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Dementia

Overview

Dementia is characterized as a syndrome involving the gradual decline of cognitive function in two or more domains, leading to difficulties in daily activities. These cognitive domains include memory, abstract reasoning, language, praxis, perception, visuospatial skills, personality, and social behaviour. By the age of 60, approximately 1% of the population is prone to dementia.

  • Alzheimer’s disease
  • Benign tumours (e.g. subdural haematoma or subfrontal meningioma)
  • Cortical Lewy body disease
  • Cerebrovascular disease
  • Corticobasal degeneration
  • CJD
  • CADASIL
  • Depressive pseudodementia
  • Frontotemporal dementia (10%)
  • HIV
  • Hypothyroidism
  • Normal pressure hydrocephalus
  • Syphilis
  • Vitamin B12 deficiency

  • Aging
  • Lack of physical activity
  • Smoking
  • Excessive alcohol intake
  • Obesity
  • Unhealthy eating habits
  • Uncontrolled blood pressure and cholesterol and blood sugar levels
  • Depression
  • Social isolation
  • Low educational level
  • Cognitive inactivity
  • Air pollution

Neurologist

  • Primary investigations
    • Complete blood count (CBC) and erythrocyte sedimentation rate (ESR)
    • Standard biochemical tests
    • Thyroxine (T4) level assessment
    • Vitamin B12 concentration levels
    • Serological testing for syphilis (e.g., VDRL and TPHA)
    • Chest X-ray (CXR)
    • Brain imaging via CT or MRI
    • Comprehensive neuropsychological evaluation
  • Secondary investigations
    • Cerebrospinal fluid (CSF) analysis
    • Testing for HIV infection
    • Genetic analysis
    • Electroencephalography (EEG)
    • Volumetric MRI
    • Single-photon emission computed tomography (SPECT)
    • Brain tissue biopsy

Dementia cannot be cured. However, the following are used to bring about temporary relief from symptoms:

  • Cholinesterase inhibitors
  • Memantine
  • Lecanemab (Leqembi) and donanemab (Kisunla) approved by the USFDA
  • Medicines for depression, sleep problems, hallucinations, parkinsonism, or agitation
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