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Anthea Rowan

This is the first instalment in a series on dementia, including the research into its causes and treatment, advice for carers, and stories of hope.
There was a time I didn’t know anything about dementia – other than it meant a person lost their memory. Right?
I certainly didn’t know how common it was. But common it is: 55 million people are living with the condition worldwide.
With nearly 10 million new cases every year, there will be almost 80 million dementia sufferers by 2030, and 139 million by 2050, according to the World Health Organization.
And I had no idea that dementia is the seventh leading cause of death and the major cause of dependency among older people globally.
I didn’t know these things because I didn’t need to. Not until my mother forgot who I was did it occur to me to look at the stats and the facts of this illness.
Fifty-five million.
You can’t cure dementia but you can lower risk of suffering it, doctors say
It’s a terrifying number but, if you’re one of those millions more who care for, and live with, those 55 million, it’s oddly comforting: I’m not alone in all this.
I have a daily Google news alert set for “dementia”. On the day of writing, ABC News describes a course on how to care for a patient with dementia (it’s important, but it makes it sound simpler than it is); a study published in Washington finds that an underactive thyroid may predispose a person to dementia; and several sites carry the story of an elderly man with Alzheimer’s disease who has gone missing.
Yesterday’s news carried a piece on the sensory changes dementia sufferers endure. I recalled a description from a virtual dementia tour, as described by the American writer Dani Shapiro, in which participants wore thick gloves to mimic the lack of dexterity that accompanies dementia, and earphones that played a rattle of sound to conjure the auditory challenges.

My mother’s compromised senses manifest mostly in touch: her perception of heat and cold is muddled, as is that of wet and dry. As she pats down her bed, she complains: “It’s damp.” It’s dry as a bone.
The Centres for Disease Control and Prevention – the US national public health agency, based in Atlanta, Georgia – defines dementia not as a specific disease, but rather “a general term for the impaired ability to remember, think, or make decisions”.
Alzheimer’s disease – my mother’s diagnosis – is the most common type of dementia; it accounts for up to 80 per cent of dementia cases.
She remembers little of her past, and cannot decide what to do now, in the present, nor what to do next: get up, get dressed, make a mug of tea? That’s mostly because she often cannot remember how to do these things, or where the things involved in the doing are.
As the daughter of a woman who lives with the illness … I am determined to avoid my mother’s fate

But dementia is not just about remembering or thinking or decision-making. My mother has visual hallucinations: people that I cannot see apparently walk across the lawn, while invisible children play on an unseen swing.
Sometimes these visions perturb her: “Why are those people in the garden, when will they go?”
I buy into the fantasy to reassure her: “They’ll go soon mum. Shall we have a cup of tea?”
Tips on avoiding Alzheimer’s and where to turn when it’s a loved one
Distraction is a useful tool in the face of dementia. A sufferer cannot hold a thought for long. Or remember it. The moment passes and she is calm again.
Dementia is also about the blurring of lines between what is real and what is not: frequently my mother, having spent a peaceful afternoon in front of the television, will describe the characters of a well-known Netflix series as people she has met in real life.

I first encountered dementia in a friend’s mother. I watched as she guided her mum gently by an elbow towards a seat when, as a group, we went out for lunch, or gathered at a child’s birthday party. Her mother said nothing, looking vacantly, uninterestedly, silently on.
I never attempted to greet her. I am ashamed of that now: a warm hand on her shoulder as I passed, a smile, a hello. While all these things would have gone unacknowledged by my friend’s mother, they would have been noticed, and welcomed, by my friend.
Why didn’t I greet her? Or sit by her for a few moments and chat to her? Was I scared of her? Embarrassed?
Mostly, I think, I didn’t know what to do, or say. So I did something worse: nothing.
Dementia, Alzheimer’s and the rising toll on working carers
While I am ashamed, retrospectively, I don’t think my response in the face of dementia is unusual. I watch friends now, giving my mother a wide berth. I don’t blame them. But I wish they understood and behaved differently. Because I wish I had.
According to the London-based Alzheimer’s Disease International – an umbrella organisation of more than 100 associations around the world that support people with dementia and their families – someone in the world develops dementia every three seconds. Let me say that again: every three seconds.
We’re living longer. And while getting old means you’re more at risk of it, dementia isn’t an inevitable part of ageing.

This single fact is heartening. There are things you can do to minimise your risk. As the daughter of a woman who lives with the illness, and one who knew nothing about it until I was forced to get up close and personal with it, I am determined to avoid my mother’s fate.
Regular exercise, studies suggest, lowers the risk of cognitive decline by 35 per cent; remaining socially active reduces it by 15 per cent; and doing household chores reduces it by 22 per cent.
If we arm ourselves against dementia with information, will we be safe?
Possibly. But only if we know what it looks like.
Like what you read? Follow SCMP Lifestyle on Facebook, Twitter and Instagram. You can also sign up for our eNewsletter here.


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Wellness

How caring for a parent with dementia taught me about symptoms, prevention and why seeking out the latest research is so important

Author Anthea Rowan (right) with her mother.

Author Anthea Rowan (right) with her mother, who has Alzheimer’s disease, the most common type of dementia. Photo: Anthea Rowan

Anthea with her mother. Photo: Anthea Rowan

Studies suggest that regular exercise lowers the risk of cognitive decline by 35 per cent. Photo: Getty Images

Staying active can help prevent or delay the onset of dementia, studies suggest. Photo: Shutterstock

Why healthcare for an ageing population should focus on disease prevention, rather than treating people when they’re already ill

Rather than just treating diseases as they occur, preemptive screening for at-risk age groups and education are key to proper healthcare for an ageing population. Photo: Shutterstock

“Ageing in place” involves older people being given opportunities to lead productive lives and to be able to remain in their homes rather than having to move into institutions. Photo: Shutterstock 

John Beard, director of the Global Centre for Modern Ageing at Flinders University Tonsley in Adelaide, Australia. Photo: Global Centre for Modern Ageing

Educating people on how to age well will help them live longer, healthier lives, experts say. Photo: Shutterstock

A common consensus among experts is that current healthcare systems are focused on helping sick people get well rather than on preventing illness. Photo: Shutterstock

Elderly women sitting in a bench in a housing estate in Hong Kong. Redeveloping and redesigning the healthcare system may help people live longer, healthier lives all around the world. Photo: Getty images 

Until Alzheimer’s disease has a cure – dementia experts are optimistic that will be soon – mitigating risk factors is key

Alzheimer’s disease accounts for 70 to 80 per cent of all dementia in people over the age of 60. Photo: Shutterstock

Professor Nancy Ip is a neuroscientist at the Hong Kong University of Science and Technology who says new findings are deepening our understanding of Alzheimer’s and revealing promising drug targets for development. Photo: Nancy Ip

Dr Bosco Ma says Alzheimer’s disease accounts for 70 to 80 per cent of all dementia in people over 60. Photo: Dr Bosco Ma

Experts advise against arguing with someone who has Alzheimer’s. Photo: Shutterstock

A healthy brain compared to a brain with Alzheimer’s disease. Illustration: Shutterstock

How to live a longer, healthier life: 6 expert tips and tricks, from being happy and getting enough sleep to exercising more and not stressing out

Experts reveal what six habits you should introduce to your lifestyle to gift yourself a longer, healthier life. Photo: Shutterstock

Eating a diet of mostly plants has been proven to reduce our risk of chronic diseases. Photo: Shutterstock

Veganuary happens in January, and there is no better time to remind ourselves of the benefits of having a plant-based diet. Photo: Shutterstock

Dr Anna Herby is the nutrition education programme manager at the Physicians Committee for Responsible Medicine in the United States. Photo: Anna Herby

Having regular health check-ups can help flag issues early so you can treat them more easily. Photo: Shutterstock

Dr Lily Wong is a family doctor at The London Medical Clinic in Hong Kong. Photo: Lily Wong

Aim to get a minimum of seven to nine hours of quality sleep a night. Photo: Shutterstock

To live a longer and healthier life, learn to de-stress. Yoga, meditation and breathwork all help to ease anxiety. Photo: Shutterstock

Lifestyle

Health & Wellness

Health

Family & Relationships

Decoding dementia

Why should you have a brain scan to test for dementia when there’s no cure? Knowing can help you delay its onset, neurologist says

It can be daunting to get a brain scan to test for signs of dementia, but a neurologist behind new research reveals the advantages of knowing early. Photo: Shutterstock

New research has found that dementia can be detected as early as nine years before symptoms manifest, and this could have significant implications for treatment. Photo: Shutterstock

Timothy Rittman, the neurologist who led the dementia research at Cambridge University. Photo: Cambridge University

A brain scan showing signs of dementia. Photo: Getty Images

Lizzie Perry, founder of This is Dementia, with her father, who was diagnosed with the disease at 58. Photo: This is Dementia

The approval in the US of a new drug that slows the onset of Alzheimer’s makes Rittman hopeful about the future of dementia treatment. Photo: Cambridge University

Why women are more likely to have dementia than men as they age, and how exercise and engagement can help lower your risk

Women may be at a greater risk of developing Alzheimer’s than men for a number of reasons: biological, societal or cultural. Experts suggest exercise and social engagement can help offset the risk. Photo: Getty Images

The spread of tau – the protein that clumps into the telltale tangles of dementia – may contribute to Alzheimer’s disease. Photo: Shutterstock

Female twins with a male co-twin were less likely to be diagnosed with dementia than female twins with a female co-twin. Photo: Shutterstock

Prenatal care and monitoring pregnant women’s health is key, as it may impact cognition and dementia risk in later life. Photo: Shutterstock

Taking regular exercise is key for women – and men – to reduce the risk of dementia. Photo: Shutterstock

How high or low blood pressure increases the risk of dementia, and why it’s never too late, or early, to adopt a healthy lifestyle to manage it

Having blood pressure that is too high or too low has been linked to a higher risk of dementia, but it’s never too late to start living a healthy lifestyle that will help maintain optimal blood pressure. Photo: Shutterstock


An optimal blood pressure reading, easily measured with a home device, is around 120/80. Photo: Shutterstock

Dr Ruth Peters was lead author of a study looking at the links between blood pressure and dementia. Photo: Dr Ruth Peters

It’s never too late, or too early, to start thinking about brain health and living a healthy lifestyle. Photo: Shutterstock

Problems with reasoning, planning, judgment, memory and other thought processes may result from damage caused by impaired blood flow to the brain – which may be brought on by high blood pressure. Photo: Shutterstock

6 dementia fighting tips from Dr Sanjay Gupta and Marc Milstein, experts on brain health – walk, talk, read, learn, relax, and eat and drink properly

We can protect ourselves against the risk of dementia with some simple lifestyle practices. Exercising (above), eating a good diet, drinking less alcohol, socialising, reading more and trying new things all help keep the brain sharp, say brain experts including Dr Sanjay Gupta. Photo: Shutterstock 

The cover of one of Dr Sanjay Gupta’s book. Photo: Simon & Schuster

The cover of Marc Milstein’s book. Photo: Marc Milstein

Drink alcohol mindfully and ask yourself why you are having that drink. Photo: Shutterstock

Learning new things creates new brain cell connections and helps keep your mind sharp. Photo: Shutterstock

Reading is good for brain health. Try to read a wide range of book styles, and join a book club to discuss with others what you are reading. Photo: Shutterstock

During sleep, our brains are restored and repaired, so relaxing is important if we’re going to get those seven hours of quality sleep. Photo: Shutterstock

Relationships keep us engaged, interested and interesting, and may help prevent dementia. Photo: Shutterstock

‘Like a light switch’: how sundowning syndrome affects dementia sufferers – and their carers; what it is and tips for how to cope

A person with dementia may experience “sundowning” syndrome - towards the end of the day they become more agitated, confused, panicked, resistant to instruction and restless. This affects their carers, too. Photo: Shutterstock

A person in bed, unable to sleep. Conservative estimates suggest about 20 per cent of dementia patients experience sundowning at some point.

Trey Todd is a neuroscientist at the University of Wyoming. Photo: Trey Todd

Sundowning was coined in 1987 by Lois Evans of Penn Nursing at Pennsylvania University. Photo: University of Pennsylvania

The pineal gland in our brain produces melatonin, which is what helps prompt us to sleep and awaken. In a broken system it is disrupted. Melatonin supplements might help fight sundowning. Photo: Shutterstock

Taking a patient with sundowning syndrome for a walk at a consistent time each day, morning or evening, may alleviate symptoms. Photo: Shutterstock

Getting out into the daylight early in the day is good for our sleep patterns, whether we have dementia or not. Photo: Shutterstock

Healthy marriage, healthy mind? Dementia risk lower for people married a long time, studies show; expert suggests why

Research suggests that people who have stayed married for a long time have a lower risk for dementia because they feel less lonely, are more likely to eat well and exercise more, and are more cognitively engaged. Photo: Shutterstock

Vegard Skirbekk is a researcher at the Norwegian Institute of Public Health. Photo: Norwegian Institute of Public Health

Anthea Rowan’s parents on their wedding day. Photo: courtesy of Anthea Rowan

A long-time married partner represents a security that provides a buffer against stressors. Photo: Shutterstock

Anthea Rowan and her husband on their wedding day. Photo: courtesy of Anthea Rowan

If you live with a partner long term, you are more likely to develop healthy daily patterns, to eat well and exercise more. Photo: Shutterstock

‘Dementia village’ that’s the first of its kind helps residents live normal lives, has a restaurant, theatre and supermarket – and no one wears a white coat

Residents are free to live their lives as they like at the world’s first “dementia village”, The Hogeweyk in The Netherlands. Photo: The Hogeweyk

The Hogeweyk, a “dementia villlage” in the Netherlands, provides care and a familiar and safe environment in which people with dementia live while retaining their own identity and autonomy as much as possible. Photo: The Hogeweyk

Jannette Spiering is the senior managing adviser and co-founder at The Hogeweyk in the Netherlands, which offers “humanising care for people with dementia”. Photo: The Hogeweyk

Residents relax around the fountain in the theatre square at The Hogeweyk. Photo: The Hogeweyk 

Residents of The Hogeweyk respond positively to their increased autonomy. Photo: The Hogeweyk

Residents at the healthcare facility take part in a painting class. Photo: The Hogeweyk

Hearing loss dramatically raises the risk of dementia, so why are so many people in midlife doing nothing to prevent it? A test is easy to arrange

Hearing loss has been linked to a higher risk of dementia and cognitive decline,  say experts, who recommend testing for preventable hearing problems (above).  Photo: Getty Images

Alison Huang, a senior research associate at the Cochlear Centre at Johns Hopkins, in the US, says hearing loss makes the brain work harder to process sounds. Photo: Johns Hopkins

Jiang Fan from the School of Public Health at China’s Shandong University. Photo: Shandong University

Checking your hearing in midlife is crucial, and can help you stave off cognitive deterioration. Photo: Shutterstock

Can HRT reduce dementia risk? New hormone replacement therapy studies say yes, upending 2002 reports

HRT use has been linked to better cognition, blood flow and brain size and a reduction in all neurodegenerative disease in recent studies. Photo: Shutterstock

HRT (hormone replacement therapy) use has been linked to better cognition, blood flow and brain size and a reduction in dementia and other neurodegenerative disease in recent studies. Photo: Shutterstock

If HRT is started after the age of 65, brain cells will have already been deprived of oestrogen for many years. This could mean there is a decline in neuronal connections – the brain’s messaging system. Photo: Shutterstock

HRT was found to be most effective when introduced early in menopause, says Anne Marie Minihane, director of the UK’s Norwich Institute of Healthy Ageing at the University of East Anglia. Photo: University of East Anglia

Dr Andrea Kwakowsky from at the University of Galway in Ireland believes the “critical period” for starting HRT is within five years of menopause. Photo: University of Galway

How can you prevent dementia? Free brain health online tool teaches the risks and gives essential tips on avoiding it

The new free “Think Brain Health Check-in” online tool from Alzheimer’s Research UK doesn’t test your memory but checks how well you’re looking after your brain and gives tips to help prevent dementia. Photo: Shutterstock

Dr Susan Mitchell is head of policy at Alzheimer’s Research UK. Photo: Dr Susan Mitchell

The Think Brain Health Check-in asks how often you challenge your brain - and then highlights why challenging your brain is key to staving off dementia. Photo: Shutterstock

Getting a good night’s sleep every night is one way to lower the risk of developing dementia. Photo: Shutterstock

Up to 40 per cent of dementia cases could be prevented if people were mindful of the risk factors for the illness and made lifestyle changes to prevent them. Photo: Shutterstock

Can lack of sleep raise dementia risk? Yes, studies say – but with one exception

Having only five hours of sleep a night can increase dementia risk by 30 per cent for adults over 50, one study says. Photo: Shutterstock

One tip to overcome insomnia is to avoid clock-watching. Photo: Shutterstock

Taking a warm shower or bath in the hour or so before bed may help you fall asleep – and stay asleep. Photo: Shutterstock

Professor Roger Wong of the department of public health and preventive medicine at the State University of New York’s Upstate Medical University. Photo: Roger Wong

Sleep aids can heighten dementia risk, Wong says. Photo: Shutterstock

Can’t sleep? Try getting up and engaging in cognitively stimulating activities, like reading or making jam. Photo: Shutterstock

Dementia and ACB scores: how common prescription and over-the-counter drugs raise the risk of memory loss and cognitive decline

Certain common drugs, including antihistamines, antacids, antidepressants and anti-anxiety medicines, can disrupt the neurotransmitter acetylcholine, dubbed the “memory molecule” increasing the risk of dementia. Photo: Shutterstock

The writer, Anthea Rowan, with her mother. Photo: Anthea Rowan

Taking medications that block the action of acetylcholine can lead to memory loss, problems with spatial awareness, and cognitive decline. Photo: Shutterstock

Studies have found that anticholinergic drugs carried “significant’ dementia risk” for the over-65s. Photo: Shutterstock

Doctors need to be mindful of the risks posed by anticholinergic drugs, especially to an already at-risk population: the over 65s. Photo: Shutterstock

How to safeguard your ageing brain: build ‘cognitive reserve’ with mental and physical exercise, and stay active and socially engaged

The phrase ‘use it or lose it’ is not just a hypothesis, it’s a basic biological fact that holds as true for our brains as our muscles or bones. Photo:
Shutterstock

Our brains, like our muscles need regular use to stay healthy and flexible, say experts, and keeping our brains active builds our ‘cognitive reserve’, helping us to stave off dementia. Photo: Shutterstock

Geriatric psychiatrist Dr David Merrill recommends the active pursuit of activities that keep the brain sharp to stave off dementia. Photo: Dr David Merrill

Dorina Cadar says cultural and social engagement, reading, doing crossword puzzles, visiting art galleries, clubs and cinemas, and volunteering all increase our cognitive reserve. Photo: Dorina Cadar

Visiting an art gallery or doing something new and different are good ways to build up cognitive reserve. Photo: Shutterstock 

How yoga benefits dementia patients: new study uncovers brain-health boosts, supporting earlier research

Yoga has health benefits including better brain neuroplasticity, improved sleep quality, and more robust cardiorespiratory fitness, all of which help people experiencing cognitive decline or dementia. Photo: Shutterstock

Dr Diana Karamacoska is a research support programme fellow in healthy ageing and dementia at the NICM Health Research Institute at Western Sydney University. Photo: Courtesy of Diana Karamacoska

Yoga could be helpful in managing brain inflammation, particularly with its mindfulness component. Photo: Shutterstock

Wendy Du is the founder of Shan Studios in Hong Kong. Photo: Wendy Du/Shan Studios

Du has maintained a daily yoga practice for 10 years. Photo: Courtesy of Shan Studios

5 nutrients good for brain health that can delay dementia, or prevent it, and foods to eat with a high concentration of them

Research has identified some key nutrients we need in our diets to maintain good cognitive function and delay or prevent the onset of dementia. Photo: Shutterstock

Eating healthy isn’t just good for our bodies, it’s good for our brains, too. Photo: Shutterstock

Zahinoor Ismail, of the O’Brien Institute for Public Health at the University of Calgary. Photo: University of Calgary

Kale with pine nuts is a dish high in magnesium, and so good for brain function. Photo: Shutterstock

Oatmeal, and other wholegrain foods such as brown rice and quinoa, are rich in magnesium. Photo: Shutterstock

Mackerel is a fish that is especially high in magnesium. Photo: Shutterstock

How caring for a parent with dementia taught me about symptoms, prevention and why seeking out the latest research is so important

Anthea Rowan knew little about dementia until her mother developed Alzheimer’s and forgot who her daughter was In this first instalment in a series on dementia, the author explains how delving into research is key to preventing or delaying the condition in herself

Anthea Rowan knew little about dementia until her mother developed Alzheimer’s and forgot who her daughter was

In this first instalment in a series on dementia, the author explains how delving into research is key to preventing or delaying the condition in herself