"Keep Forgetting"...Dementia Warning Signs in Parents Spotted During the Holidays [Kok! Health]

1 in 10 people over 65
Early detection can slow disease progression

As the Lunar New Year holiday approaches and families gather for the first time in a while, many people begin to worry about changes in their parents' memory or behavior. Dementia is a frightening disease for anyone, but if it is detected early and appropriate treatment is started, it is possible to slow the rate of cognitive decline.

Image generated by Google Gemini.

According to the Ministry of Health and Welfare, 1 in 10 people aged 65 or older has dementia. There are many different causes of dementia, but the most common is Alzheimer's disease, which accounts for more than about two-thirds of all dementia cases.

Alzheimer's disease is a degenerative brain disorder in which an abnormal protein called beta-amyloid accumulates in the brain and damages nerve cells. In the early stages, it is common to see people having difficulty remembering recent events or conversations and repeatedly asking the same questions. They may forget what they just heard, or their speech may trail off because they cannot recall the names of objects.

As the disease progresses, they may become confused about dates and days of the week, or lose their sense of direction even in familiar places. As judgment and planning abilities decline, everyday activities such as managing money or taking medications can become difficult. In addition to memory loss, many patients also experience behavioral changes such as depression, anxiety, insomnia, irritability, and suspicion. If such changes persist for several months or longer and begin to interfere with daily life, it is hard to attribute them to normal aging.

"If you suspect it, do not delay and consult a specialist"

The starting point for diagnosis is the family's observations. It is important to clearly organize and convey to medical staff when the changes began, what has changed, and how it has changed. At the hospital, doctors assess whether there is cognitive decline through interviews and examinations, and then confirm it objectively with neuropsychological testing. Blood tests and brain MRI scans are used to check for other possible causes. If necessary, an amyloid PET scan is performed to directly examine the beta-amyloid protein accumulated in the brain and thereby improve diagnostic accuracy.

The goal of treatment is not to restore memory to its original state, but to maintain the current level of functioning for as long as possible. Medications currently in use focus on slowing disease progression and alleviating symptoms. In a study that followed patients with mild Alzheimer's disease for about eight years, approximately 20% of those who took cholinesterase inhibitors were admitted to long-term care facilities, whereas most patients who did not receive treatment deteriorated to the point that it was difficult for them to continue living at home. Recently, antibody therapies that remove beta-amyloid have been introduced, opening up a new chapter in slowing progression in patients at an early stage.

Prevention is also important. Lee Dong-young, a professor in the Department of Psychiatry at Seoul National University Hospital, emphasizes the lifestyle principle of "knowing yourself and your enemy" as the key to preventing Alzheimer's disease. This includes: protecting the cerebral blood vessels (by managing high blood pressure, diabetes, and obesity, and by not smoking); avoiding overeating and excessive drinking; maintaining physical activity such as walking at least three times a week; and adopting an attitude of living joyfully so that stress and depression do not persist for long periods. In particular, controlling blood pressure in middle age plays a decisive role in reducing the risk of dementia in old age.

Professor Lee said, "Memory decline or behavioral changes in patients with Alzheimer's disease are symptoms caused by changes in the brain, not by a lack of willpower or personality flaws," adding, "It is helpful to use short, simple sentences, reduce the number of choices, and respond to repeated questions by calmly giving the same explanation again." He continued, "Environmental cues such as calendars, clocks, notes, and photographs are useful in reducing confusion, and when Alzheimer's disease is suspected, it is important not to delay but to consult a specialist and receive an accurate assessment and diagnosis."