Dementia results in the decline of cognitive functions such as memory, attention, problem solving, language, and planning abilities. Contrary to popular belief, it is not a single disease but a syndrome that includes specific conditions such as Alzheimer’s disease. It could also develop due to underlying medical conditions.

Dementia progression can lead to changes in speech, personality and behaviour, often accompanied by hallucinations and delusions. Early diagnosis is crucial because, while dementia is irreversible, addressing underlying conditions early on can prevent or slow cognitive decline.

Healthcare providers and the public alike often dismiss mild cognitive impairment as a normal part of ageing. However, when this interferes with daily activities like self-care, financial management and social interactions, it’s indicative of a more serious issue at play.

The 2018 National Health and Morbidity Survey revealed that 8.5% of the population aged 60 and above, or about 260,000 people, have dementia. Last year, 7% of Malaysians reported memory and cognitive issues, yet only 6% sought help, largely owing to a lack of awareness, as well as associated stigma and discrimination.

Modifiable risk factors

The Lancet Commission on Dementia Prevention, Intervention and Care has identified 14 modifiable risk factors contributing to dementia, as follows:

• Hearing loss: Untreated, this can lead to social isolation and cognitive decline. Make it a point to undergo regular hearing assessments, and use hearing aids where appropriate to minimise this risk.
• Smoking: This bad habit is linked to vascular damage, which can increase the risk of dementia. Quitting smoking at any age can reduce this risk.
• High blood pressure: With hypertension being a risk factor, it’s crucial to manage your blood pressure through diet, exercise and/or medication.
• Obesity: Maintaining a healthy weight through a balanced diet and regular physical activity is essential for cognitive health.
• Physical inactivity: Regular physical activity enhances blood flow and reduces inflammation in the brain, improving cognitive function. Aim for at least 150 minutes of moderate-intensity exercise a week.
• Diabetes mellitus: Control your blood sugar levels through diet, exercise, and medication to stave off the potential onset of type-2 diabetes.

• Excessive alcohol consumption: Heavy drinking has been linked with brain damage. Limit your alcohol intake to recommended levels to help preserve cognitive function.
• Air pollution: Avoid long-term exposure to airborne pollution by undertaking measures that ensure cleaner air, such as using filtration systems and wearing a N95 mask when outdoor air quality is poor.
• Traumatic brain injury: Wear a helmet and take precautions when carrying out high-risk activities to prevent head injuries.
• Lack of education: Promote lifelong learning and brain-health activities such as puzzles and games to build cognitive reserves.
• Depression: Occurrence of this mental health condition in mid- and later life is linked to an increased risk of dementia. As such, it is crucial to seek therapy and/or medication to safeguard one’s cognitive and psychological wellbeing.
• Social isolation: As loneliness and isolation can accelerate cognitive decline, it’s vital to be socially active and remain connected with others.
• High LDL cholesterol: Elevated levels of low-density lipoprotein (LDL) cholesterol have been associated with an increased risk of dementia. Manage your cholesterol through a healthy diet, regular exercise, and/or medication.
• Untreated vision impairment later in life: Left untreated, vision impairment in older adults can lead to social isolation and cognitive decline. Prioritise regular eye check-ups and timely correction of vision problems.

By focusing on these modifiable risk factors, individuals can take proactive steps to prevent or delay the onset of dementia. Early intervention through regular check-ups and cognitive assessments allow for timely management of these risks.

This article was written by Dr Lim Su Yin, consultant neurologist and senior lecturer in internal medicine; Dr Yau Weng Keong, associate professor of geriatrics and internal medicine; and Dr Lee Chung Wah, consultant and senior lecturer in psychiatry at the School of Medicine, Faculty of Health and Medical Sciences, Taylor’s University.