Memory Loss Is Not Inevitable: Understanding Cognitive Health and Dementia | SJMC

  

As the global population ages, cognitive impairment and dementia have become significant public health concerns. Maintaining brain health not only helps delay cognitive decline but also significantly improves quality of life. Unfortunately, many people focus more on wealth or physical health, often neglecting the crucial aspect of cognitive health. Many are unaware that they may already be experiencing mild cognitive impairment (MCI).

Dr. Chin Ai-Vyrn, a consultant geriatrician and internal medicine specialist at Subang Jaya Medical Centre (SJMC), stresses that everyone is at risk of cognitive health issues, not just the elderly:

"Neglecting cognitive health doesn't necessarily mean that you will develop cognitive impairment, dementia, or brain-related issues but it increases the risk that this will happen. It is important to know as much as you can about cognitive and brain health and take early steps to maintain cognitive function. Losing your memory or experiencing cognitive decline is akin to losing one's identity. It is never too late to focus on cognitive health, and if you have any concerns, do not hesitate to seek professional help."

Dr. Chin highlights that the brain is an incredibly complex organ. We should be mindful of our cognitive function and brain health as early as we can if we want to have a clear mind and a good quality of life as we get older.

Cognitive health is vital. Dr. Chin Ai-Vyrn urges individuals to look after their cognitive health and seek professional help if they notice signs of cognitive decline in themselves or their loved ones. 

What is Cognitive Health?

Cognitive health refers to the proper functioning of various brain functions, including memory, attention, language, judgement, and learning ability. Regardless of age, cognitive health is the foundation of a high-quality life.

Memory loss is often the first symptom that raises concerns about potential cognitive decline. However, Dr. Chin points out that memory loss is not the only indicator of cognitive impairment. He encourages individuals to consult a specialist or geriatrician if they or their loved ones show any of the following symptoms. Early diagnosis and intervention can help prevent or slow further deterioration while allowing for better long-term care planning.

Mild Cognitive Impairment vs Dementia – What’s the Difference?

Cognitive impairment refers to a decline in cognitive function, with dementia being the most severe form. Mild cognitive impairment (MCI) lies between normal ageing and dementia:

"MCI symptoms are more pronounced than normal ageing, but cognitive function tests do not indicate a level severe enough for a dementia diagnosis. Individuals with MCI can still maintain independence in their daily life. While both MCI and dementia affect cognitive function, MCI is less severe. In some cases, MCI may progress to dementia, but this is not always the case."

Dementia is a medical condition characterised by a significant decline in thinking ability that interferes with daily life. "It occurs when neurons and their connections in the brain are damaged or lost due to diseases or injuries. Symptoms may include memory loss, language difficulties, issues with judgement or decision making as well as changes in behaviour or personality, depending on the part of the brain that is affected."

"Globally, someone is diagnosed with dementia every 3.2 seconds, with approximately 10 million new cases each year. Currently, over 55 million people worldwide live with dementia, and this number is projected to rise to 139 million by 2050."

The prevalence of MCI increases with age and is estimated to be three times higher than that of dementia. In Asia, the standardised prevalence of MCI ranges from 5% to 20%, depending on the country, age group, and diagnostic criteria used. Around 10–15% of MCI cases progress to dementia annually, but early intervention can delay or even reverse cognitive decline.

"Regardless of whether it’s MCI or dementia, age remains the most significant non-modifiable risk factor. Among those aged 60–65, approximately one in 50 people will have dementia, while in individuals over 80, the prevalence increases to one in three. As the worldwide population, including Malaysia, ages, cases of cognitive impairment will inevitably increase. Therefore, we must take proactive measures to maintain brain health and cognitive function while educating the public on the importance of cognitive well-being."


Signs of Cognitive Impairment

  • Frequent forgetfulness or memory loss
  • Decline in executive functioning
  • Difficulty completing familiar tasks
  • Confusion about time, place, or people
  • Struggles with abstract thinking
  • Misplacing items in inappropriate locations
  • Difficulty with speech, comprehension, or
  • communication
  • Changes in personality, mood, or behaviour
  • Poor judgement
  • Loss of initiative or motivation

Three Common Myths About Cognitive Health

Myth 1: Memory Decline and Dementia Are Just Normal Parts of Ageing

A common misconception is that dementia is an inevitable part of ageing. According to the 2024 World Alzheimer’s Report, 65% of healthcare professionals mistakenly believe dementia is a normal ageing process, while 80% of the general public share the same misconception.

While memory impairment is a common symptom of dementia, ageing can also cause some decline in memory, said Dr. Chin. Occasional forgetfulness do not necessarily indicate dementia. However, persistent memory lapses that affect how well you function on a daily basis is not a normal part of ageing. It is important to distinguish between normal age-related changes and memory loss due to illnesses like Alzheimer’s disease. Dementing syndromes can also cause impairments in other cognitive areas other than memory, including language, judgement, spatial awareness, and abstract thinking. It can also affect emotions, behaviour, and social inhibitions which can progressively worsen over time. Therefore, a decline in memory is not the only symptom of dementia and a persistent forgetfulness, is not a part of normal ageing—if there are any concerns always get assessed.

Myth 2: Dementia is Unavoidable in Old Age, So There’s No Need to Worry About Cognitive Health

The Guinness World Records lists Jeanne Louise Calment as the longest-living person, passing away at 122 without dementia. Dr. Chin emphasises that not everyone develops dementia, and many elderly individuals in their 80s and 90s maintain normal cognitive and functional abilities.

While genetics play a role, lifestyle choices can also increase or decrease dementia risk. Modifiable risk factors include chronic conditions (e.g., diabetes, obesity), vascular diseases (e.g., hypertension, high cholesterol, coronary artery disease, stroke), mental health issues (e.g., depression, anxiety), head trauma, environmental factors, and lifestyle habits. Managing these risk factors can help reduce the likelihood of dementia.

14 Risk Factors for Dementia

  • Lack of physical activity
  • Smoking
  • Excessive alcohol consumption
  • Air pollution
  • Traumatic brain injury
  • Social isolation
  • Low education level
  • Obesity
  • High blood pressure
  • Diabetes
  • Depression
  • High LDL cholesterol
  • Hearing impairment
  • Vision impairment

Myth 3: Cognitive Impairment and Dementia Are Untreatable, and Patients Can Only Accept Their Fate

While dementia cannot be cured at the moment, it can be managed. Dr. Chin pointed out that various interventions can help slow its progression, alleviate symptoms, enhance patients' quality of life, and reduce the burden of care on their families and caregivers.

“The first step in managing cognitive impairment or dementia is seeking a proper diagnosis from a specialist. Treatment depends on the underlying cause, and reversible conditions (e.g., thyroid disorders, vitamin B12 deficiency, obstructive sleep apnoea) should be addressed promptly."

It is also essential to assess whether the patient is taking any medications that could impact cognitive function, and to help manage associated risk factors, such as optimising vascular risk protection and adjusting lifestyle choices. Where appropriate, medications or supplements can be used to slow or reduce the risk of disease progression. The earlier cognitive impairment or dementia is diagnosed, the sooner effective measures can be implemented to help the patient manage their condition and receive comprehensive care. "He believes that what we urgently need to change is the public’s perception and misunderstanding of cognitive impairment and dementia, as well as the stigma that accompanies these conditions."

According to Dr. Chin, early diagnosis and intervention can help prevent or slow further deterioration while allowing for better long-term care planning.

How to Protect Cognitive Health and Slow Brain Decline

How can you protect cognitive health and slow brain decline? Start with these simple lifestyle changes:

  • Eliminate harmful habits: It's essential to maintain good habits for overall health. Unhealthy behaviours such as smoking and excessive drinking can negatively impact cognitive function.
  • Adopt a balanced and nutritious diet: Aim to eat plenty of fruits and vegetables to ensure an adequate intake of vitamins and minerals, which support brain health. Following Mediterranean or rainbow diet principles is recommended, along with incorporating Omega-3-rich foods, such as fatty fish, into your meals.
  • Stay physically active: Regular exercise helps keep the body strong and the mind sharp. Aim for at least 150 minutes of exercise per week, or a minimum of five sessions.
  • Manage stress: Too much stress can worsen cognitive decline, so it’s important to find ways to reduce stress and avoid excessively stressful situations whenever possible.
  • Maintain social engagement: Staying active in social activities helps keep the brain engaged and agile. Having friends from different generations also help to broaden our perspectives and expose us to new ideas.
  • Exercise your brain: Participate in brain-stimulating activities, such as puzzles or interactive games. You can also use tools like diaries, notes, calendars, and alarms to support memory and improve daily functioning.
  • Get a good night’s sleep.

Source: China Press