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Thursday, January 21, 2010

Her mom doesn't recognise her

Today 21st January 2010. I was invited as a guest in a television programme name “Fitrah Kasih”. Two other guests were Premah (ex-RTM Radio DJ) and a motivator Amin Idris. Though I work with UKM Medical Centre, but for this programme I represented GEM (Association of Gerontology Malaysia). The host of the programme were Hanna and Fifi. The title of this week’s programme is “Quran Buruk” (Unused Quran) which refers to elderly with dementia. In the Al-Quran, surah Yaasin Allah swt says "Whoever we permit to live a long time we revert to weakness. Do they not understand?"(36:68). When I talked to the producer over the phone she was asking me the difference between dementia and Alheizmer and what is dementia.

“Dementia or in Malay language “Nyanyuk” is a condition where one’s brain cells are damaged or die. 60 to 80 percent of dementia is due to Alheizmer disease where no specific cause can be identified. The rest could be due to vascular dementia (related to cerebrovascular diseases such as hypertension, heart disease, stroke etc); Lewy Body dementia (presence of certain type of protein in the brain which causes brain cell damage) may also be a s result of hypothyroidism, deficiency of vitamin B12, drug induced, infections or accidents leading to brain injury. Dementia can affect any age but majority the elderly. The older you are the higher the chances for you to get dementia.

During the programme they highlighted a case of a woman who lost her mum. She suddenly disappear (allerged to have gone to her daughter in law’s house in Raub, Pahang but never came back. She disappeared for few years).

Well, this is one of the symptoms a demented person will present. They quite often lost their way. They do not know how to get back to their own house. Among the common feature of dementia are LOST OF RECENT MEMORY – if we talk to someone with dementia, we will find that they will keep on asking the same question. They forget that they have asked the question and also forget that we have given them the answer. Thirdly INABILITY TO USE PROPER LANGUAGE – they find it difficult to use simple word, hence use wrong words in their sentence leading to people cannot understand what they were trying to say. Fourthly, DISORIENTATION TO TIME AND SPACE – they will not be able to differentiate between day and night, morning and evening. They also do not know where they are. Another is INABILITY TO THINK LOGICALLY – they put things in weird places. For example put their watch in the sugar jar, putting iron in a fridge. They also can have MOOD SWING – we do become moody at times but dementia patient’s mood swing very fast. They can be calm, depressed, happy, angry in a short period. They also can LOOSE INTIATIVE – prefer to be alone, don’t like to mix around, just sit in their room. They can also show WEIRD BEHAVIOUR – they can accuse people stealing their property, pass motion anywhere. They can also have HALLUCINATIONS –a relative of mine who had dementia, she always talked to plants and said that the plants are little children. When she looked in the mirror, she saw someone else. They can also loose the ability to CARRY OUT THEIR DAILY ROUTINE – can’t drive, cook, get dress, bathe or eat.

They were also concern as to why demented person can only remember incidents from the past and not recent memory.

In dementia patients, their brain cells become corrupted. So they are not able to store new message. For example if they keep their watch in a cupboard, they cannot store this message, hence they forget. But past stories which have been stored long time ago, still remain with them. However some type of dementia such as vascular dementia can loose both short as well as long term memory.However sad to say the long term memory may be lost as the condition progresses.

They wanted to know if there is any treatment for dementia.

There is no medication yet that can cure dementia. However there are medications that can help to slow down the progress of the disease.

Who are at risk or what are the risk factors for dementia?

There are a few risk factors such as age itself, family history, alcohol intake, smoking (higher risk of atherosclerosis and vascular diseases), diabetes, high level of bad cholesterol, low intake of fruits and vegetables.

Whatever it is, I would like to stress here that family members are the one who will notice the changes in the elderly. If suspicious, please consult a doctor. Screening such as ECAQ (Elderly Cognitive Assessment Questionnaire; MMSE (Mini Mental State Examination) and Drawing the Clock test can be done. Patient need to investigated fully to assess the risk factors, possible causes. Also to properly plan the care for them.

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