Category Archives: Articles

I attended a symposium on neurocognitive functioning in Singapore last month. Some take home messages that are important and relevant to us as we go into our senior years healthfully and gracefully!!

A lot of the lectures were focused on the importance of maintaining good vascular health to delay the onset of dementia. Research is moving intervention targets to pre-stroke identification and lifestyle management.

Factors that prevent/delay post stroke cognitive impairment (which we can apply for other conditions as well):

1. High educational level or life-long learning. Keep yourself open to learning new things – learn a new language, take art/painting classes – just keep learning!
2. Keep being productive – delay retirement. You can lessen your work load and pace but keep working and being productive.
3. Manage your stress level – remove unnecessary stress in your life!
4. Increase your leisure time – be it physical, social or intellectual activity.
5. Stay socially engaged, do things with others such as having lunches with friends, outings with family, chatting with exercise mates!
6. Control the metabolic risk factors for dementia such as obesity, diabetes, high blood pressure, high cholesterol level.
7. Control cardio-metabolic factors such as diabetes.
8. Maintain your physical health e.g. maintaining a healthy weight level and avoiding inactivity.



9. Maintain good nutrition. Follow a good diet that is high in folate (good for memory, learning & language), Omega 3, drink tea and eat curry!
10. Control environmental factors. High density of people with high volume of amenities (e.g. restaurants, movie/play houses, museums, etc) is generally better for your brain.

I have been asked how one can handle anxiety. These are ways you can help yourself:

1. First, know yourself and what triggers your attacks. When you are about to experience or are going through an anxiety attack, observe your thoughts and write them down. This will help you identify the triggers of your anxiety attacks.

2. Once you know the events and circumstances that trigger your attacks you can sort them into what is solvable and what is not.

3. For triggers that are “solvable”, take concrete/tangible steps to address the problem (e.g. taking a test, talking in front of an audience, attending a convention and having to “network” with strangers).

If you need the help of a professional, consult a psychotherapist or a counselor or talk to a friend.

4. For triggers that are not “solvable”, make peace with them and accept them (e.g. being diagnosed with a medical condition, conflicts with parents or siblings, a death of or separation from a loved one).

A therapist can also help you develop strategies to manage these stresses.

5. Exercise regularly. Aerobic dancing /kickboxing /yoga /jogging are great ways to not only live healthily but also to get the anxiety and stress out of your system.

6. Make sure to get enough sleep. Some helpful techniques to prepare you for bedtime: avoid watching TV at night, tone down the lights in your room, drink warm milk, read a book.

7. When you get up in the morning, smile at yourself in the mirror and say “Hi beautiful/handsome, let’s have a great day!”

This is the continuation of the previous article on Depression and Dementia.

What is the relationship of Depression and Alzheimer’s Disease (AD)?
• The biological changes caused by AD may intensify a predisposition to depression;
• Depression may increase the chances of developing AD;
• Depression can affect quality of life of persons with AD:
   ◦ Worsening cognitive decline
   ◦ Greater disability with regard to Activities of Daily Living
   ◦ Increased dependence on caregivers

What is the difference between Depression and Dementia?
• Depression develops more quickly than Dementia
• Problems with speech, reasoning, orientation to time & space usually common in persons with Dementia & not with Depression.
• Persons with Depression may occasionally complain of difficulty remembering but will be able to do so with prompts.
• Persons with Depression may complain of impaired reasoning & memory but these improve after medication or when depression lifts
• Lack of motivation (apathy) to do things seen in both conditions, but this disappears when anti-depressive medication is given.

(sources: helpguide.org., alheizmer.org.uk, mayoclinic.org)

Causes of Depression
• Traumatic event
• Changes in one’s life situation (e.g. retirement, moving to a new house)
• Effects of certain illnesses or side effect of medication
• Social Isolation or lack of social support
• Lack of meaningful things to do (e.g. after retirement)
• Worries over issues of money, relationships

Signs of Depression
A persistent condition characterized by feelings of:
• Sadness & hopelessness
• Loss of energy & appetite
• Loss of interest or pleasure in activities once enjoyed
• Problems remembering, concentrating or making simple decisions
• Increased agitation and restlessness

Managing Depression
• Self help
   ◦ Regular physical exercise (e.g. walking, yoga, Zumba dancing)
   ◦ A reassuring regular daily routine
   ◦ Planning social activities with people, decreasing social isolation
   ◦ Increased time spent doing enjoyable activities (reminiscence & life story work, cooking with a group)
   ◦ Engaging in a hobby (e.g. crocheting, reading)
   ◦ Volunteering one’s time and talents in an organization
   ◦ Making changes in the environment (reducing unwanted stimuli e.g. lights, noise, crowds)

• Talking Therapy (individual counseling & w/ support group)

• Medical Management (Antidepressant Medication)

(sources: helpguide.org., alheizmer.org.uk, mayoclinic.org):

We all experience stress at work and at home. Here are some facts about stress to help us understand and manage it better (sources: helpguide.org., alheizmer.org.uk, mayoclinic.org):

What is Stress?
• Body’s way of responding to perceived threats
• Body releases stress hormones (e.g. adrenaline, cortisol) which cause
• Physical changes in your body (“fight or flight”)
• Equips you to respond to situation (e.g. focused, alert)
• Too much and too long is harmful to your body and mind

Signs of Stress: Cognitive Symptoms
• Memory problems
• Inability to concentrate
• Poor judgement
• Seeing only the negative
• Anxious racing thought
• Constant worrying

Signs of Stress: Emotional Symptoms
• Moodiness
• Irritability or short temper
• Agitation, inability to relax
• Feeling overwhelmed
• Sense of isolation, loneliness
• Depression or general unhappiness

Signs of Stress: Behavioral and Physical Symptoms
• Eating more or less
• Sleeping too much or too little
• Isolating yourself from others
• Using alcohol, cigarettes or drugs

Getting Help:
• When experiencing low mood and difficulties with memory, consult your doctor (neurologist) or go to the Brain Wellness Center at Asian Hospital & Medical Center to investigate cause;
• Depression and stress can cause changes in thinking & memory function which can sometimes be mistaken for dementia;
• Neurocognitive screening will help determine whether changes are due to dementia and depression/anxiety/stress;
• Appropriate diagnosis will lead to appropriate intervention.