Normalising dementia as Malaysia becomes an ageing nation

It is estimated that over 55 million people live with dementia across the globe, of which 60 to 70 per cent have Alzheimer’s disease.

However in its latest report today, Alzheimer’s Disease International (ADI) revealed that up to 85 per cent of those living with dementia may not receive post-diagnosis care.

The reason for this discrepancy is mostly due to lack of awareness, both among the general public and medical professionals, says ADI CEO Paola Barbarino.

She told Astro Awani that one of the biggest challenges to address was the persistent stigma surrounding the neurological condition.

An ADI survey last year found that up to 62 per cent of healthcare professionals saw it as part and parcel of old age.

“A lot of people still don’t believe that Alzheimer’s or dementia are diseases. They still believe it is caused by normal ageing,” she said.

“But if you see the brain of a person with Alzheimer’s and the brain of a healthy person at the same age, they’re completely different.”

Dementia on the rise

The 2018 National Health and Morbidity Survey found that 8.5 per cent of older adults in Malaysia could suffer from dementia.

But according to geriatrician Dr Elizabeth Chong, this was possibly only “the tip of the iceberg” as the disease was still a taboo subject.

“When you talk about dementia, everyone thinks it is equivalent to memory loss but that is not true. Dementia is presented in different ways, it is not that straightforward.

“A lot of times it is related to losing grasp of a language, or sometimes there are mood disorders and behavioural problems,” she explained.

Paola noted that the ageing population in lower-middle income countries was growing rapidly, even faster than that of North America or Europe.

Now with COVID-19 in the picture, those figures may rise even further.

“But cases are increasing anyway. We are working very hard with a lot of governments to get them to prepare for the fact that this is not going away,” she said.

Despite the number of dementia cases continuing on an upward trend, global progress to address the disease remains slow.

In Malaysia, a National Dementia Plan is in the works, in line with its commitment with 194 other countries at the 2017 World Health Assembly.

But Paola said the pandemic had hampered any advancements in the last few years.

The ADI is scheduled to meet with Health Minister Khairy Jamaluddin next month to discuss resuming the plan and implementing it.

On Sept 12, Khairy revealed that his father-in-law and former Prime Minister Tun Abdullah Ahmad Badawi had dementia and that his condition was deteriorating.

“Many of you may wonder where the fifth prime minister of Malaysia is. Dementia is a...very cruel condition because the body is there but the mind isn’t,” he had said.

The first step of seeking help

Chong stressed the importance of receiving an early diagnosis, as it could better prepare families on how the disease may progress.

It will also ensure better quality of life for both the patient and their caregivers in the long run.

If caught early, patients may also undergo cognitive stimulation therapy which will help maintain their cognitive function as long as possible.

The most difficult part, said Chong, is taking the initiative to seek help over memory loss from a local health clinic. After which, one may be referred to a specialist who will conduct further tests to ascertain the illness and confirm its relation to dementia.

“There are some treatments to slow down the progression of the disease. It is very important to come early when you can still walk, talk and function so that we can maintain that state.”

Chong called for Malaysia to work harder to address dementia given its status as a developing country that is heading towards becoming an aged nation by 2030, in which over 15 per cent of its population will be over 60 years old.

Failure to prepare for this, she warned, would affect Malaysia’s productivity and the healthcare system’s expenditures. There would also be inadequate care for the increasing number of senior citizens.

“Things will not move forward and we will end up treating complications and a lot of disabled elderly individuals, which is going to cost the country more.”

Prevention is better than cure

There are several things one can do to minimise their risk of developing dementia, including the usual balanced, healthy diet and regular exercise.

One crucial factor, said Paola, would be for those with hearing impairments to ensure they wear their hearing aids.

“If you don’t hear very well, you will socially isolate yourself because you simply cannot follow conversations. That then makes your brain deteriorate more quickly.”

She said it was also beneficial for people to constantly socialise, be it with family, neighbours or other members of your community.

“Playing games such as crossword puzzles or sudoku is another way to maintain your brain,”

“Better still, trying new educational activities like learning a new language or dance, always helps.”