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The Lost Behind Dementia

Symptoms and diagnosis

By Neurosurgery Singapore

What is Dementia?

Dementia describes a group of symptoms affecting memory, thinking and social abilities severely enough to interfere with your daily life. It isn’t a specific disease, but several different diseases may cause dementia.

Though dementia generally involves memory loss, memory loss has different causes. Having memory loss alone doesn’t mean you have dementia.

Alzheimer’s disease is the most common cause of a progressive dementia in older adults, but there are a number of causes of dementia. Depending on the cause, some dementia symptoms may be reversible.

What are some symptoms of Dementia?

Dementia symptoms vary depending on the cause, but common signs and symptoms include:

Cognitive changes

  • Memory loss, which is usually noticed by a spouse or someone else
  • Difficulty communicating or finding words
  • Difficulty with visual and spatial abilities, such as getting lost while driving
  • Difficulty reasoning or problem-solving
  • Difficulty handling complex tasks
  • Difficulty with planning and organizing
  • Difficulty with coordination and motor functions
  • Confusion and disorientation

Psychological changes

  • Personality changes
  • Depression
  • Anxiety
  • Inappropriate behavior
  • Paranoia
  • Agitation
  • Hallucinations

“Dementia is a major global health problem; in the absence of a cure there is increasing focus on risk reduction, timely diagnosis, and early intervention.”

What types of diagnosis?

  • The following procedures also may be used to diagnose dementia:

    • Cognitive and neuropsychological tests. These tests are used to assess memory, problem solving, language skills, math skills, and other abilities related to mental functioning.
    • Laboratory tests. Testing a person’s blood and other fluids , as well as checking levels of various chemicals, hormones, and vitamins, can help find or rule out possible causes of symptoms.
    • Brain scans. These tests can identify strokes, tumors, and other problems that can cause dementia. Scans also identify changes in the brain’s structure and function. The most common scans are:
      • Computed tomography (CT), which uses x rays to produce images of the brain and other organs
      • Magnetic resonance imaging (MRI), which uses magnetic fields and radio waves to produce detailed images of body structures, including tissues, organs, bones, and nerves
      • Positron emission tomography (PET), which uses radiation to provide pictures of brain activity
    • Psychiatric evaluation. This evaluation will help determine if depression or another mental health condition is causing or contributing to a person’s symptoms.
    • Genetic tests. Some dementias are caused by a known gene defect. In these cases, a genetic test can help people know if they are at risk for dementia. It is important to talk with a genetic counselor before and after getting tested, along with family members and the doctor.

Assisting those with Dementia 

  • Occasional memory lapses are common as people get older, especially in the presence of stress, depression, and acute physical illness; review the patient after appropriate treatment has been given or a reasonable length of time has elapsed

  • If you suspect dementia, take a history from both the patient and the main family carer; the latter’s suspicions are often correct

  • Be aware that certain groups of people are at greater risk of developing dementia—for example, those who have had a stroke and those with Parkinson’s disease

  • Early identification of modifiable risk factors for dementia may reduce the numbers of people developing dementia in later life

  • Effective and useful treatments exist for people with dementia; have a low threshold for referring someone with suspicious symptoms for a specialist memory assessment

  • Assess both the physical and the mental health of the main family carer; supporting informal carers is an important part of dementia care

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