What is Dementia?
Dementia is a condition which involves progressive and cognitive deficits.
It usually affects memory first, with subsequent progression to cause dysphasia, agnosia, apraxia, diminished ability with executive function and eventually personality disintegration.
Causes of Dementia
It is caused by damage to or loss of nerve cells and their connections in the brain.
Symptoms of dementia
Early Stage
The following are symptoms of an early stage dementia:
- forgetfulness
- losing track of the time
- becoming lost in familiar places.
Middle Stage
The following are the symptoms of the disease condition in its middle stage :
- becoming forgetful of recent events and people’s names
- becoming confused while at home
- having increasing difficulty with communication
- needing help with personal care
- experiencing behaviour changes, including wandering and repeated questioning
Late Stage
Late stage dementia presents with the following symptoms:
- becoming unaware of the time and place
- having difficulty recognizing relatives and friends
- having an increasing need for assisted self-care
- having difficulty walking
- experiencing behaviour changes that may escalate and include aggression
DSM-5 diagnostic Criteria
To diagnose Dementia, the following criteria need to be met:
- There must be significant cognitive decline from a previous level of performance in one or more of the following cognitive domains attention, executive function, learning and memory, language, perceptual motor and social cognition.
- These deficits affect independence in performing everyday activities.
Treatment for Dementia
Non-pharmacological Treatment
- Psychoeducation about the disorder, to the patient and family
- Mini Mental Status Examination, functional and behavioural assessment should be performed every 6 months.
Pharmacological Treatment
There is currently no treatment available to cure dementia
Treatment of mild to moderate dementia
- S: donepezil (PO) 5mg initially, may increase to 10mg/24hours after 4-6weeks
Treatment of moderate to severe dementia
- S: donepezil (PO) 5mg initially, may increase to 10mg /24hours after 4-6weeks; may further increase to 23 mg/day after 3 months.
In addition to the above drug treatment option, always keep an eye on the patient. Do not allow him or her to leave the house without someone.