Category Archives: Checklists

When a person perceives his memory or other cognitive function as “not as good as before” but scores within “average range” in objective testing, he may be experiencing Subjective Cognitive Decline (SCD) – the initial sign of Dementia.

The next stage of the disease is normally symptoms of Mild Cognitive Impairment (MCI).

This is when mild signs of cognitive decline start to appear although person is still able to function in his work (employment) and in activities of daily living.

Mild signs of decline could include forgetfulness, decreased efficiency in performing familiar tasks, disorientation as to place and time, changes in mood and behavior.

MCI is usually the stage before conversion to Alzheimer’s Disease (AD).

Dementia is the final stage in the expression of this disorder.

SCD and MCI do not always follow this course. For instance, there have been cases where a person’s SCD progresses to MCI and then goes back to SCD. There are cases where a person goes directly from normal functioning to Dementia.

Source: Symposium speaker Wiesje M. Van Der Flier, UV University Medical Center Amsterdam, The Netherlands

In my practice, I have come across clients, particularly retirees, with complaints of deterioration of their memory. After a neuropsychological assessment, results showed that memory functioning was within average range compared to people in their age range. This meant that the memory”deterioration”was not really a deterioration but rather diminished memory capacity due to, in this case, depression. I have also noticed that some clients were less prone to depression and memory decline than others. These people:

1. Were engaged in an activity or hobby that they were passionate about.

2. Were engaged in some form of exercise on a regular basis (e.g. walking, swimming, gym/aerobic dancing).

3. Had friends or family with whom they spent time and shared activities with on a regular basis. These friends and family not only provided social interaction but emotional support as well.

4. Had a spiritual life.

5. Had enough hours of fitful sleep (6-8 hours).

6. Ate a healthy diet and had few medical/health issues.

7. Were optimistic and did not take themselves too seriously.

Actually, this list for a meaningful life after retirement can apply to anybody at any age! We would be happy campers indeed if we could incorporate most, if not all of the above, into our daily lives.

Dementia is a general term for a decline in mental ability severe enough to interfere with daily life. The most common type of dementia is Alzheimer’s Disease (The Alzheimer’s Association, alz.org).

Alzheimer’s Disease International (ADI) estimates that in 2013 there were 44.4 million persons worldwide with the disease. This number is estimated to increase to 75.6 million in 2030 and to 135.5 million in 2050. Much of the increase will be in developing countries – the fastest growth seen to take place in China, India and South Asia.

The following are tell-tail signs of Alzheimer’s Disease:

1. Memory loss
2. Difficulty performing familiar tasks
3. Problems with language & communication
4. Disorientation with regard to location or time
5. Poor or decreased judgement
6. Problems with keeping track of things
7. Misplacing things
8. Changes in mood and behavior
9. Changes in personality
10. Loss of interest in hobbies and personal activities

When a loved one is showing the above conditions, the Alzheimer’s Association recommends seeing a neurologist right away for a professional evaluation to determine the condition and to confirm if dementia is indeed the problem. Early diagnosis can give the person with dementia and his family the opportunity to explore available treatments, preserve quality of life and plan for the future.

Sources: Alzheimer’s Association (www.alz.org) and Alzheimer’s Disease Association (ADA), Singapore (www.alz.org.sg)

Is your child having problems in school (e.g. poor grades) and in social situations? Is

she at times described as “tamad” (lazy) or “matigas ang ulo” (hard headed)?

It may be good to answer the following questions to see if there is more to your loved one’s condition than the usual issues of a child:

1. Does your child have difficulty organizing tasks and activities?

2. Does he/she lose things necessary to perform these tasks and activities, such as toys, school assignments, pencils, books?

3. Does your child make careless mistakes in schoolwork and is not able to give close attention to details ?

4. Does he/she have a difficult time following through on instructions and finishing schoolwork and chores?

5. Does your child have difficulty sustaining attention in tasks and play activities?

6. Does he/she seem not to listen when spoken to directly?

7. Is your child forgetful in daily activities?

If the answer is yes to most of the above questions then your child may be manifesting a condition called ADHD (Attention Deficit Hyperactive Disorder) predominantly Inattentive Type *

If you notice these problems in your child, you can take the following measures:
– talk to your child’s teachers regarding their observations in the classroom;

– consult a Developmental Pediatrician and/or Psychologist for a formal assessment/diagnosis, intervention planning and referrals to appropriate professionals.

It is best to set an appointment with the “Dev Ped” as soon as possible as the waiting period may take as long as 6-8 months!

Teamwork with the Dev Ped, Psychologist, Teachers and other allied medical professionals (Occupational Therapists, Speech Therapists etc) will help you assess and document your child’s condition, and determine the interventions and accommodations needed to help your child and the family manage the situation effectively.

*(Source: DSM-IV-TR, pp 92-93)

As defined by the Centers for Disease Control & Prevention:
“Autism is a neurodevelopmental disorder characterized by impaired social interaction,verbal and non-verbal communication, and by restricted and repetitive behavior. The diagnostic criteria require that symptoms become apparent before a child is three years old.” It is important to watch out for early signs of the condition in you child. The earlier the diagnosis, the earlier the interventions, the better the outcome for the child. The better the outcome the better the quality of life for everyone in the family. The early signs are:

Early signs of autism in babies and toddlers
– Doesn’t make eye contact (e.g. look at you when being fed).
– Doesn’t smile when smiled at.
– Doesn’t respond to his or her name or to the sound of a familiar voice.
– Doesn’t follow objects visually.
– Doesn’t point or wave goodbye or use other gestures to communicate.
– Doesn’t follow the gesture when you point things out.
– Doesn’t make noises to get your attention.
– Doesn’t initiate or respond to cuddling.
– Doesn’t imitate your movements and facial expressions. (Source: Helpguide.org)

If you notice any of these behaviors in your baby, consult your pediatrician or a developmental pediatrician soonest.