Understanding dementia ‐ what it means to you and your family.
While the possibility of developing a form of dementia
increases with age, dementia is not a normal part of
aging. “The increasing number of people with dementia
reflects the growing population of seniors,” says Dr.
Michael Wilkins‐Ho, Head of the Division of Geriatric
Psychiatry at the University of British Columbia, “people
over the age of 65 constitute the fastest‐growing
segment of the population.” At the moment, one in five people are in that age group; by 2034, the
ratio will be one in four.
Alzheimer Disease represents about half of all dementia cases. It progresses slowly, usually beginning
with some loss of short‐term memory and later including memory lapses like forgetting names of
familiar people and failing to turn off the stove or lock the door. “While there are cases of early‐onset
Alzheimer’s, most people begin to exhibit symptoms after the age of 65,” says Dr. Wilkins‐Ho. While
each form of dementia has distinct characteristics, there is some overlap to the symptoms. Vascular
dementia, the second most common form, can result from stroke or a series of mini‐strokes. “It is not
uncommon for someone to have more than one cause for memory changes,” says Dr. Wilkins‐Ho,
“diagnosis can be tricky.”
Lifestyle appears to be as important for prevention of dementia as it is for heart disease and cancer.
“It’s important to identify the reversible issues than can contribute to dementia, says Dr. Wilkins‐Ho.
Thyroid dysfunction, or calcium or vitamin B12 deficiency can create memory problems that mimic
Alzheimer Disease. “The first step in diagnosing dementia is to rule out other physical and
psychological conditions that we can treat,” says Dr. Wilkins‐Ho. Clinical depression and anxiety should
also be ruled out before considering dementia. Once a patient has been diagnosed with dementia,
medications are available, however there is currently no cure for Alzheimer Disease. “At best,
medications slow down the progress of the disease,” says Dr. Wilkins‐Ho.
Alzheimer Disease progresses at varying rates according to factors including an individual’s overall
health and, to a degree, genetics. “Impaired hearing or vision contribute to confusion and isolation for
a person with dementia,” says Dr. Wilkins‐Ho. If someone needs a hearing aid or has cataracts or
macular degeneration, it is critical to address these issues.
Occupational Therapists and Physiotherapists can help people with dementia to maintain their physical
function. “This should be the focus,” says Dr. Wilkins‐Ho, “along with intellectual activity, such as doing
the daily crossword puzzle.” People should also stay socially active. “Maintaining key relationships is
critical for people with dementia,” says Dr. Wilkins‐Ho.
The Dementia Action Plan, Priorities and Actions for Health System and Service Redesign was produced
by the British Columbia government to help people with dementia and their caregivers to plan for
health care, treatment options, and end of life care. “Discussions about the end of life can be scary and
people tend to avoid them,” says Dr. Wilkins‐Ho, “but the earlier this subject can be addressed, the
more input a person with dementia can have to their own care.”
“People need to talk about dementia and all of its implications, for the benefit of the person with
dementia and also their families and other care givers,” says Dr. Wilkins‐Ho, “public education about
dementia and end of life decisions should focus on quality of life and maintaining a sense of
The Action Plan provides a framework for early detection and early engagement with patients and
their families. “It’s particularly useful in helping patients and care givers navigate the system,” says Dr.
Wilkins‐Ho. Dementia patients should consider financial arrangements and discuss creating advance
directives for end of life care. The Action Plan can help people with these challenging issues, and can
be found at http://www.health.gov.bc.ca/library/publications/year/2012/dementia‐action‐plan.pdf.
The document includes contact information for additional resources.
“Canada is the only G8 country with no national seniors health strategy,” says Dr. Wilkins‐Ho, “we need
to be able to expect more from our health care system.” Old age does not guarantee dementia. “If you
have it, life can still be filled with meaning and joy,” says Dr. Wilkins‐Ho, “so plan realistically and don’t
be afraid to talk about it.”
Scheduled for publication in Sing Tao Daily News, January 2015