Sunny Health

It’s almost impossible to miss the video about “Ah Keng” taking care of his demented grandfather. In the past weeks, this bittersweet mini film made by local director Royston Tan a couple of years ago for the Health Promotion Board has been making its rounds again on television and the social media, promoting public awareness about dementia. In the film, the grandfather's mind is so disoriented that he is hallucinating about feeding his chickens, despite living in a HDB flat and possibly not been in a poultry farm for decades. While it is heart-warming to see "Ah Keng" doing the right thing to keep his grandfather happy and occupied by following his antics, in reality, many adult Singaporeans are so busy working to support our families that we find it hard to spare time for our healthy parents, let alone provide adequate special care for those who need it. In this case, prevention is better than a cure that doesn't look likely to exist in the near future. After all, leading a blissful and fulfilled life till the end of one's days is a common desire of most people.


In an aging population like Singapore, it is important to understand dementia and its implications. Contrary to popular belief, it is not normal for elderly people to exhibit signs of obvious deterioration in memory and intellectual functions, as well as become cranky when one isn’t originally like these. These are notable symptoms of dementia, and are not part of the normal ageing process. However, age is a high risk factor for dementia, hence people often speak of age and dementia in the same vein. In Singapore, the prevalence rate of people with dementia aged 65 years and above is about 6.2%.

Why is dementia such an intimidating illness?

Growing old shouldn’t be scary as it is a natural process that everyone goes through. What frightens people about ageing is the possibility of losing dignity – losing capability to do regular tasks, and having to depend on others. This is precisely what happens with dementia. When dementia patients lose memory and brain functions, they have to depend others on many necessary daily activities, including bathing and eating. They even pose a danger to their lives, not knowing how to identify and avoid hazards. They lose their ability to make decisions and even to enjoy their old age.

Can dementia be prevented?

Sadly, no concrete cause of dementia has been discovered, though the following are known to be risk factors:

• Diseases that cause degeneration or loss of nerve cells in the brain such as Alzheimer's, Parkinson's and Huntington's.
• Diseases that affect blood vessels, such as stroke
• Toxic reactions, like excessive alcohol or drug use.
• Nutritional deficiencies, like vitamin B12 and folate deficiency.
• Infections that affect the brain and spinal cord, such as AIDS, dementia complex and Creutzfeldt-Jakob disease.
• Certain types of hydrocephalus, an accumulation of fluid in the brain that can result from developmental abnormalities, infections, injury, or brain tumors.
• Head injuries
• Infectious disease
• Brain tumours
• Depression
• Thyroid problems
• Cardiovascular factors e.g. hypertension, heart disease, high cholesterol
• Genetic factors (rare)
• Illnesses other than in the brain, such as kidney, liver, and lung diseases, and diabetes can all lead to dementia.
• Down syndrome (patients with Down syndrome will develop the brain changes of Alzheimer's disease by 40 years of age.)
• Age

Yes as you can see, most of the factors leading to dementia are basically deterioration of health (which explains why dementia is more prevalent in old age), which can be prevented if you adopt a healthy lifestyle.

But even if it is too late, don’t despair, as the impact of dementia can be reduced with the right treatments and care, even if it cannot be eliminated completely. In my next blog entry, I’ll discuss about the symptoms of dementia and how to seek treatment.