Health Problems of the Elderly

Dementia is a progressive disease of the brain. There is decline in cognitive and intellectual function such as memory, comprehension, learning capacity, the ability to think and calculate, as well as language and judgment. Patients gradually deteriorate with impaired functioning in daily activities, some also with emotional and behavioural problems. In Hong Kong, according to a local study published in 1998, dementia affects about 4% of people aged over 65, with increase in incidence with advancing age.

Causes of dementia

1. Alzheimer's Disease: cause unknown, likely to be hereditary in nature, the most common type (about 65%)
2. Vascular Dementia: due to multiple minor strokes, affects about 30% of elders with dementia
3. Other causes: e.g. brain tumour, head injury, vitamin B 12 deficiency, drug and alcohol abuse, hypothyroidism and depression

Stages of dementia and common presentations

1. Early stage - memory loss with decreased ability to think
2. Intermediate stage - easily get lost, mood changes and behavioral problems, need assistance with daily activities
3. Late stage - language impairment, cannot recognize relatives, may become incontinent and totally dependent

Management

1. Seek early medical advice and treatment if there is suspicion of dementia.
2. Some drugs may improve memory and cognitive functions of patient with early Alzheimer's Disease. Non-cognitive symptoms such as depression, psychotic features and sleep problems may benefit from drug treatment as well. However, there is no cure for dementia.
3. Other treatment includes behavioral therapy, programmes to improve memory and cognitive function. Education and counseling to patients and carers are also important.
4. Carers of demented patient can attend health talks, support groups etc. to acquire more caring skills and stress management techniques.

Prevention

• Prevention of Alzheimer's Disease is not yet known.
• Multi-infarct dementia may be prevented by adopting a healthy lifestyle which includes a balanced diet, regular exercise, no smoking and no excessive drinking. Proper control of hypertension and diabetes mellitus is also essential.

Information Hotlines and Support Services related to "Mental Health"

Related topics

Stroke

Depression

Hypertension

Diabetes Mellitus

Dementia (communication skills)

Behavioral Management in Persons with Dementia

Activity Program for Persons with Dementia

Dementia - Daily Living

Reference :

Resource Book on Psychosocial Health Promotion in the Elderly (Traditional Chinese Only)