Dealing with the realities of dementia

Demensia Brunei

Dementia entails the deterioration or failure of the brain. This leads to several symptoms that may include memory loss, difficulties with thinking, problem-solving or language.

In Brunei, the local term used to describe forgetful older people is lali or nyanyuk. Sound familiar? This is perceived as normal in our community for older people but it is not. It could be a symptom of dementia. Since it causes worsening brain function, it affects the memory and other abilities that may interfere with daily life.

Dementia also affects other brain functions. Comparing the size of normal brains and those with dementia, the size of the latter is smaller due to damage from dementia. You may encounter people with dementia; each with different kinds of symptoms.

Dementia may trigger a decline in thinking abilities, while others might have problems with communication or visuospatial abilities, depending on which part of the brain is affected.

Eventually, all parts of the body’s function will also slowly deteriorate, including communication skills, control over emotions and even physical movement.

A common misconception is that only older people get dementia. The main cause of dementia is Alzheimer’s disease and people aged 65 and above are at higher risk of getting the disease. In Brunei, it is likely that vascular dementia is also prevalent because there are a lot of people with risk factors such as obesity, heart problems and stroke.

Dementia can also strike people in their 30’s to 50’s, which is called younger-onset or early-onset dementia. Damage to the brain from injuries such as from car accidents or trauma can also lead to dementia.

The following are the 10 warning signs of dementia:

Memory loss

Declining memory, where a person often forgets things, especially short-term memory or recent events. People with forgetfulness may still remember other related facts but a person with dementia may not even remember the ‘bigger picture’. In the worst case, they can’t recognise or remember their family members.

Difficulty performing familiar tasks

People with dementia often find it hard to complete daily tasks. One may not know what order to put on their clothes or preparing a meal.

Problems with language

Occasionally people have trouble finding the right word. But a person with dementia often forgets simple words or substitutes it with unusual words when they speak or write. This causes problems with speech and writing, such as mispronunciation or wrong spelling. At a later stage, it becomes hard for normal people to understand what they are talking about.

Disorientation to time and place

We sometimes forget the day of the week or where we are going but a person with dementia encounters this more often. They can also become lost in familiar places such as the road they live in, where they are or how they got there, and not know how to get back home. A person with dementia may also confuse night and day.

Poor or decreased judgement

A person with dementia may dress inappropriately, such as wearing several layers of clothes on a warm day. They may take unnecessary risks due to being impulsive or not thinking things through.

Problems keeping track of things

A person with dementia may find it hard to follow a conversation or keep up with tasks such as paying their bills on time. Sometimes, they can’t remember when or what they are talking about. It is also hard for them to keep track of what people are saying because they forget what was being said.

Misplacing things

Anyone can temporarily misplace their wallet or keys but it becomes more frequent over time for people with dementia. A person with dementia may also put things in unusual places such as in the fridge or in the oven.

Changes in mood and behaviour

People may become sad or moody from time to time but a person with dementia may become unusually emotional and experience rapid mood swings for no apparent reason. For example, after making a joke, they may laugh then cry for no obvious reason.

Trouble with images and spatial relationships

People with dementia may have difficulty in reading, judging distances, and determining colour in contrast. In terms of perception, they may look in a mirror and think they are looking at someone else instead of realising they are looking at their own reflection. Dementia can also cause changes in visual and spatial abilities, such as distinguishing food from the plate.

Withdrawal from work or social activities

A person with dementia may isolate themselves from people and become very passive, sitting in front of the television for hours, sleeping more than usual, or appear to lose interest in hobbies.

How to prevent or reduce risk of dementia?

Currently, there is no cure for dementia. In only 10 to 20 per cent of dementia (specific subtypes), the symptoms can be slowed down after medical treatment, but the underlying process will always remain despite diagnosis and treatment.

There are several ways to reduce the risk of getting dementia. Firstly, look after your heart. Avoid smoking, which can increase the risk of getting dementia by causing problems with blood circulation around the body, including blood vessels to the brain, and the heart and lungs.

Be physically active. Exercise is good for your heart, blood circulation and mental well-being. Try to reach 30 minutes of exercise several times a week.

Eat healthily. A healthy, balanced diet reduces the risk of dementia by helping the brain and body to function properly. These lifestyle choices also help reduce risk of other disease conditions including cancer, diabetes, obesity, stroke and heart disease.

Exercising or challenging your brain such as reading, solving puzzles or learning new language keeps your brain going. It is also encouraged to enjoy social activities. Try and make time for friends and family and combine physical and mental exercise through sports and hobbies. It is beneficial for brain health and reduces the risk of dementia and depression.

Mid-life is an important time to start taking care of your body more seriously. Take control of your health and get annual medical check-ups for your body.

What should you do if you know someone who you suspect has dementia?

Have a look through the 10 warning signs of dementia. Go through the checklist and decide if you, your family or friends have these symptoms. If they do, go to your nearest clinic, seek advice and get checked by the doctors. They will assess and perform a clinical examination and blood tests. If they suspect a diagnosis of dementia, they may refer to a specialist for further evaluation or scans. They will also give practical advice on what to do to reduce risk and manage dementia.

Why is it important to raise awareness about dementia in Brunei?

Raising or spreading awareness involves talking about a very serious and important matter that requires people’s attention. In an international survey, two out of three people globally had little or no understanding about dementia. There is still no medication or vaccination, while treatment only slows the progression of dementia.

Every three seconds, someone in the world develops dementia. Imagine how widespread this disease is, and we do not have effective medicines to cure this yet. People must be aware to seek early treatment to delay the worsening condition.

If people present themselves earlier for a medical check, a high rate of early diagnosis allows doctors to monitor the person’s condition. The public also should have knowledge of an effective healthy lifestyle and try to reduce the risk of getting dementia. Prevention is better than cure.

Dementia is the highest cause of disabilities in older people. It does not only affect the person who has it but also the people around them.

Educating yourself at an early age is important to prepare for the future. As people get older, it is important to reduce the possibility of getting dementia.