How Early Detection Can Help Prevent and Slow Dementia

September 20, 2024

By Dr Lim Su Yin, Consultant Neurologist and Senior Lecturer in Internal Medicine, School of Medicine, Faculty of Health and Medical Sciences, Taylor’s University

Dr Yau Weng Keong, Associate Professor of Geriatrics and Internal Medicine, School of Medicine, Faculty of Health and Medical Sciences, Taylor’s University

Dr Lee Chung Wah, Consultant and Senior Lecturer in Psychiatry, School of Medicine, Faculty of Health and Medical Sciences, Taylor’s University

Understanding dementia

Dementia is not a single disease but a syndrome that can result directly from specific conditions such as Alzheimer’s disease or develop due to other underlying medical conditions. Many forms of dementia are linked to treatable conditions. Early diagnosis is crucial because while dementia itself is irreversible, addressing underlying conditions early can prevent or slow cognitive decline.

Cognitive function includes memory, attention, problem-solving, language, and planning abilities. Dementia is a significant decline in these cognitive functions, impacting daily life. It is common for both the public and healthcare providers to dismiss mild cognitive impairment as a normal part of aging. However, when cognitive decline interferes with daily activities like self-care, financial management, and social interactions, it is crucial to take it seriously. Dementia progression can lead to changes in speech, personality, and behaviour, often accompanied by hallucinations and delusions.

The 2018 National Health and Morbidity Survey (NHMS) of older adults in Malaysia revealed that 8.5% of the population aged 60 years or more, or about 260,000 people, have dementia ¹. In 2023, 7% of Malaysians reported memory and cognitive issues, yet only 6% sought help, largely due to a lack of awareness, stigma, and discrimination associated with the disease.

Globally, awareness of dementia remains low, making it difficult for families to recognise early signs and to intervene. Undiagnosed dementia often leads to avoidable social, financial, and medical issues such as getting lost, getting into accidents, falling victim to scams, or experiencing medical complications. Caregivers face significant challenges when a loved one is diagnosed with dementia as they often lack the necessary knowledge and skills to navigate complex legal, financial, and medical systems.

Prevention and early intervention are vital

This year’s World Alzheimer’s Day theme “Time to Act on Dementia, Time to Act on Alzheimer’s “underscores the urgency of addressing dementia. The Lancet Commission on Dementia Prevention, Intervention, and Care have so far identified 14 modifiable risk factors contributing to dementia. By focusing on these modifiable risk factors, individuals can take proactive steps to prevent or delay the onset of dementia. Early intervention through regular check-ups and cognitive assessments allow for timely management of these risks. Dementia prevention is a collective responsibility that requires awareness, education, and action from the individual, community, health policymakers, and the government.

14 modifiable risk factors for dementia

Hearing Loss – Untreated hearing loss can lead to social isolation and cognitive decline. Having regular hearing assessments and using hearing aids can minimise this risk.
Smoking – Smoking is linked to vascular damage which can increase the risk of dementia. Quitting smoking at any age can reduce this risk.

Hypertension – High blood pressure is a significant risk factor for dementia. Managing blood pressure through diet, exercise, and medication can protect against dementia.
Obesity – Mid-life obesity increases the risk of dementia. Maintaining a healthy weight through a balanced diet and regular physical activity is essential for cognitive health.

Physical inactivity – Regular physical activity enhances blood flow and reduces inflammation in the brain, improving cognitive function. Aim for at least 150 minutes of moderate-intensity exercise per week.

Diabetes mellitus – Type 2 diabetes mellitus increases the risk of dementia. Managing blood sugar levels through diet, exercise, and medication is crucial for reducing this risk.

Excessive alcohol consumption – Heavy drinking is associated with brain damage and dementia. Limiting alcohol intake to recommended levels can help preserve cognitive function.

Air pollution – Long-term exposure to airborne pollution, especially PM2.5, has been linked to dementia. Advocacy for cleaner air and personal measures like using air filtration systemsand wearing a N95 mask when outdoor air quality is poor can help reduce this risk.

Traumatic brain injury – Repeated head injuries increase the risk of dementia. Wearing a helmetand taking precautions in high-risk activities can prevent these injuries.
Limited educational opportunities for youth – A lower level of education is associated with a higher risk of dementia. Promoting lifelong learning and cognitive activities can build cognitive reserve and delay the onset of dementia.

Depression – Depression in mid-life and later life is linked to an increased risk of dementia. Seeking treatment for depression such as therapy and medicationis vital for mental and cognitive health.

Social isolation – Loneliness and social isolation can accelerate cognitive decline. Staying socially active and connected with others can protect against dementia.

High LDL cholesterol – Elevated levels of low-density lipoprotein (LDL) cholesterol have been associated with an increased risk of dementia. Managing cholesterol through a healthy diet, regular exercise, and medication can help reduce this risk.

Untreated vision impairment in later life – Vision impairment in older adults, if left untreated, can lead to social isolation and cognitive decline. Regular eye check-ups and timely correction of vision problems could help minimise this risk.