Dr Jinesh Mukesh Shah, Associate Consultant from the Department of Neurology at National Neuroscience Institute (NNI), answers your questions about dementia - how to reduce your risk and help others living with it.
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.
11. Question by Karin
Hi Dr, I have the following questions:
1) Why does one get dementia?
2) Who are at a higher risk of dementia?
3) How to confirm one has dementia?
4)Anyway to prevent/avoid it?
Thank you for your advice.
Answer by Dr Jinesh Shah
Hi Karin,
Dementia occurs when parts of the brain involved in cognition are diseased. This may occur from a myriad of causes, with Alzheimer’s disease being the most well-known.
Patients with specific risk factors or prominent family history may be at higher risk of dementia. 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. There are also other risk factors related to disease states such as depression, obesity, high blood pressure and diabetes, and one can work with their doctor to optimise these as much as possible.
The diagnosis of dementia is made by integrating the clinical history and examination findings together with investigation results.
12. Question by Dino
Dear Dr Jinesh,
Can Ginkgo biloba supplements aid in enhancing memory for individuals with dementia
Additionally, what strategies can be employed to assist individuals with OCD?
Kindly advise, thanks.
Answer by Dr Jinesh Shah
Hi Dino,
Evidence for gingko biloba supplements in the literature is mixed with some studies finding benefit whilst others did not.
OCD is a mental health condition and queries with regards to this would be best addressed by a psychiatrist.
13. Question by Annie
Dear Dr,
Does dementia run in the family? If my parent has the condition, does it increase my chances of getting it? Any ways to reduce the incidence?
Answer by Dr Jinesh Shah
Hi Annie,
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 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.
14. Question by Christine
Hi Dr,
How can I get test what’s the chance of me getting Dementia in my life?
Anything I can do now to prevent or even slow it down?
I am a 57-year-old female. Thank you.
Answer by Dr Jinesh Shah
Hi Christine,
Current testing for prediction of subsequent risk of dementia would mainly be focussed on genetic testing where appropriate.
Dementia may also be associated with modifiable risk factors which you can address 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.
To monitor your memory and cognitive health, you may wish to use the
Memory Care tool on SingHealth’s free Health Buddy app. The Memory Care tool has a memory care checklist that you can use to monitor your memory and thinking – based on your answers it will advise you if you have possible signs of dementia that should be evaluated by your family doctor. For more information about the Memory Care tool, please click
here.
15. Question by David
Hi Dr Jinesh, I am 60 and semi-retired.
What should I do to best avert dementia?
And what food should I eat and what food to avoid?
Answer by Dr Jinesh Shah
Hi David,
Dementia may also be associated with modifiable risk factors which you can address 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.
With regards to diet, whilst there is no specific diet that has been definitely proven to reduce the risk of dementia, however adopting a balanced diet rich in fruit, vegetables and cereal and minimising red meat and sugar is helpful.
16. Question by Rachel
Dear Dr, thank you for having this forum.
I have some questions on dementia.
1. My mom (age 74) has been misplacing her things and could not find them. She also tends not to be able to find her way around when she’s outside. Are these symptoms of dementia?
2. How do I know if a loved one has dementia?
3. What can I do if my mom has dementia?
4. If a parent has dementia, would the children have higher risk of getting dementia?
5. What foods are good in preventing dementia?
Your advice is much appreciated.
Answer by Dr Jinesh Shah
Hi Rachel,
Misplacing items and getting lost may possibly be symptoms of dementia but do not diagnose dementia per se. If a loved one displays impaired cognition, it may be a good idea to visit the doctor for an evaluation. If your mother indeed has dementia, you may discuss possible treatment options with the managing doctor.
You can also use the
Memory Care tool on SingHealth’s free Health Buddy app to check if your mother has possible signs of dementia. The Memory Care tool has a memory care checklist that you can use to monitor memory and thinking – based on the answers it will advise you if your mother has possible signs of dementia that should be evaluated by her family doctor. For more information about the Memory Care tool, please click
here.
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.
With regards to diet, whilst there is no specific diet that has been definitely proven to reduce the risk of dementia, however adopting a balanced diet rich in fruit, vegetables and cereal and minimizing red meat and sugar is helpful.
17. Question by SP Teo
Dear Dr Shah,
I would like to know whether the taking of "memory loss" supplements will help in the slowing down of dementia?
For a diabetes patient who is on Metformin, does Metformin also help to slow down the aging process and thus help in slowing down dementia?
Thank you for answering my questions.
Answer by Dr Jinesh Shah
Hi SP Teo,
There is no strong evidence to support the use of over-the-counter memory supplements to slow down the disease course of dementia.
Some studies have shown the benefit of metformin in decreasing the occurrence of cognitive decline in a specific profile of patients but this may not apply to all patients.
18. Question by Mrs Nanz
Dear Dr,
I am already 64. My daily routine is to have morning walks with my husband. Have interest in reading books and enjoying traditional Chinese tea and doing Chinese calligraphy. I am also musically inclined. So, these are my hobbies.
My mum is already 98 probably and she is at her last stage of dementia, which she started around her late 60's. All her siblings (especially her sisters) had it too.
Does this mean that dementia is hereditary? Will I get it too? I’m deeply worried.
Answer by Dr Jinesh Shah
Hi Mrs Nanz Tan,
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.
If the culprit gene is inherited, a person may have an increased risk of developing dementia.
To monitor your memory and cognitive health, you may wish to use the
Memory Care tool on SingHealth’s free Health Buddy app. The Memory Care tool has a memory care checklist that you can use to monitor your memory and thinking – based on your answers it will advise you if you have possible signs of dementia that should be evaluated by your family doctor. For more information about the Memory Care tool, please click
here.
If you are the main caregiver for your mother, you may also find the
Dementia Caregivers resources useful on the Memory Care tool. This includes a checklist for dementia caregivers to monitor their wellbeing and check for warning signs of ‘burn-out’.
19. Question by Amelia
Hi Dr,
I would like to know in current times, as technology continues to dominate more and more of our elderly loved ones life, are you aware of any recommended programs or even phone apps that we can have them engage in to keep their mind active, rather than just physical activities?
Answer by Dr Jinesh Shah
Hi Amelia,
It is important to have a good balance of physical activity, social interaction and mental activity to reduce one’s risk for dementia. There are no recommended apps; and the nature of mental activity can be varied as per the person’s preferences and abilities.
20. Question by KS
Hi Dr, I would like to get your advice on the following:
a. Where can we get our seniors tested for dementia?
b. What are the typical symptoms of dementia? My senior tends to be forgetful on things she does but at times do display to have good memory for things that she likes or favours.
Answer by Dr Jinesh Shah
Hi KS,
Symptoms of dementia may include forgetting easily, getting lost in previously familiar locations and being unable to plan. If your loved one displays symptoms of cognitive decline including those above, it may be a good idea to see your family doctor for an evaluation.
To check if your relative has possible signs of dementia, you may also wish to use the
Memory Care tool on SingHealth’s free Health Buddy app. The Memory Care tool has a memory care checklist that you can use to monitor your memory and thinking – based on your answers it will advise you if you have possible signs of dementia that should be evaluated by your family doctor. For more information about the Memory Care tool, please click
here.
21. Question by Joo Siong
Dear Dr Jinesh Shah,
I am 53 this year and both my parents have dementia. I suppose I have a high risk of getting dementia later in life, so if I start to take dementia medications now, will it help to prevent me from getting dementia?
Answer by Dr Jinesh Shah
Hi Joo Siong,
A prominent family history of dementia, especially if the 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.
There are currently no medications that can prevent the onset of dementia as current medications are only able to treat symptoms. However, there are steps that you can take to reduce your risk of dementia, including quitting smoking (if you smoke), doing 150 minutes of exercise a week, eating a healthy balanced diet and staying mentally and socially active. Going for health screening can help to detect risk factors such as high blood pressure and diabetes, which can be controlled with medication and lifestyle changes.
22. Question by Vivek
Dear Dr,
My mom is 93 years old, and she has recently been diagnosed with dementia. I read this article and she is showing all signs mentioned in your article e.g. aggression, not recognising her own family etc.
Dr I really need some advice how to manage this?
While she lives in India, your advice will be of immense help. I am myself a Singapore citizen. Thank you for your advice.
Answer by Dr Jinesh Shah
Hi Vivek,
Sorry to hear about your mother being diagnosed with dementia. It can indeed be challenging looking after a loved one with dementia.
Management strategies may involve both medication and non-pharmacological measures. Amongst the latter, these may include frequent familiarisation, continued social engagement, maintenance of routines and creating a calm and safe environment. Her doctor may be able to offer further advice on possible medication options for her behavioural symptoms. Hope this is helpful.
23. Question by Andrew
Hi Dr,
Of late I am starting to have short-term memory lapse. There are times I cannot recall what I did two days ago. Is there a way to help me regain my memory? I am 72-years-old, fit and healthy. I do my physical workouts 3 times a week, Mon, Wed and Fri.
I also play golf twice a week. I do drink alcohol after the games. At the moment, I am taking Daneuron and Levetiracetam once every morning.
Hope you can help me recover from this.
Answer by Dr Jinesh Shah
Hi Andrew,
Sorry to hear about your symptoms. I would suggest further evaluation by your family doctor to reach a diagnosis so that more specific management advice can be provided.
Meanwhile, to monitor your memory and cognitive health, you may wish to use the Memory Care tool on SingHealth’s free Health Buddy app. The Memory Care tool has a memory care checklist that you can use to monitor your memory and thinking – based on your answers it will advise you if you have possible signs of dementia that should be evaluated by your family doctor. For more information about the Memory Care tool, please click
here.
24. Question by Sally
Dear Dr Shah,
My mum is 94 years old and diagnosed with dementia mid stage.
Lately she kept crying the whole day, she is under Tan Tock Seng specialist. We have problems handling her.
She has speech problem and cries for almost a whole day. She will do this at intervals of about half an hour. She lives in a 3-room flat and is cared for by her 2 youngest children who stay with her.
When they go to work, she keeps asking for them. Please guide us on how to handle this type of patient.
Answer by Dr Jinesh Shah
Hi Sally,
I’m sorry to hear about your mother’s diagnosis. It must be difficult managing her. Mood-behavioural issues are a challenging aspect of dementia care for caregivers. However, there may be both pharmacological and non-pharmacological means to help your mother. The latter may include avoidance of social isolation and continued social engagement. Do speak to your doctor about these various options. I hope this was helpful.
25. Question by Pee Hui
Hello Dr Shah, I have the following questions:
1. What gets a formal diagnosis of dementia? Criteria please.
2. I have a friend who was diagnosed to have depression some 30 years ago. Now she is not too clued in - meaning she is lost, blur, mixes up info easily... I know she is slowly but surely dementing but not at the level where you can say she has dementia. What can she do?
Thank you for your advice.
Answer by Dr Jinesh Shah
Hi Pee Hui,
The diagnosis of dementia mainly rests of the identification of significant and acquired cognitive impairment causing interference of independence in everyday activities.
Mood disorders such as depression may also cause apparent cognitive impairment that may be difficult to differentiate from dementia.
I would suggest that she sees her family doctor for evaluation to identify the underlying diagnos(es) and for appropriate treatment and/or referral.
26. Question by Yean Lan
Dear Dr Shah,
I am interested to know:
1) how does dementia come about and what is it doing to our brain?
2) when do we have to get it checked, and what are the triggers?
3) Is there any cure if diagnosed early?
4) what are the treatment options and side-effects of the treatment?
5) How does the treatment help improve the patient's condition?
6) Cost and duration of treatment?
7) Is dementia hereditary?
Thank you.
Answer by Dr Jinesh Shah
Hi Yean Lan,
Dementia occurs due damage to parts of the brain involved in thinking and memory (cognition), which most commonly occurs from a neurodegenerative process but there are many other causes, such as stroke. I will suggest getting evaluated if one has cognitive symptoms.
Meanwhile, to monitor your memory and cognitive health, you may wish to use the Memory Care tool on SingHealth’s free Health Buddy app. The Memory Care tool has a memory care checklist that you can use to monitor your memory and thinking – based on your answers it will advise you if you have possible signs of dementia that should be evaluated by your family doctor. For more information about the Memory Care tool, please click
here.
There is new treatment that may slow down the course of dementia in a specific profile of patients, however it is currently not approved for clinical use in Singapore. Other treatments may aid with cognitive symptoms. Each of these may have different possible adverse effects.
A prominent family history of dementia, especially if the 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.
27. Question by Carol
Dear Dr Jinesh,
I have the following questions on dementia:
1) Do all patients with dementia show up a shrinkage in the brain or other brain abnormalities in CT scans? More specifically, if there is no abnormality detected in the brain via CT scan, can a patient still be diagnosed with dementia?
2) How can we tell if a patient has mild cognitive impairment or dementia?
3) There are supplements sold which are said to be helpful to improve brain functions. Examples are Neuroregain, U brain 100 etc. Are these helpful for dementia patients?
Thank you.
Answer by Dr Jinesh Shah
Hi Carol,
many patients with dementia may have normal CT scans. However, there are more detailed scans that can potentially be performed that may yield further information.
Diagnosis of dementia requires the presence of cognitive symptoms.
Meanwhile, to monitor your memory and cognitive health, you may wish to use the Memory Care tool on SingHealth's free Health Buddy app. The Memory Care tool has a memory care checklist that you can use to monitor your memory and thinking – based on your answers it will advise you if you have possible signs of dementia that should be evaluated by your family doctor. For more information about the Memory Care tool, please click
here.
A small subgroup of patients may find certain supplements helpful, but there is no one supplement proven to help all patients with dementia.
28. Question by Rosalind
Hi Dr Jinesh,
My husband has been diagnosed with PCA at age 55 and is currently 57 years old. He has problem writing and counting notes can all these skills be re-learned?
Answer by Dr Jinesh Shah
Hi Rosalind,
I am sorry to hear about your husband’s diagnosis. Recovery of lost function may be difficult to achieve. However, do discuss with your husband’s specialist whether a referral to the allied health therapists may help to equip him with the necessary skills to manage with the deficits.
29. Question by Nielly
Hi Dr,
Does dementia cause one to vomit?
My mother (77 years old, diagnosed with PD) lately has been having these symptoms (pale face, vomit) for 1 to 2 months (approx. interval 2 weeks once).
The vomitting can be more than 10 times. No prior "warning". She can be fine in morning and starts to vomit late afternoon.
No fever, no tummy issues, etc. A&E did blood test, x-ray can’t find anything. Really don’t know what's wrong. Polyclinic doctor advised to admit her to hospital.
Please advise.
Answer by Dr Jinesh Shah
Hi Nielly,
Vomiting can occur due to a multitude of causes. Dementia, in itself, should not cause vomiting. It might be a good idea to follow the advice of your managing doctor.
30. Question by Alice
Dear Dr Jinesh Shah,
I contacted with pemphigus foliaceus due to auto immune disorder.
I have been taking centrizine medication for 5 years, will it lead me to dementia?
May I know the cost to run the test for dementia?
Is dementia genetically inherited?
My mum contacted lung fibrosis due to auto immune disorder that leads her to chronic ischemia. I'm curious whether I will develop dementia as I age.
Appreciate your reply, thank you.
Answer by Dr Jinesh Shah
Hi Alice,
Certain medications can cause cognitive impairment whilst patients are taking them. However, there is no good evidence to state that long-term use of cetirizine will definitely lead to dementia.
The diagnosis of dementia is based on cognitive symptoms.
To monitor your memory and cognitive health, you may wish to use the Memory Care tool on SingHealth’s free Health Buddy app. The Memory Care tool has a memory care checklist that you can use to monitor your memory and thinking – based on your answers it will advise you if you have possible signs of dementia that should be evaluated by your family doctor. For more information about the Memory Care tool, please click
here.
A prominent family history of dementia, especially if the 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.
Based on your description, your mother and you have different autoimmune diseases and thus your risk of ischemia may be different.
31. Question by Ismat
Hi Dr,
Are there other early symptoms for dementia besides forgetting? Thank you.
Answer by Dr Jinesh Shah
Hi Ismat,
While memory difficulties are the most recognisable of symptoms of dementia, other symptoms may include difficulty with planning activities, getting lost easily or behavioural changes such as agitation or apathy.
32. Question by Helen
Hi Dr,
I am 53 years old this year. I sleep average 5 to 6 hours since my early age (as a teenager).
Is lack of sleep one of the causes for a person to have dementia at later age?
Now, I had difficulty memorising a person’s name and recalling people I met not long ago.
I do not have family history of dementia. Please advise and thank you.
Answer by Dr Jinesh Shah
Hi Helen,
Sleep requirements may vary from person to person. Sleep disturbances may both be a cause and manifestation of dementia.
Meanwhile, to monitor your memory and cognitive health, you may wish to use the Memory Care tool on SingHealth’s free Health Buddy app. The Memory Care tool has a memory care checklist that you can use to monitor your memory and thinking – based on your answers it will advise you if you have possible signs of dementia that should be evaluated by your family doctor. For more information about the Memory Care tool, please click
here.
33. Question by Judy
Hi Dr,
Ever since my mum has been diagnosed with mild dementia last August 2022 (she was already showing signs in Jan when I took her to the polyclinic for a referral but the appointment was only available in August), she has been chomping down on her teeth non-stop (like teeth grinding during sleep except hers is all day non-stop).
The doctor says it’s not a side effect of her dementia medicine, Donepezil. I notice she is also swaying her body while sitting and gently swinging her arm as well.
When I ask her why, she says it makes her feel comfortable. I assume she is self-soothing which I understand dementia patients do.
Is the chomping down also a form of self-comfort? Is there any way we can substitute this as this action is causing her dental issues? It seems involuntary and she seems unable to control herself.
Thank you for your advice.
Answer by Dr Jinesh Shah
Hi Judy,
Your mother’s symptoms of involuntary teeth grinding as well as trunk and limb movements may not be related to her dementia and require further evaluation as to the underlying cause. You can speak to your mother’s doctor looking after her dementia.
34. Question by Janet
Dear Dr Jinesh, I am female, age 55.
Would appreciate your reply to the following questions:
a) There were times whereby I could not recall if I have done certain thing (usually minor stuff), only to repeat the minor task again. How would I know if it’s just mere forgetfulness (could be I was also thinking about other stuff while carrying out the minor task etc) or is a progression of Dementia?
b) I had Covid 19 in December 2022. I started to experience on and off or partial loss of smell few months after recovering from Covid 19.I understand that loss of smell is also a symptom of Dementia. How would I know of the loss of smell (on & off or partial) is due to Covid 19 or Dementia? In the case of loss of smell for Dementia, is it an early symptom or a much later symptom?
c) At what age does Dementia affect a person or it does not necessarily affect everyone?
d) How to prevent Dementia?
e) Currently, any medication or any forthcoming promising medication that could cure Dementia?
I look forward to receiving your replies. Thank you.
Answer by Dr Jinesh Shah
Hi Janet,
The diagnosis of dementia is based on difficulties in thinking and memory (cognitive deficits) which interfere with independence in daily activities.
Meanwhile, to monitor your memory and cognitive health, you may wish to use the Memory Care tool on SingHealth’s free Health Buddy app. The Memory Care tool has a memory care checklist that you can use to monitor your memory and thinking – based on your answers it will advise you if you have possible signs of dementia that should be evaluated by your family doctor. For more information about the Memory Care tool, please click
here.
The loss of smell may be seen in certain kinds of dementia but if related to dementia is likely to be associated with other symptoms of disturbances in thinking and memory. Nonetheless, you can evaluate your loss of sense of smell with a family doctor to see if it requires further evaluation.
Dementia is more often seen in the elderly but can affect younger patients as well.
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, however adopting a balanced diet rich in fruit, vegetables and cereal and minimizing red meat and sugar is helpful. Exercise 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.
There are no known medications that can cure dementia. However, there are medications available for treatment of dementia in a select group of patients.
35. Question by Pauline
Dear Doctor,
My mum had dementia at the age of 66, will the children have a higher chance of getting it too? Are there ways to prevent it? Thank you.
Answer by Dr Jinesh Shah
Hi Pauline,
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 regards to diet, whilst there is no specific diet that has been definitely proven to reduce the risk of dementia, however adopting a balanced diet rich in fruit, vegetables and cereal and minimizing 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.
36. Question by Selina
Dear Dr,
A good day to you. I have questions about Dementia as follow:
a) What are the early symptoms of Dementia? My husband suspects that he has dementia. When he checked with the GP in polyclinic, the doctor just asked him a few simple questions and that’s all. The questions the GP asked are meant for patients that already have Dementia.
b) Where can we assess whether we have Dementia?
c) If it is confirmed that my husband has early symptoms of Dementia, what can he do?
d) My father-in-law has dementia. He tends to get angry with us when we tried to clarify with him what he said. Do you have any advice for us to communicate with patient with Dementia?
e) Is there a life span for Dementia patients?
Thank you for your advice.
Answer by Dr Jinesh Shah
Hi Selina,
Symptoms of dementia may include forgetting and getting lost easily as well as difficulty planning.
Meanwhile, to monitor your memory and cognitive health, you may wish to use the Memory Care tool on SingHealth’s free Health Buddy app. The Memory Care tool has a memory care checklist that you can use to monitor your memory and thinking – based on your answers it will advise you if you have possible signs of dementia that should be evaluated by your family doctor. For more information about the Memory Care tool, please click
here.
If your husband is diagnosed with dementia, you can consider speaking to the diagnosing doctor for more specific advice. Nonetheless, management strategies may involve both medication and non-pharmacological measures. Amongst the latter, these may include frequent familiarisation, continued social engagement, maintenance of routines and creating a calm and safe environment.
Communicating with patients with dementia can be challenging. Suggestions include trying to communicate with the patient in a conversational way, rather than asking sequential questions which may tire or intimidate the patient. Try to also avoid talking to the patient as if he/she were a child. Use short and simple sentences. Communicate clearly and calmly.
The cognitive symptoms of dementia themselves are not life-threatening. However, patients with dementia may lose function over time, and may be at risk of medical complications which may be life-threatening if severe. It is also possible that they may pass on from conditions not related to dementia.
Thus, patients with dementia can have very variable life expectancies.
37. Question by Debra
Dear Dr Shah,
I have a couple of questions about handling my father who has mild dementia - he currently lives with my mother and I live apart.
How do you find ways to motivate the patient to be more active when he often uses excuses like 'I'm too tired to go for a walk', 'My eyesight isn't good, I don't want to leave the house', 'I'd rather watch TV than sing along to songs' etc.
How do you deal with hoarding? Is it recommended to quietly clear things away and dispose of them? Honestly my mom has been doing this because he doesn't remember what he has anyway...
Answer by Dr Jinesh Shah
Hi Debra,
Looking after a patient with dementia, especially if they have behavioural symptoms that can be challenging. There is no one fixed strategy that works with all patients, and one patient may require multiple strategies. Such strategies may include doing activities together with him, engaging his friends, trying a variety of exercises, offering rewards etc.
Hoarding may be a coping mechanism to deal with changing memory and confusion. Again, multiple strategies may help. However, it is important to take note of potential hazards from hoarding e.g. fire safety. Secondly, organise the clutter into various bins. It may be helpful to include the patient as part of the process to split the items to keep, donate or throw away, empowering them to make choices. Lastly, immediately remove all items to be discarded.
38. Question by Debra
Hi Doctor,
Does the present of white matters in a mri brain scan indicate a person has dementia? When is the right time to seek medical treatment? Thanks.
Answer by Dr Jinesh Shah
Hi Vincent,
White matter is a normal part of the brain. A patient with significant white matter disease may have cognitive impairment. If significant white matter disease is detected during a brain scan, the doctor who referred the patient for a brain scan will be informed. He or she will review and advise the patient accordingly.
Meanwhile, to monitor your memory and cognitive health, you may wish to use the Memory Care tool on SingHealth’s free Health Buddy app. The Memory Care tool has a memory care checklist that you can use to monitor your memory and thinking – based on your answers it will advise you if you have possible signs of dementia that should be evaluated by your family doctor. For more information about the Memory Care tool, please click
here.
39. Question by Colleen
Hi,
Is there an accurate way to determine what precise type of dementia one has?
Are there drugs or treatments available so far to slow down or stop Alzheimer instead of just treating the symptoms?
Answer by Dr Jinesh Shah
Hi Coleen,
The stepwise approach to diagnosing dementia would be to first confirm its presence, followed by evaluating the underlying cause. Investigations such as blood test and brain scans will help the doctor to determine the likely cause of dementia.
Yes, there is new treatment to slow down disease progression in Alzheimer’s disease in a select group of patients, however it has not yet been approved for use in Singapore.
40. Question by Crystal
Dear Doctor,
I'd like to ask you if losing time orientation is symptom of dementia. My dad is 81 years old.
And recently he wakes up in the midnight & looks for my mum as he said it's lunch/dinner time.
Please advise if his behaviour is one of the symptoms of dementia and if there is anything that we could help to prevent him to get worse.
Thank you very much.
Answer by Dr Jinesh Shah
Hi Crystal,
Disorientation to time may indeed be a symptom of dementia. You may consider getting him evaluated by a doctor.
Meanwhile, to monitor your father’s memory and cognitive health, you may wish to use the Memory Care tool on SingHealth’s free Health Buddy app. The Memory Care tool has a memory care checklist that you can use to monitor memory and thinking – based on your answers it will advise you if one has possible signs of dementia that should be evaluated by your family doctor. For more information about the Memory Care tool, please click
here.
41. Question by Lillian
Dear Dr Shah,
a) My mum has dementia, so we need to activate the LPA that we made when she is still of sound mind. What is the best way to do that? How do we get her assessed that she is no longer of sound mind?
b) My mum sticks her hands into her soiled diaper, and then will smear her dirty hands on other parts of her body. How can we stop this behaviour?
c) My mum is 90, has dementia, and is losing weight, but she still has a healthy appetite and in fact we are giving her more food. What could be the cause, and what should we do to stop her weight loss?
Your advice is much appreciated, thank you.
Answer by Dr Jinesh Shah
Hi Lilian,
Your mother’s mental capacity can be assessed by any registered medical doctor, who can subsequently indicate her capacity on the LPA form. For more information, visit the Ministry of Social and Family Development website:
MSF | Using a Lasting Power of Attorney
Looking after patients with dementia, especially those with behavioural symptoms can be challenging. Strategies to deal with smearing of her soiled hands include using clothing that makes access to faeces limited, such as one-piece items that zip up the back.
In addition, mittens may also make digging of faeces more difficult to perform. Make sure constipation is not the issue. She may require a visit to the doctor for a physical examination to exclude local irritation or infection. Providing patients the opportunity to be involved in activities that involve use of her hands such as folding towels, or playing with clay can be considered.
With regards to your mother’s unintentional loss of weight, I would recommend evaluation by a doctor to rule out other medical conditions.
Ref: I23
