Forgetting names, misplacing keys, or getting lost in a familiar place could be signs of old age, or it could point to an underlying medical condition – dementia. Dementia is not a normal part of ageing, but a brain disease in which there is a gradual degeneration of specific regions of the brain affecting memory, language ability, judgement, mood and behaviour.

​Dr Dennis Seow, Head and Senior Consultant from the Department of ​Geriatric Medicine ​at Singapore General Hospital, gives detailed answers to your questions.


Question by mosmos

Any there any early warning signs or symptons to find out whether our love ones are suffering from dementia? Will there be any medication to treat dementia? Does dementia only affect those older age person?

Answered by Dr. Dennis Seow Senior Consultant Dept of Geriatric Medicine Singapore General Hospital

Locally, we have observed that patients in the early stage present with consistent short term memory loss that affects their daily activities eg keeping appointments, taking medication, etc. They may tend to buy marketing items repeatedly and forget they have bought them already. For those who cook, cooking standard usually drops and the food can become too salty or sweet and ingredients are omitted. The repertoire of dishes cooked also decreases. Familiar names and telephone numbers are harder to recall and misplacement of items is common.

For those who drive, they may get lost or have difficulty finding their way along familiar routes and they may make hasty decisions like changing lanes or turning into a road suddenly. Repetition of questions, instructions or word finding difficulties are also common. Quarrels between spouses or with relatives are not uncommon as a result of a person’s poor memory, misjudgments and misundertsandings.​

10 early warning signs are as below:


Question by sgborn01

At what point do we know that it is getting more pronounced to seek medical help? Is there any medical help for dementia?

Answered by Dr. Dennis Seow Senior Consultant Dept of Geriatric Medicine Singapore General Hospital

Locally, we have observed that patients in the early stage present with consistent short term memory loss that affects their daily activities eg keeping appointments, taking medication, etc. They may tend to buy marketing items repeatedly and forget they have bought them already.

For those who cook, cooking standard usually drops and the food can become too salty or sweet and ingredients are omitted. The repertoire of dishes cooked also decreases. Familiar names and telephone numbers are harder to recall and misplacement of items is common. For those who drive, they may get lost or have difficulty finding their way along familiar routes and they may make hasty decisions like changing lanes or turning into a road suddenly. Repetition of questions, instructions or word finding difficulties are also common. Quarrels between spouses or with relatives are not uncommon as a result of a person’s poor memory, misjudgments and misundertsandings.

There is medication that can help slow down the decline in cognition in persons with dementia. Medications can also ameliorate the negative symptoms of personality or behaviour change if non-pharmacological measures are unable to help. However, the medications have side effects and not all patients may be suitable to take the medications. It is best to see an expert to properly assess the patient’s suitability to take the medications.


Question by cooladvice

How often is this visible in mid age executives like 30-40 years old ? Is memory loss (losing the sharp memory) also similar to dementia ? How do you recommend treating this in the day-to-day executives of this age group ? Is there any natural cure like exercises, dietary precautions etc.?

Answered by Dr. Dennis Seow Senior Consultant Dept of Geriatric Medicine Singapore General Hospital

Amongst middle age executives, dementia may not be so common but certainly possible. Dementia that afflicts the younger age group may not be of the Alzheimer’s type but of another form for example Fronto-temporal Dementia. If the memory loss is consistent, affects day to day functioning and is obvious to family and colleagues, thorough evaluation by a specialist is warranted.

On the other hand, memory loss in the middle age working group may not be due to dementia. Other factors or diseases need to be assessed or excluded first as memory can often improve once these factors / diseases are treated. Examples include stress (exhaustion) from family or work life, lack of sleep, thyroid illness, obstructive sleep apnoea, depression, anxiety disorders, overuse of sedatives, excessive alcohol intake etc.


Question by kcfoong

Hi Doctor,

Is Dimentia hereditary? And if someone experienced a trumatic concussion, especially involving the head, will he be more susceptible to get dimentia? Thank you.

Answered by Dr. Dennis Seow Senior Consultant Dept of Geriatric Medicine Singapore General Hospital

For the early onset form of Alzheimer’s disease which affects the younger age group (30-50 years), the hereditary element is quite strong.

In the Singapore, amongst the older population (>65 years) with late onset Alzheimer’s disease, the hereditary element is much less significant. Other factors such as diabetes mellitus, hypertension, stroke , hyperlipidemia actually contribute significantly to dementia amongst the older persons, more so than the hereditary element in this age group.

Repeated head trauma or concussions is a risk factor for developing dementia.


Question by lslseren

Does Dementia cause someone to look like a mentally illed person? For example, talking to ownself at the mirror, speaking to nobody, does not want people to stop him from what he/she wants to do.

Answered by Dr. Dennis Seow Senior Consultant Dept of Geriatric Medicine Singapore General Hospital

Most patients with dementia actually look normal hence their memory impairment or functional impairment may often be overlooked by relatives or friends. However, a proportion of patients with dementia may develop negative behavioural and personality changes including delusions , hallucinations (auditory/visual) , increased irritability or agitation, wandering etc.

It is important to note that psychiatric or other medical conditions can also present with these symptoms. Hence, for the profile of patient described in the question above, it is best to seek medical help and evaluation before ascertaining the cause(s).


Question by spatak1

What can we do to help a patient or close kin with dementia ? Besides taking the medication, is there anything else that can help to slow down the deterioration. We introduce interactive games, such as card games, memory board games but she lost the interest in less than 5 min. We try to have short conversation on recalling simple things like "what do you have for lunch ?", and she brush off without trying much effort to recall. The patient seems to be in own world even in a group as in a family. Help...thanks

Answered by Ms. Julian Lee Hui Min Nurse Clinician ( Specialty care) Singapore General Hospital

In order to help a close kin with dementia, for the caregiver(s) it is foremost to have a good understanding of what dementia is so as to aid their understanding of what their loved one is experiencing as a result of having the illness. Joining a dementia support group such as the Alzheimer’s Disease Association of Singapore can help one learn more about the disease, receive support and learn tips on how to managing challenging caregiving situations from experts and other caregivers. Various hospitals also have their own support programmes. Do check the ADA website or check with your doctor for more information.

Besides medication, having a good family or social support is important in slowing down the deterioration as it gives the person with dementia comfort and reassurance. Engaging them with exercise and activity e.g. reminiscence therapy (discussing past events, activities or experiences) can help to promotes their sense of security by remembering past memories that are familiar to them. This will help to improve their level of well-being. Enrolling into a Dementia Day Activity centre near the home can also be very useful. The patient benefits from social interaction with persons outside the family and receives cognitive stimulations through various activities outside the house. Family members can also gain some respite while the patient attends Dementia Day care.

A person with dementia has difficulty remembering and recalling recent events and information. Therefore, avoid games or questions that rely on their short-term memory. Instead, ask simple or close ended questions e.g. “Did you have your lunch?” Or open ended questions with options e.g. “Did you have rice or noodle for lunch?”.


Question by ChaiKeng

What are the basic tests for dementia? Any medications? ChaiKeng

Answered by Dr. Dennis Seow Senior Consultant Dept of Geriatric Medicine Singapore General Hospital

There is medication that can help slow down the decline in cognition in persons with dementia. Medications can also ameliorate the negative symptoms of personality or behaviour change if non-pharmacological measures are unable to help. However, the medications have side effects and not all patients may be suitable to take the medications. It is best to see an expert to properly assess the patient’s suitability to take the medications.


Question by oj1992

My 85 year old mother in law who is living with us likes to cook on her own but does not remember it. Hence she ends up with a burnt pot often. We got her an induction cooker but she prefers the gas stove. She is also not keen on taking her diabetic medication regularly. I tried to give her the medication but she brushed me off and said she is capable of taking care of herself. I am at wits end as her condition has worsened and the doc is even suggesting insulin injection for her. How can I help her ? Thank you.

Answered by Ms. Julian Lee Hui Min Nurse Clinician ( Specialty care) Singapore General Hospital

This is certainly a common and challenging situation that is encountered often. The person with dementia has poor insight and safety awareness but is unaware of the decline in her mental faculties.

Engaging and participating with the person would be a good way to start. You can explain to her that you would like to learn cooking from her or cook together with her as a pretext to supervise her cooking; and it can also be a great bonding activity. Do not be vexed or irritated if she makes mistakes during cooking. Rather, be patient, prompt and guide her through the cooking process. Designating someone else to do the main bulk of the cooking (if possible) while letting her cook a few simple dishes would be one way of continually engaging her.

Watch for potentially dangerous situations e.g. leaving the stove burning or turning on the gas without lighting it or turning it off. In such situations, one may have to change the stove switches so that it is tamper-proof or remove the gas stove altogether.

Regarding her medications, it is important to determine-Find out the reasons for her refusal of medication and work towards solvingto solve the her problem. In our observations of caregiving experiences, the relationship of the caregiver to the patient is important. Often, the patient may refuse to take medication when asked to do so by a foreign domestic helper, son- or daughter-law. The patient may however, be more willing to take medication from her own spouse or child. This is especially so for those children that the patient is particularly close to. Grandchildren whom the patient is particularly fond of can also be enlisted to help supervise the medication taking.

Reducing her medications and/or synchronizing all her medications to once or twice daily to reduce the burden of medication taking is also very helpful. Do check with the doctor to seek help and advice on this.

-There is no one particular method, you have to trial and error to see what suits her. There are many Oother methods that you can try includee.g. using humour, cajole, or distraction.


Ref: T12