SYNOPSIS

Dementia can occur in 1 in 12 to 20 of older adults (5 to 8%) aged 65 years and above, with the incidence increasing with age. Globally, someone in the world develops dementia every three seconds. At present there are approximately 50 million persons with dementia worldwide with the number set to triple to 150 million by 2050.

This talk is aimed at persons who are
- interested in knowing more about dementia in general
- worried about their own memory or cognitive function
- caring for or know someone with dementia.

It is hoped that the content will benefit everyone as the topics covered include risk factors, symptoms, diagnosis, treatment and prognosis or outlook. In particular, there will be a section on management of behavioural or psychological symptoms of dementia(BPSD) which can include aggression, agitation, change in behaviour and depression.

Dementia is defined as a syndrome of progressive cognitive impairment severe enough to affect activities of daily living(ADLs). The symptoms include poor short term memory, difficulty learning new tasks, difficulty with ADLs such as cooking, driving and personal hygiene and change in behaviour or personality. There are different types of dementia such as Alzheimer’s Dementia, vascular dementia, Parkinson’s Disease Dementia and others.

A person concerned about dementia can seek medical opinion from their family doctor who can arrange preliminary tests before onward referral to a specialist including a geriatrician, neurologist or psychiatrist. The doctor will take a thorough history from the patient and family members or someone who knows the person well. Cognitive testing will be conducted, taking the person’s education background into consideration. A full set of blood tests and brain imaging such as a CT or MRI scan will be organized.

Dementia treatment includes pharmacological (drugs) and non-pharmacological methods provided by carers. The medication for dementia does not cure or fully reverse the symptoms, but may slow down the worsening of symptoms. It is of great importance that carers know that treating the person with dementia with kindness, patience and reassurance is an important part of treatment, as the drugs may not be effective without the carers’ support. Good nutrition, physical activity and recreational activity should also be part of the management plan.

A person diagnosed with early dementia may still be able to plan their own care in future with an advanced care plan developed together with their family and doctor. In advanced or end-stage dementia, the person will likely be fully dependent on another for their daily activities. In these circumstances, the main aim of treatment would be palliative or comfort measures.


BIODATA OF SPEAKER

Dr Tan Kit Mun is a Consultant Geriatrician in the University of Malaya Medical Centre (UMMC) in Kuala Lumpur since 2013. She is also a consultant geriatrician in the University of Malaya Specialist Centre (UMSC) since 2017. She was a consultant geriatrician in St Vincent's University Hospital (SVUH) Dublin from 2009 to 2012 prior to returning home to Malaysia.

Dr Tan graduated from the Medical School in Trinity College, Dublin, Ireland and was conferred MB, BCh, BaO (II Hons) in 1999. She then became a member of the Royal College of Physicians (Edinburgh) UK in 2002. Dr Tan completed her specialist training in Geriatric Medicine and General Internal Medicine in 2009 and received her Certificate of Satisfactory Completion of Specialist Training (CSCST) from the Irish Committee of Higher Medical Training (ICHMT) from the Royal College of Physicians Ireland (RCPI).

Dr Tan's special interest are in stroke, atrial fibrillation, the comprehensive geriatric assessment, frailty, dementia and osteoporosis, together with other conditions that the older person experiences. She is actively involved in the Malaysian Geriatric Medicine specialist training scheme and is a trainer of specialist trainees in geriatric medicine and medical officers in the Master in Internal Medicine Programme in the Faculty of Medicine, University of Malaya. She is active in research related to ageing and the older person and presents her research findings annually at the Malaysian Congress of Geriatric Medicine.