Physician Recommends Self-Assessment Tool to Detect ‘Very Early Dementia’

Dementia is caused by encephalopathy (brain lesion) leading to decreased brain function. As the population ages, the number of people with dementia is increasing year by year.

According to statistics from the Ministry of Health and Welfare of Taiwan, the population of people with dementia will exceed 300,000 in 2022, of which 96 percent are over 65, and the trend is moving towards younger patients.

Dr. Liou Jhong-ping, a Taiwanese physician, pointed out that if the elders in the family are often forgetful and lose their temper because of this, but are unwilling to seek medical treatment, it is likely to be a manifestation of “very early dementia.”

Recently, Dr. Liou, a cardiologist, posted on Facebook some general features of common diseases. He said some diseases are difficult to treat, such as cancer and immune diseases. On the other hand, some, like high blood pressure, and high cholesterol are not that difficult to treat, the only problem here is the patients do not realize they need treatment.

The most difficult problem is that the patient does not know that he is sick, does not accept that he needs help, is unwilling to be treated, and is difficult to treat… that is dementia.

Dr. Liou shared some real-life cases he came across recently. He said that one relative and one friend consulted him about the situation of their parents on possible dementia.

The two elders were both highly active and successful men and women in their careers when they were young. What is puzzling here is, that their elders seem not to realize they might be starting to ‘degenerate.”

They often blame others for not explaining things clearly and misplacing things here and there so they cannot find them. Even worse they do not like to talk about their problem of declining cognitive ability in daily life.

Eight Point Scale to Help Early Detection

“Without the ‘sense of disease awareness,’ not realizing that he/she is sick, and therefore will have no idea of what the problem is, so how and where to start treatment?”

Dr. Liou explained that when you find your parents often forgetting where they put things, dropping money often, forgetting things that he/she was told to do earlier, and often throwing tantrums at others about it, then it is likely a symptom of “very early dementia.”

When the above happens, Dr. Liou suggested that it can be confirmed by the “Very Early Dementia Screening Scale.” If more than two of the eight questions are satisfied, the elders should be persuaded to admit there is a problem with his/her mental performance, and medical treatment should follow as soon as possible.

This scale is an attempt to overcome the indifference seen in most patients with “very early dementia,” who might not be aware of the worries of their family members, and as such are not willing to see a doctor.

Through this self-assessment, elders will become more aware of their own problems and can increase the patient’s sense of urgency too.

The “Very Early Dementia Screening Scale” consists of the following eight questions:

1. Difficulty in making a correct judgment: such as easily falling victim to fraud or a scam, making a bad financial decision, or buying a gift that is inappropriate for the recipient.
2. Decreased interest in activities and hobbies.
3. Repeat the same questions, stories, and statements continuously.
4. Difficulty in learning how to use tools, equipment, and gadgets. For example TV, stereo, remote control, air conditioner, washing machine, water heater, or microwave oven.
5. Forgetting the correct month and year.
6. Difficulty dealing with complex finances. For example personal or family balance of payments, bills, and income tax.
7. Difficulty remembering appointment times.
8. There are persistent thinking and memory problems.

Dr. Liou reminded us that Taiwan is currently entering an aging society, and dementia is all around us. Able to Identify patients as early as possible and seek medical treatment, and through the help of relatives, friends, and social welfare, together we can offer much help to the family elders to deal with hidden dangers earlier.