh says.

Non-modifiable risk factors—things that we can’t change—include:

  • Advancing age
  • Being female
  • Certain types of dementia can be passed down from parent to child; however Dr Teh assures us that having a gene for one of these types of dementia is not a surefire guarantee that the person will develop that type of dementia

Meanwhile, modifiable risk factors include:

  • Diabetes mellitus
  • High blood pressure or hypertension
  • Obesity
  • Excessive alcohol consumption
  • Smoking
  • Depression
  • Traumatic brain injury
  • Sedentary lifestyle
  • Social isolation
  • Mid-life hearing impairment
  • Air pollution

“The more risk factors a person has, the higher their chances of getting dementia,” Dr Teh says.

TEN EARLY WARNINGS OF DEMENTIA TO WATCH OUT FOR
  • Memory loss
  • Difficulty performing familiar tasks
  • Problems with language
  • Disorientation to time and place
  • Poor or decreased judgement
  • Problems keeping track of things
  • Misplacing things
  • Changes in mood and behaviour
  • Challenges understanding visual and spatial information
  • Withdrawal from work or social activities
WHERE TO SEEK HELP IF YOU BELIEVE THAT YOUR LOVED ONE MAY HAVE DEMENTIA

It is fine to consult a general practitioner or GP, who can refer your loved one to a specialist if necessary.

A geriatrician is a specialist that can help with dementia in older persons, and other types of specialists such as neuropsychologists and psychiatrists may also step in to help.

DEMENTIA CAN’T BE CURED, BUT IT CAN BE SLOWED DOWN

Dr Teh shares that there is no cure for dementia at the moment.

However, she assures us that there are many measures or strategies to slow down the progress of the disease and provide both the affected person and their caregivers a better quality of life.

“The most important part of dementia care is to get diagnosed early and get professional advice on the management plan,” says Dr Teh. “Every person with dementia is unique and the approach should be individualized. The basic principles of care include understanding the disease pattern and the struggles or difficulty they are facing, providing a supportive environment, maximizing their strength and minimizing their loss due to cognitive decline.”