STIMULATED TASKS: Mr Lenny Leow, accompanied by his wife, Mdm Priscilla Lim, loves the 3-D software, which simulates real-life activities, such as buying groceries at the supermarket.
A NEW 3-D programme makes it easier to diagnose dementia, allowing patients to get treatment faster.
Retiree Mr Lenny Leow used to spend about three hours a day on the computer, surfing the Internet and playing games. But he was beginning to get a bit forgetful.
A doctor sent him for memory tests conducted by a psychologist. He was given a long list of questions which tested his memory, visual-spatial skills, executive function (ability to do a job), language skills and brain processing speed. It took him about two hours to answer all the questions.
“I was asked things like ‘What is 97 minus 8?’, and to join letters and numbers on a flowchart. The tests made me feel like a fool,” said Mr Leow, 80, who had taken at least three memory tests since he reported having memory difficulties about a year ago.
“I can be a little forgetful at times. I will forget where I put my mobile phone, but it’s not total memory loss. I can still do simple mathematics,” said Mr Leow, a former sales supervisor.
He was introduced to a new 3-D software that was developed to diagnose brain function in stroke and early dementia patients.
Conceived by the National Neuroscience Institute (NNI) and developed by Integrated Health Information Systems, the software simulates real-life activities, such as buying groceries at a supermarket or choosing ingredients for breakfast.
Playing a computer game
As patients perform the simulated tasks, data from their actions and decisions are tracked and compiled. A diagnosis can be made within 45 minutes, which is up to 80 per cent less than the time needed using conventional tests.
Mr Leow adapted very quickly to the software and even enjoyed himself. “It is so much more interesting than the questions the doctors used to ask me. It’s much faster too. I’m basically playing a computer game.”
Dr Nagaendran Kandiah, Consultant, Department of Neurology, NNI, has been developing the software since 2010.
He said: “As a diagnostic tool, the software needs less manpower than traditional tests. This translates to less waiting time at the hospital, earlier diagnosis and faster treatment.”
Although there is currently no cure for dementia, early diagnosis allows treatment to take place sooner and this helps to slow down the onset of the condition (see box).
Dr Nagaendran said there are three main stages of dementia: mild, moderate and severe.
It takes three to four years for the condition to progress from one stage to another. With early treatment, it could take as long as eight years for a patient’s dementia to deteriorate to the next stage.
Dr Nagaendran said Mr Leow suffers from mild cognitive impairment, which is the stage before mild dementia. The software can be used only by patients with good vision and who are computer literate, but Dr Nagaendran expects the number of elderly people who are computer literate to increase over time.
Meanwhile, his team is looking into ways of making the software more user-friendly, and there are plans to develop touchscreen and multilingual versions.
“There are also plans to market this as a home-screening tool that can be prescribed by doctors,” he said.
Stress may contribute to young onset dementia.
Although dementia typically affects those above 65 years old, the youngest patient at the National Neurological Institute (NNI) is 48 years old, according to Dr Nagaendran Kandiah, Consultant, Department of Neurology, NNI.
The patient suffers from young onset dementia, which can affect those between 40 and 65.
“This is worrying because younger patients are more economically active and, in their case, there’s a bigger social impact,” said Dr Nagaendran.
He said the cause of young onset dementia is not fully known but stress could be an indirect factor.
“When someone feels stressed, his diet is affected and he exercises less often. This can lead to other health conditions such as diabetes and high cholesterol that can cause strokes which, in turn, lead to dementia.”
USER-FRIENDLY: Dr Nagaendran Kandiah is looking into ways to improve the 3-D diagnostic tool.
Four common forms of dementia
1. Alzheimer’s disease
Accounts for about 70 per cent of all dementia cases.
Usually occurs in people 65 years and above.
Brain scans will show shrinkage of the brain’s memory centre.
Symptoms include short-term memory loss, changes in judgment or reasoning and
loss of the ability to perform familiar tasks.
2. Vascular dementia (dementia caused by strokes)
Accounts for about 25 to 30 per cent of all dementia cases.
Can occur in patients as young as 40 and is often related to stroke.
Because their memory can still be good, many patients fail to seek treatment.
Can be managed by preventing stroke.
3. Parkinson’s Disease (PD) with dementia
PD dementia accounts for about 5 to 10 per cent of all dementia cases. About 30 to 80 per cent of patients with PD will develop dementia.
Executive (job) and spatial functions might be affected.
4. Fronto temporal dementia
Accounts for 20 per cent of young onset dementia cases.
Usually occurs in patients in their 50s.
Affects mainly language ability and behaviour. Patients may behave impulsively, but their memory and orientation abilities remain relatively intact
• This story was first published in Singapore Health, Jan/Feb 2013.