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| What is dementia?
The term dementia refers to the abnormal degeneration of brain functions. If not treated, it will lead to the gradual loss of cognitive functions, such as learning and understanding ability, use of language, sense of direction and the ability to make judgements, which would seriously affect an individual's future daily life.
Broadly speaking, "Alzheimer's Disease" and "Vascular Dementia" are two most common forms of dementia.
Alzheimer's Disease is the most common type of dementia, accounting for about 65% of cases, but its cause is still unknown and there is as yet no cure for the disease.
Vascular Dementia accounts for approximately 30% of all cases of dementia, and results in brain impairment through suffering a stroke or vascular disease. Other causes of dementia include depression, malnutrition, thyroid gland disorder, lack of vitamin B12 and brain trauma. Parkinson's disease and AIDS may also result in dementia.
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 How common is dementia?
Although dementia is not as common as, for instance, cancer and heart disease, 5-15% of persons aged 65 or over suffer from the illness, and the incidence rate increases with the progression of age. The incidence rate among women is higher than among men.
At present, one new case is confirmed every seven seconds, and it is expected that by 2040, the number of dementia sufferers world-wide may reach 80 million. The situation in Hong Kong is not optimistic either. There were 70,000 confirmed cases last year and that figure does not include sufferers in the community whose condition had not been identified. With the progressive ageing of Hong Kong's population, dementia is set to exert enormous pressure on the medical and healthcare system and on society as a whole. |
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Early diagnosis and Treatment
Although there is no cure for dementia, research has demonstrated that people with early dementia may delay the progression of symptoms in the moderate and severe stages if provided early enough with medication and appropriate training in exercising brain functions.
Many sufferers of dementia misinterpret early symptoms as part of the normal ageing process, and thus miss the optimum time for intervention. Early intervention both enables the individuals with dementia to receive treatment and training, and eases the difficulties and pressure experienced by family and/or other care-givers. Early intervention also enables patients to seek timely assistance from community services, and to learn how to adapt to their condition. Emotional conflict between dementia sufferers and those in daily contact with them can be minimised by greater mutual understanding of the illness and its effects.
Brain Tour |
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Mild cognitive impairment
Forgetfulness often accompanies the normal ageing process, and this may be no more than mild cognitive impairment. However, research has shown that every year the condition of 12%-15% of persons over the age of 65 who suffer from mild cognitive impairment degenerates to dementia. Early treatment may help prevent this degeneration process, and exercising the brain can play an important role in prevention. |
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How to distinguish between the early symptoms of dementia and normal ageing
Below are some examples of behaviour, which, although not definitive, may suggest the difference between a person suffering from dementia and one experiencing some degree of forgetfulness and symptoms of the normal ageing process.
| Persons possibly suffering from dementia |
Persons experiencing normal symptoms
of
the ageing process |
| Unable to remember things which happened very recently (for example, whether or not they ate breakfast, what they have just seen on television, or been told by someone) |
May forget some details, but remember the generality of events |
| Unable to cope with normal daily activities (cooking a simple meal, for example) |
Generally capable (but may, for example, forget to add certain ingredients to a meal) |
| Unable to name and describe the function of everyday objects (such as a toothbrush) |
May occasionally forget the appropriate term |
| Have only a vague idea of the present time and date |
May occasionally forget the day or date, but otherwise aware of what is happening |
| Unable to find their way to familiar places (including, perhaps, even their own homes) |
May occasionally forget where they are supposed to be going, but still able to find the place |
| Make irrational decisions as to what clothing to wear (warm clothing in very hot weather, for example) |
No such problem |
| Unable to perform simple arithmetical tasks |
Still capable of performing such tasks, though perhaps not as efficiently as previously |
| Leaving objects in inappropriate locations (such as a wallet in a microwave oven) |
Sometimes forget where they left an object |
| Sudden emotional swings of mood (from calm to highly agitated, for instance) |
Sometimes weary and depressed |
| Lose interest in things previously enjoyed; become paranoid, suspicious of others' good intentions; easily upset or frightened |
Tired of daily work and social activities |
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| How to prevent dementia
There are some simple steps that can be taken to help prevent or lessen the effects of dementia, and maintaining good physical and mental health is very important in this regard. Specifically, one should make the effort to stay mentally, physically and socially active, as well as adopting a "brain-healthy" diet. |
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| Stay mentally active |
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Brain exercises and cognitive stimulating activities such as riddles and sudoku, as well as activities that improve hand-eye co-ordination are very helpful in this respect. Active mind training is important, and this should be a daily, life commitment. Of course, elderly people cannot expect to be as mentally agile as youngsters, but the pursuit of activities like learning new languages, reading and writing will certainly help keep their minds alert. Family members, friends and care-givers should be aware of the importance of these activities, and encourage the elderly to adopt them to improve their quality of life. |
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| Remain socially active |
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Volunteer work can be both interesting and rewarding, and elderly people too can benefit from this type of activity, not only as recipients but as volunteers themselves. Who better to offer help and support to the elderly than those of their own age who are both physically and mentally fit enough to do so? Working to improve the welfare of others is a good way of remaining socially active, mentally alert and physically fit – all of which may help protect against dementia. |
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| Stay physically active |
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Physical exercise is an effective way of maintaining both mental and physical health, and has an important role to play in preventing dementia. Tai chi, for example, benefits both the mind and the body, and is particularly suited to elderly people because it has no violent impact, but there are also many other activities which are similarly beneficial. Regular exercise not only improves blood circulation and stimulates the growth of brain cells, but also significantly reduces the risk of developing conditions which can lead to dementia, such as heart disease, stroke and diabetes. |
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| Adopt a brain-healthy diet |
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An excellent guide to healthy eating is the so-called "4 low, 1 high" rule, which means adopting a diet which is low in fat, salt, sugar and cholesterol, but high in fibre. Moreover, research has shown that regular consumption of fruit and vegetables which contain anti-oxidants may help protect brain cells. |
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Mini-Mental State Examination
The Mini-Mental State Examination (MMSE) is a clinical screening tool commonly used internationally to evaluate a person's mental state. The scope of assessment covers time and place orientation, registration and recall of information, attention and calculation, and language ability. Scholars in Hong Kong have adapted the MMSE to create a Chinese version, the CMMSE, to cater for the needs of the elderly in Hong Kong. The CMMSE will be employed in the "Care for the Elderly – Active Mind" programme, to determine whether there is a need for elderly persons to attend memory training courses. |
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Memory Training Kit
The "Memory Training Kit" is the first set of training materials designed for elderly Chinese persons suffering from early memory impairment. It aims at improving memory, delaying degeneration of cognitive functions and reducing the chances of developing dementia. The training is based on five elements: attention, registration and recall, cognitive ability, oral presentation and problem solving ability. The total training package covers 36 topics, of which 8 have been selected for the "Care for the Elderly – Active Mind" programme, to be taught by professionals.
Those undergoing training will attend two lessons a week. The lessons will focus on understanding memory impairment and dementia, training in attention ability, and special memory methods. Participants can also improve their memory by taking part in active mind games, assignments and exercises during lessons. They will be asked to complete their assignments in "self-study manuals" in order to strengthen their memory and cognitive ability, and to apply skills in their daily lives. Participants will undergo memory (cognitive) assessment both before and after training to measure their progress. Those who would like to further their training after completing the selected 8 topics may contact relevant institutions teaching the whole 36 topics. |
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| Case sharing |
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