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Old age significantly increases one's risk of getting dementia – especially after 60. Unlike other illnesses, the earlier the symptoms appear, the more severe the illness and the swifter its progression to severe memory loss.

Those who have suffered silent strokes are also at high risk of dementia. Globally, genetics are blamed for these strokes. But in Asia, where it has affected people in their 40s and 50s with no genetic predisposition to it, possible causes have been linked to high blood pressure and a high-salt Asian diet as well as diabetes, smoking and high cholesterol.

According to Professor Ranga Krishnan, formerly the Dean of Duke-NUS Graduate Medical School, there is no cure for dementia, but medication can slow down memory loss. That is why it is important for elders to see a doctor when early signs appear. It is also important for teens who are depressed to overcome it, live healthily and keep a positive outlook on life, to prevent strokes and dementia in middle age.

People without dementia-prone genes can reduce their risk of silent strokes by adopting a healthy, low-salt diet (the same diet advice for a healthy heart), coupled with exercise and a positive mental attitude. "This is important because what affects the mind can affect the body," he said.

Prof Ranga also stressed the importance of building reserves of strength to ward off the illness for as long as possible, even if it is already in the body. "Our bodies have reserves to handle mental and physical problems. With low reserves, dementia can be unmasked after surgery, especially in elderly patients. High reserves, built by studying, using the brain or being actively engaged in life, won't change the disease, but can reduce the chance of silent strokes."

But he said there are no long-term studies on this yet. "We can only presume."

When an older relative is depressed or getting forgetful...

• Don't presume it is just old age. People tend to withdraw and slow down in old age, but if you immediately dismiss it as "old age", you miss noticing an actual problem.
• Don't immediately attribute it to other medical problems such as diabetes or a weak heart, as this will prevent you from seeking treatment for the real problem, which is dementia.
• Don't miss getting a doctor's evaluation. Although dementia cannot be cured, medication can make the elder feel better, look better, and stay better for much longer.

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