Dementia is a disease that many people overlook, unlike cancer or heart disease. In reality… dementia significantly affects daily life. However, if detected early… this disease can be completely cured.
Abnormal symptoms… when dementia occurs
- Memory impairment and reduced ability to learn new things, such as inability to remember short-term events. In severe cases, patients may forget past events and familiar people, including close relatives.
- Language impairment, such as difficulty finding words, using incorrect words, incorrect or inability to write and read.
- Inability to perform daily activities as usual, decreased ability to take care of oneself, such as eating, bathing, and toileting, either unable to do or doing incorrectly.
- Changes in mood and personality, which may include irritability, aggression, depression, or apathy.
- Insomnia, hallucinations, paranoia, and anxiety.
Diagnosis
- Physical examination, medical history taking, neurological examination, and mental status tests including memory, learning, language use, calculation, orientation to time and place, and planning ability.
- Blood tests to check thyroid, liver, and kidney function, as well as electrolyte levels that may be causes.
- Magnetic resonance imaging (MRI Brain) or electroencephalogram (EEG) to assist in treatment planning.
- In some cases, cerebrospinal fluid analysis may be performed if brain infection is suspected.
Treatment guidelines
- Doctors focus on treating the cause in diseases that can be cured, such as cerebrovascular disease, brain infections, thyroid dysfunction, hydrocephalus, brain tumors, folate deficiency, vitamin B12 deficiency, and drug overdose. Patients in this group, if treated correctly and timely, with minimal brain damage, may return to normal. Delayed treatment may result in significant disability.
- Focus on symptomatic treatment for those who cannot be cured, such as Alzheimer’s disease, advanced brain cancer, brain infections in some AIDS patients. Treatment may only relieve symptoms but cannot stop brain degeneration. Good care and family understanding help patients live longer and importantly improve the quality of life for both patients and their families.
Supportive treatment methods
- Medication to relieve psychiatric symptoms (such as hallucinations or aggression), reduce insomnia, or provide vitamins and electrolytes in cases of nutritional deficiency.
- Physical therapy to strengthen muscles, prevent joint stiffness and muscle atrophy, including dance therapy and self-care training.
- Occupational therapy to stimulate thinking, calculation, reading, concentration, and memory, and to alleviate depression, such as playing games, drawing, dancing, and discussing past and present events. These activities should be conducted by well-trained facilitators.
- For patients with severe symptoms in the late stages who may be completely dependent, care focuses on preventing complications from limited mobility and prolonged bed rest. Common complications include pneumonia, pressure ulcers, and urinary tract infections. At this stage, care should ensure the patient’s maximum comfort.
Dementia can be prevented
There are many factors that cause dementia, some of which we can prevent and avoid, and some types can be cured. Even though some types cannot be cured, the most important thing is to start taking care of the brain from a young age and start today, not wait until old age to pay attention. Important actions include eating a balanced diet with appropriate portions, drinking clean water according to the body’s needs, emphasizing vegetables and fruits because they contain vitamins and minerals, getting sufficient and regular rest to allow the brain to rest, and exercising the brain to stimulate its function, such as playing calculation games, handicrafts, and art. Avoid brain damage by refraining from alcohol, drugs, smoking, toxic fumes, sleep deprivation, and unsafe sexual behavior to prevent AIDS and syphilis. If you have chronic diseases, they should be treated and controlled within normal limits, such as hypertension, diabetes, and high cholesterol, to prevent disease progression that leads to dementia.
Promoting love, understanding, and warmth in the family acts as a defense against stress and helps cope with problems from work and social environments. In cases where dementia is incurable, good care and treatment planning will slow down the progression, reduce patient dependency, and help families and caregivers achieve the best quality of life.
Dr. Sirarat Morrarat
Neurology Specialist
Brain and Nervous System Center, Phyathai 2 Hospital
