Bae Ji-sook
Staff Reporter
When it comes to the term ``dementia,'' some people may think of a beautiful woman in a white linen bed trying to squeeze out memories as in the movies ``Note Book'' or ``The Moment to Remember.'' Some others may think of the Korean phrase ``stick dung on the wall out of insanity.'' Both sides say dementia is a serious disorder.
However, Dr. Na Duk-lyul of Samsung Medical Center says everyone has dementia in a way. ``In this big universe, we may all have different kinds of dementia. The difference is that these people just stand out,'' he says smiling that the definition of true dementia could be very personal.
According to The Korean Association for Dementia, those with more than three to four symptoms below should visit their doctors for consultation. Caregivers or spouses should answer the questionnaires, as the patient might want to lie about the symptoms out of fear.
1. Cannot remember what month or date it is.
2. Cannot remember where an item has been placed.
3. Repeats the same question.
4. Forgets about promises.
5. Goes out to fetch something but returns empty handed because they cannot remember what they meant to get.
6. Mumbles for a moment when trying to recall the names of an item or person.
7. Keeps asking questions about something in the middle of conversation because it is hard to keep up.
8. Has got lost while out walking.
9. Cannot figure out small change when making payments.
10. Suffered from drastic character changes.
11. Cannot operate washing machines, electronic cookers or other equipment anymore.
12. Cannot tidy up the room or house.
13. Cannot dress according to time, purpose and occasion.
14. Cannot use public transportation.
15. Does not want to change underwear even though it is dirty.
Dementia happens when specific cells operating the cognitive function of the brain suffer malfunction or die out.
Two types of dementia are mostly found among people. One is Alzheimer's disease that takes the majority of patients. The direct cause of this disease is still not known. Therefore, experts say it isn't yet preventable or curable.
The disease is more likely to be found in elderly women, with a family history and of a certain genotype.
The second type is when fatty material or other foreign matter piles up inside the blood vessels in the brain. Those with hypertension, diabetes, hyperlipemia, obesity, heart disease or who smoke and lack exercise are more likely to suffer from this form of the disease.
In this case, Na stresses that the disease is preventable and more likely treatable because avoiding fatty foods and keeping up regular exercise could prevent such syndrome to a certain level.
Recently, it was found that some forms of Alzheimer's disease were caused by the excessive buildup of material in the cerebrovascular system, too. ``It means that larger number of such patients can prevent the disease,'' Na smiles.
One could hardly say that dementia is curable. But with constant care and appropriate treatment, the symptoms can be controlled and maintained at an affordable level.
Treatments vary ㅡ starting from simple exercise to medication and in some special cases, surgery. When spinal fluid inside the brain presses on the brain tissue and causes dementia, a simple operation transfers the fluids to the abdominal cavity halting the symptoms. In some cases the removal of a brain tumor alleviates the cause, too, he said.
``In most cases, prevention is the best solution,'' Na says.
Since dementia patients receive treatment for an average of 20 years or more, Na stresses relations between patients, caregivers and doctors are quite important.
He says once a person suffers from dementia, he or she will live a completely different life. ``I had a patient who was a sincere and honest family man. But when he turned 50 he had an affair, became very hot tempered,'' he says citing one of his thousands of cases.
``However, his wife stood by his side and took care of him which soothed the symptoms and now their ties are better than ever,'' he says. He says that caregivers being too hasty in healing or being impatient about the patient's mistakes could worsen the symptoms.
He says some caregivers try to pick out errors patients make. But that will only intimidate the patient and worsen the symptoms. ``If the person spells things wrong or says incorrect words, do not try to correct them but show signs of understanding. This will let the patient feel secure, which is necessary for the treatment process,'' he says.
Still he saves room for caregivers, too. ``Dementia is a long journey that a whole family is involved in. Sending the patient to professional facilities for a certain amount of time regularly will give a breath of fresh air to family members. This way both sides are less stressed.''
Na is campaigning to make the disease a ``beautiful'' one. ``If you cannot avoid it then make it less harmful.''
Those who smile a lot, have great communication with the family and positive thinking show less hostility and have less conflict with caregivers after the onset of the disease, he said.
Na is famous for being a sincere and caring doctor among patients nationwide. Being the nation's No.1 expert on dementia, he opens his sessions an hour earlier than regular to pay more attention to individuals and listen to their stories.
He also was in charge of producing a Korean version of a dementia questionnaire, mentioned above.
Graduating from Seoul National University Medical School, he now heads the Ministry of Health, Welfare and Family Affairs Clinical Research Center of Dementia of South Korea, trying to set data map for more than 5,000 patients.
``It will be the first database of its kind in the country. We expect the information to verify typical Korean types of dementia and the root cause of them,'' he said.