Dementia signals are not just memory loss... EBS 'The Great Doctor' highlights early management methods

Dementia is not a term that refers to a single disease of losing memory. It refers to a state where cognitive function declines due to various causes, making it difficult to perform daily activities independently. In addition to memory loss, changes in emotion and behavior, as well as cognitive decline due to depression, are cited as major signals surrounding dementia. Among elderly people aged 65 and older in South Korea, 1 in 10 suffers from dementia, and 3 in 10 suffer from mild cognitive impairment, which is called the pre-stage of dementia. As it is a disease that affects not only the patients but also the lives of their families, it is becoming important to distinguish causes and symptoms and prepare for changes.

EBS 1TV 'The Great Doctor' will broadcast the episode 'Time to Protect Memory, Slow Down Dementia' on October 9 at 9:55 PM. Along with Professor Son Sang-jun of the Department of Psychiatry, the program will examine various causes of dementia, the progression of symptoms by cause, and the latest treatment insights, and cover the management methods necessary to slow the progression of dementia. The broadcast will introduce mild behavioral disturbance, late-life depression, and the possibility of checking dementia risk through blood tests.

Dementia that cannot be explained by memory loss alone

The term dementia is not a specific single disease name, but a term that describes a state of declined cognitive function. When cognitive function drops due to various causes and, as a result, a certain level of difficulty arises in performing daily life, it is called dementia. Therefore, not all dementias originate from the same cause or start with the same symptoms. All dementia cannot be explained by memory problems alone, and the changes and progression processes that appear can differ depending on the cause.

Mild cognitive impairment, which is well known as the pre-stage of dementia, is a state where cognitive function has declined compared to before, but independence in daily functions is maintained. Among the elderly aged 65 and older in South Korea, the population ratio suffering from dementia and mild cognitive impairment was presented as 1 in 10 and 3 in 10, respectively. The broadcast will introduce signals other than memory changes and the management process through cases of people diagnosed with dementia and cases of people who have been managing after a diagnosis of mild cognitive impairment.

Rather than treating dementia as a single disease, the program points out that symptoms can vary depending on various causes, and conveys the process of examining the causes along with the latest treatment insights. Additionally, it examines what kind of management is needed to slow down dementia.

Mild behavioral disturbance where emotional and behavioral changes appear first

The broadcast features the case of Ms. A, a woman in her 80s who was diagnosed with dementia 8 years ago. The first change that appeared in Ms. A was not simple memory loss. Ms. A, who was usually bright and not hesitant to express her emotions, at some point began to show almost no emotional response. Even when something big happened in the house, she showed a calm appearance unlike before. The program deals with mild behavioral disturbance, where changes in emotion and behavior appear before the decline in cognitive function, in this case.

If mild cognitive impairment is a state where cognitive function has dropped but independence in daily functions is maintained, mild behavioral disturbance is characterized by emotional and behavioral changes appearing first. The reason why the mental health psychiatry community has recently been paying attention to mild behavioral disturbance as a prodromal symptom of dementia is related to this symptom pattern. The broadcast introduces what other symptoms correspond to mild behavioral disturbance besides changes in emotional expression.

When mild behavioral disturbance is present, the risk of leading to degenerative brain disease is presented as up to 3 times. The broadcast also covers the content that in cases where mild behavioral disturbance and mild cognitive impairment appear simultaneously, it leads to dementia up to 40% of the time. This is a risk figure presented by the program, a part that explains the reason why mild behavioral disturbance is examined separately from mild cognitive impairment. The broadcast identifies changes in emotion and behavior that may appear before memory loss becomes distinct as one of the warning signals of dementia.

In Ms. A's case, the change first appeared as a difference in personality or emotional expression. Previously, she expressed her emotions well, but afterward, she showed almost no response even to big events in the house. The program introduces this change by distinguishing it from simple memory problems and pays attention not only to mild cognitive impairment, known as a prodromal symptom of dementia, but also to mild behavioral disturbance. It also presents the figures for cases where mild behavioral disturbance and mild cognitive impairment appear together to deal with the difference and relationship between the two states.

Cognitive decline due to depression and pseudodementia

Ms. B, a woman in her 70s, suffered from depression while caregiving for her husband's Alzheimer's disease. Later, as symptoms of frequent physical pain and blurred memory appeared, she felt the fear that she herself might have dementia. The diagnosis received at the hospital was cognitive decline due to depression, namely, pseudodementia. The program introduces cases where memory, concentration, and thinking ability decline due to late-life depression and examines them by distinguishing them from dementia caused by degenerative brain diseases.

Pseudodementia refers to a state where declines in memory, concentration, and thinking ability appear similar to dementia, but the actual cause is a mental health problem such as depression. Citing the 2024 Lancet Commission on Dementia report, the broadcast materials report that depression increases the risk of dementia by more than 2 times. At the same time, it explains that it differs from dementia caused by degenerative brain diseases in that cognitive function can be recovered again if the underlying depression is treated.

Ms. B suffered from depression after caregiving for her husband and experienced physical pain and memory decline. After visiting the hospital with the thought that it might be dementia, she received a diagnosis of cognitive decline due to depression. Through this case, the broadcast deals with situations where it cannot be immediately considered dementia just because memory has become blurred. It introduces the characteristics of pseudodementia, where symptoms appear similar to dementia, and points to examine when distinguishing it from real dementia.

The program does not treat late-life depression as a separate issue from dementia. While depression is presented as a factor that increases the risk of dementia, it also conveys that cognitive decline caused by depression has the possibility of recovering after the underlying condition is treated. Through this, the show covers how diagnosis and treatment can differ depending on the cause, even if similar declines in memory and concentration appear. Distinguishing the characteristics of pseudodementia from real dementia is one of the topics to be explored in the broadcast.

Methods for identifying risk through blood tests and management cases

Mr. C, a man in his 70s, has consistently engaged in physical exercise and social activities after being diagnosed with mild cognitive impairment four years ago. In a recent brain age test, the result showed he is 9.6 years younger than his actual age. The original text introduces Mr. C as a case of slowing the progression of dementia through management. The broadcast asks not only about management after symptoms appear but also whether dementia risk can be identified before symptoms manifest.

A blood test is introduced as a diagnostic method gaining attention recently. While brain imaging is mainly used to check the current progression of dementia, it is explained that blood tests can identify risk factors related to dementia using a small amount of blood. The program also covers how discovering risk factors in advance can delay the progression of dementia as much as possible through appropriate management and treatment. However, the questions of how far blood testing has progressed and when it can be utilized in actual clinical settings are presented as topics to be examined in the broadcast.

After being diagnosed with mild cognitive impairment four years ago, Mr. C continued physical exercise and social activities, receiving a result in a brain age test that he is 9.6 years younger than his actual age. The original text explains this as a case of slowing the speed of dementia progression according to management. Along with this case, the program examines methods for identifying risk factors through blood tests and the possibility of management after early detection.

The broadcast covers dementia-related signals and diagnostic methods that are difficult to identify through memory loss alone, such as emotional changes, late-life depression, and blood tests. It examines the symptoms and progression processes that appear depending on the cause of dementia, latest treatment insights, and introduces management methods to delay dementia. The episode ‘Time to Protect Memories, Delay Dementia’ will be broadcast on Friday, October 9 at 9:55 PM on EBS 1TV, and can be rewatched on the EBS website after the broadcast.

Read the original (Korean)