Clinically referred to as Major Neurocognitive Disorder, dementia is characterised by a
significant decline in one or more cognitive domains, including memory, attention, language,
executive functioning, perceptual-motor skills, and social cognition. According to the
DSM-5-TR and ICD-11, this decline interferes with independence in daily activities and
represents a deterioration from previous levels of functioning.

Dementia is typically progressive and results from underlying neurological or medical
conditions affecting the brain.

Types of Dementia

1. Alzheimer’s Disease
Alzheimer’s Disease is the most common form of dementia.
Key Features:

•  Gradual memory loss, especially for recent events
•  Difficulty with language and problem-solving
•  Disorientation and confusion
•  Progressive decline in daily functioning

2. Vascular Dementia

Vascular Dementia occurs due to reduced blood flow to the brain, often following strokes or
chronic vascular conditions.

Key Features:

•  Impaired judgment and planning
•  Slowed thinking
•  Stepwise cognitive decline
•  Associated cardiovascular risk factors

3. Lewy Body Dementia

Lewy Body Dementia is associated with abnormal protein deposits called Lewy bodies in the
brain.
Key Features:

•  Fluctuating cognition and attention
•  Visual hallucinations
•  Parkinsonian symptoms such as stiffness and tremors
•  Sleep disturbances

4. Frontotemporal Dementia
Frontotemporal Dementia primarily affects the frontal and temporal lobes of the brain.
Key Features:

•  Marked personality and behavioural changes
•  Loss of social awareness and inhibition
•  Language difficulties
•  Early onset compared to other dementias

Common Symptoms of Dementia

Cognitive Symptoms

•  Memory loss affecting daily life
•  Difficulty concentrating and reasoning
•  Poor judgment and decision-making
•  Language and communication problems
•  Disorientation to time and place

Behavioural and Psychological Symptoms

•  Mood swings, anxiety, or depression
•  Irritability and agitation
•  Suspicion or paranoia
•  Apathy and social withdrawal
•  Hallucinations or delusions in some cases

Functional Symptoms

•  Difficulty performing routine tasks
•  Challenges in managing finances or medications
•  Problems with personal hygiene
•  Increasing dependence on caregivers

Early Warning Signs

Recognising early symptoms can lead to better outcomes:

• Frequent forgetfulness
• Difficulty finding words
• Misplacing items regularly
• Getting lost in familiar places
• Trouble completing familiar tasks
• Changes in personality or behaviour
• Decline in work or social functioning

When to Seek Professional Help
Consult a healthcare professional if an individual experiences:

•  Persistent memory loss
•  Confusion or disorientation
•  Difficulty managing daily activities
•  Noticeable personality or behavioural changes
•  Challenges with communication
•  Progressive cognitive decline

Early diagnosis allows better management, planning, and support.

Delirum

delirium is a neurocognitive disorder characterised by an acute and fluctuating disturbance in
attention, awareness, and cognition. According to diagnostic systems such as the DSM-5-TR
and ICD-11, delirium:

• Develops over a short period (hours to days),
• Represents a change from baseline functioning,
• Fluctuates in severity throughout the day, and
• Results from an identifiable medical or physiological cause.

It is considered a medical emergency, particularly among hospitalised and elderly
individuals.

Core Symptoms of Delirium
Cognitive Symptoms

•  Reduced attention and concentration
•  Disorientation to time, place, or person
•  Memory disturbances
•  Confused or disorganised thinking
•  Difficulty understanding or communicating

Perceptual Disturbances

•  Visual or auditory hallucinations
•  Misinterpretations and illusions
•  Paranoid or delusional thoughts

Behavioural and Emotional Symptoms

•  Agitation or restlessness
•  Irritability, anxiety, or fear
•  Sudden mood changes
•  Suspiciousness or withdrawal
•  Emotional instability

Physical and Sleep-Related Symptoms

•  Disturbed sleep-wake cycle
•  Daytime drowsiness and nighttime agitation
•  Reduced or increased motor activity
•  Fluctuating levels of consciousness

Types of Delirium

1. Hyperactive Delirium

•  Restlessness and agitation
•  Hallucinations and irritability
•  Increased alertness and emotional instability
•  Often easily recognised

2. Hypoactive Delirium

• Lethargy and reduced responsiveness
• Drowsiness and slowed movements
• Withdrawal and decreased interaction
• Frequently mistaken for depression or fatigue

3. Mixed Delirium

•  Alternating periods of hyperactivity and hypoactivity
•  Fluctuating levels of alertness and behaviour

Warning Signs Requiring Immediate Attention
Seek urgent medical care if a person experiences:

• Sudden confusion or disorientation
• Rapid behavioural or personality changes
• Hallucinations or severe agitation
• Extreme drowsiness or unresponsiveness
• Difficulty speaking or staying alert
• Confusion following surgery, infection, or medication changes

Early intervention can be lifesaving