Dementia can profoundly affect the physical, mental and social well-being of patients, as well as those near and dear to them. 

Forgetfulness is the most well-recognised symptom of dementia but in some, it may present with other symptoms. These may include getting lost in familiar places, difficulty planning tasks and behavioural changes such as aggression.   

By understanding the risk of dementia and spotting the signs, those affected may be able to reach an earlier diagnosis, so they and their family members can get the treatment and support they need to live as well as possible with the condition. 

If you have a question on how to reduce your risk of dementia, or are a caregiver in need of advice for looking after a loved one with dementia, don't hesitate to ask our specialist now!

Do you know up to 20% of dementia and Alzheimer's patients suffer from sundowning? Learn more about it in this video!

About Dr Jinesh Shah

Dr Jinesh Mukesh Shah is an Associate Consultant with the Department of Neurology, National Neuroscience Institute. He has a clinical interest in dementia, particularly with regard to investigations and treatments. 

Questions and answers on dementia

1. Question by Amy

Dear Doctor,

If there is a marked family history of dementia, does it mean that descendants are more at risk of developing dementia? What can such people do to reduce their risk? What are the best foods and exercises to prevent dementia (e.g. must it be high-intensity exercise, or weight training, and for how long every week)?

Answer by Dr Jinesh Shah

Hi Amy,

A prominent family history of dementia, especially if dementia occurred at an early age, may be suggestive of an underlying genetic basis as the cause of dementia. If the culprit gene is inherited, a person may have an increased risk of developing dementia.

Making changes to one’s lifestyle is a great way to optimize one’s risk profile for dementia.

With regard to diet, whilst there is no specific diet that has been definitely proven to reduce the risk of dementia, adopting a balanced diet rich in fruit, vegetables and cereal and minimising red meat and sugar is helpful. 

Exercising is important and has been shown to reduce the risk of dementia. People should engage in a range of exercise types e.g. aerobic, resistance to maximise their benefits from exercise. Whilst it would be good to achieve at least 150 minutes of exercise over a week, the important thing is to start and exercise regularly, and step up as tolerated.

2. Question by Faridah

Hi Doctor,

My mom who is 73 tends to forget very easily..for example, if I were to tell her something 1 minute ago, she would ask again the next minute. Are these signs of dementia? She is also very moody.

Answer by Dr Jinesh Shah

Hi Faridah,

Memory difficulties can be one of the prominent symptoms of dementia, whilst behavioural and mood changes are also commonly seen. I would suggest you take her to her family doctor so she can be assessed as there may be alternative causes for her symptoms. 

3. Question by teresa

Hi Dr,

I am a married female aged 52. I would like to ask is Dementia hereditary ? My dad’s sister had dementia and my dad could have Vascular Parkinsonism.

Does it give me a higher chance of having dementia?

Answer by Dr Jinesh Shah

Hi Teresa,

Dementia can be hereditary, and a genetic basis may be suspected if there is a prominent family history of dementia, especially if it occurs at a young age.

Vascular parkinsonism is not classified under dementia.

4. Question by GH

Hi Dr Jinesh,

I’m currently 46 years old. Ever since 3 years back, I have been experiencing serious forgetfulness. Examples are as follows:

a) I just finished a meeting and when I walked back to my seat, I cannot remember anything that was discussed in the meeting, and also what items I’m supposed to follow up

b) I took 1 week leave to study for an exam but inside the exam hall I cannot remember anything that I studied. All the words on the question paper look so alien that I had to submit a blank answer script.

c) I have worked with a colleague for 4 years at a construction site, however I was just transferred to HQ for half a year and I couldn’t remember his name.

Kindly advise if the above are symptoms of early dementia. What can be done to improve the situation. Now the speed I do things has slowed to snail pace and it’s frustrating because I need to think very long and hard.

I look forward to your advice. Thank you.

Answer by Dr Jinesh Shah

Hi GH,

It sounds like your forgetfulness and slowed thinking are affecting your work and daily life. I would recommend that you see your family doctor for a check-up and share the difficulties you are facing with him/her. Your family doctor can then refer you for further evaluation if necessary.

5. Question by Emily

Hi Dr Jinesh,

I sometimes have problem remembering the names of my ex-colleagues, friends or names of places.

Also forget the amount that I paid for the things I bought after a while.

Are these symptoms of dementia? Do I need to see a doctor about this problem? 

Thank you.

Answer by Dr Jinesh Shah

Hi Emily,

Never forgetting a single detail is probably difficult to achieve. However, forgetfulness is one of the prominent symptoms of dementia. If you are concerned, I would recommend you see your family doctor for a check-up and share the difficulties you are facing with him/her. Your family doctor can then refer you for further evaluation if necessary.

6. Question by Mei Chuen

Hello Doctor,

I have 2 questions please,

a) Does brain shrinkage in a CT brain scan mean that the patient has dementia/Alzheimer's disease?

b) Is the MMSE cognitive test the gold standard in diagnosing dementia?

Thank you.

Answer by Dr Jinesh Shah

Hello Mei Chuan,

Brain shrinkage does not necessarily mean the patient has dementia or Alzheimer’s disease. It may be abnormal however, and there are many causes.

The diagnosis of dementia is based on a combination of clinical evaluation of the patient’s history, functional assessment and examination findings, interpreted in conjunction with investigations performed to reach a coherent diagnosis. 

The Mini-mental state examination or MMSE is one of the tools commonly used to evaluate a patient’s cognitive abilities but does not diagnose dementia on its own.

7. Question by martinirahman

Dear Dr,

May I know how to avoid getting dementia?

Answer by Dr Jinesh Shah

Hi martinirahman,

There are a few modifiable risk factors for dementia such as smoking, a lack of physical activity, poor diet, alcohol consumption and low levels of cognitive engagement and social isolation which a patient can easily address.

For other risk factors related to disease states such as depression, obesity, high blood pressure and diabetes, one can work with their doctor to optimise these as much as possible.

8. Question by Jasmine

Dear Dr,

MOH is concerned the burden illness like Dementia/Alzheimer’s Disease/Parkinson has on healthcare system, caregivers, cost of healthcare delivery to a fast ageing society.

Are you aware if there are any plans to provide national screening (with subsidies) for citizens of certain age groups? Early diagnosis (before symptoms show) help patients and caregivers plan ahead. Patients would want control over planning their health care needs. Thanks.

Answer by Dr Jinesh Shah

Hi Jasmine,

I am unaware of any plans for a national-level screening program for dementia at present.

9. Question by Francis

Dear Dr,

My wife (age 66) will occasionally accuse me of hiding or taking her belongings (slippers, her false teeth), which I did not and also said I have a mistress outside which is untrue. Is this a sign of dementia? Please advise, thank you.

Answer by Dr Jinesh Shah

Hi Francis,

Behavioural symptoms and delusions may be symptoms of dementia or a mental health condition. I would suggest that you encourage your wife to go for a check-up with her family doctor and accompany her to the appointment so you can share your concerns with the doctor.

10. Question by Amelia

Hi Dr Jinesh Shah,

My mum has Alzheimer’s disease and is in her advance stage. My grandma (mum’s mum) and great grandfather has it too so it seems that it doesn’t skip a generation.

What are the ways to prevent or reduce the risk of having it since we are deemed to be under high-risk category?

Answer by Dr Jinesh Shah

Hi Amelia,

A prominent family history of dementia, especially if dementia occurred at an early age, may be suggestive of an underlying genetic basis as the cause of dementia. If the culprit gene is inherited, a person may have an increased risk of developing dementia. Therefore, your risk profile will be dependent on whether you have inherited the gene which can be tested for.

However, dementia may also be associated with modifiable risk factors which you can address more easily to possibly reduce your risk of dementia. These include smoking, a lack of physical activity, poor diet, alcohol consumption and low levels of cognitive engagement and social isolation.

For other risk factors related to disease states such as depression, obesity, high blood pressure and diabetes, one can work with their doctor to optimise these as much as possible.

Ref: I23