Dementia: Disease more feared than cancer...

Senior citizens with dementia are reading books at a community center in Siheung, Gyeonggi Province.

By Yoon Ja-young

In a survey on senior citizens in 2005, they picked dementia as the most fearful disease, even more than cancer or a stroke. About 530,000 are suffering dementia in Korea, but the figure is expected to increase to 2 million in 30 years. That translates into one dementia patient in every five households. Bottom line: Dementia can be anybody’s story, be it either as a patient or a caregiver of the patient.

A dementia patient would forget all the happy youthful days, what happened yesterday, or even what they said only 15 minutes ago. They will get lost right in front of the gate and forget their family. The pain of the other family members is nothing smaller. As dementia progresses, the family has to spend six to nine hours daily, washing, feeding, dressing and watching the patient. On average, it costs 19.7 million won a year to take care for a dementia patient.

Prof. Park Kun-woo

In a class on dementia held at Korea University Anam Hospital in Seoul, doctors pointed out that dementia is especially a big concern for the country which is seeing an unprecedentedly rapid aging of society. Korea became an aging society in 2000 with the ratio of senior citizens aged 65 or older reaching 7 percent. The figure is expected to surpass 14 percent in 2018, and 20 percent in 2026, transforming Korea into a “super-aged society.”

“The number of dementia patients doubles with the increase in five years in age,” said Won Eun-soo, a doctor at the hospital. For instance, 3 percent of those aged between 65 and 69 have dementia, but the ratio rises to 48 percent among those over 85.

She explained that dementia is different from bad memory.

“Forgetfulness is a normal procedure of aging. The simple fact that you forget often doesn’t mean that you have dementia,” Won said. For instance, normal senior citizens with poor memory will forget what they had for lunch. The dementia patients, meanwhile, may have lunch again and again, forgetting the fact that they already had lunch.

The doctor said there are diverse types of dementia. There is the Alzheimer’s disease, which is the most common, and the vascular dementia, incurred by damage on the brain from cerebrovascular diseases. It accounts for 36 percent of dementia in Korea. There is also alcoholic dementia and dementia caused by problem with thyroid or liver function. Around 15 percent of dementia is curable. They are dementia caused by depression, hypothyroid, vitamin deficiency, or dementia caused by medicine or brain tumor. The rest, however, is hard to cure.

An elderly man combs his wife’s hair. She is a patient of dementia. / Korea Times file

Around 40 percent of the dementia patients have Alzheimer’s, caused by degeneration of brain cells. Risk factors include aging, family history, exposure to aluminum and a history of head injury.

The patients will not only forget things. They will have problem in recalling the words or expression and will have to go over a sentence again and again to read a book. Their personalities also change. The kind and sociable person starts shunning going out, whines like a kid, becomes selfish, and sometimes neglects hygiene. Some of them have delusion, saying someone stole their belongings or suspecting that their spouse is being unfaithful.

Doctors stress that early diagnosis crucial. “Once damaged, it is impossible for the brain cells to revive. Treatment becomes less effective with the progress of the dementia. Early diagnosis can enhance effectiveness of the treatment and slow down progress,” Won said.

However, people don’t come to the doctor early enough. “They don’t think they, or their families, could have dementia. They also mistake it as simple bad memory. Don’t forget that anybody can have dementia,” she said, recommending taking dementia test every year once you reach 60 years of age.

Tips for families

Then how about families? News of a senior citizen in his 80s, who had taken care of his wife for four years, committing suicide with his wife a couple of months ago shows the agony of the family could be bigger than that of the patient. Prof. Park Kun-woo at the hospital gave tips for the family.

First of all, he said that families take the most important role in treatment of the dementia. “Patients spend most of the time with their families. The families should correctly know about the disease,” he said. Once they understand what dementia is, then it becomes a little easier.

“You should understand them, that they are losing memories. You should not get angry even if they make you repeat the same words again and again. That’s the disease, that’s the symptom that makes the person act like that. It’s not their fault. What’s the use of yelling at the patient, ‘Why can’t you remember?’ Yelling only worsens situation,” he said.

He cited an example of a daughter who took her mother to a trip, trying to be a good daughter. The mom messed it all as everything is new to her. Dementia patients get perplexed at changes. The daughter blames the mother, and the vicious circle continues.

The professor points out that what bothers families most is not loss of memory. “The patient becomes a different person in behavior. They fill in the refrigerator, fill the house with trash, get angry, wander around, don’t sleep, don’t eat, take off their clothes, repeat the same story, and so on.”

He said the family should find out when the patients start the problematic deeds, what triggers them. Most often, they do those due to some discomforts. “For instance, the patients often get worse when they are with a new caregiver. They can’t adapt themselves to the new pattern.”

He thus advises that the children who decided to take care of the patient at their home should bring them in early. When the dementia progresses, they can’t adapt themselves to the new environment. He also added that the family should actively seek help provided by the government.

The family should focus on making comfortable condition for the patients. “If the patients wander around, it’s better to allow them to wander in a safe boundary that you set, by installing a secure lock on the gate rather than locking them in a room. Instead of getting furious about the patient forgetting to turn off the lights at the bathroom, install an automatic one.” He also recommends using nametags on their clothes in case they go missing.

Positive attitude needed

There are medications for dementia that improve cognitive function, though there won’t be dramatic improvement. Prof. Park stressed that there is difference between taking it and not taking it. Just a small improvement in memory can make daily life better.

However, there is no fundamental treatment for dementia. “You just control it, not cure it. Medicine will not make the patient become what he used to be in the past, but he would be better than the worst he could be.”

There are clinical researches going on seeking more fundamental treatment, such as dementia vaccine.

For prevention, he advised losing excessive weight, taking exercise, quitting smoking, and eating a healthy diet. He added that one should use brain, live actively, laugh much and be positive. “Studying, socializing and recollecting happy memories, such attitudes add to the connections of memories. If you have many such connections, it would be okay even if you lose one of them due to disease,” he said.