Cognitive Disorder (Dementia) is a chronic illness that affects memory, thinking, and behaviour, and is commonly seen in older adults. Dementia is not a normal part of ageing — it is a medical condition affecting brain function that requires professional assessment and care. The most common type is Alzheimer’s Disease, followed by Vascular Dementia and Lewy Body Dementia.
In Hong Kong, the prevalence of cognitive disorders has been increasing year by year with the ageing population. According to the Hospital Authority, around 10% of people aged 65 and above suffer from varying degrees of cognitive impairment. According to the Hong Kong Alzheimer’s Disease Association, there are approximately 100,000 people living with dementia in Hong Kong. The prevalence among adults aged 70 and above is estimated at 5–10%, rising to around 30–40% among those aged 85 and above. Many people mistakenly assume memory decline is an inevitable part of ageing, leading them to overlook early warning signs and miss the optimal window for intervention.
Early Warning Signs
Early warning signs of dementia include:
- Repeatedly asking the same questions or retelling the same stories
- Misplacing commonly used items and being unable to retrace steps to find them
- Getting lost in familiar places or failing to recognise familiar people
- Noticeably impaired judgement or financial management abilities
- Significant changes in personality or mood — such as sudden suspiciousness, anxiety, or emotional withdrawal
If an older adult shows any of the above signs, a cognitive assessment by a psychiatrist or geriatrician should be arranged as soon as possible to rule out other treatable causes and establish an appropriate management plan.
Symptoms
Symptoms of dementia can be grouped as follows:
- Cognitive impairment:
- Memory loss, especially short-term memory
- Difficulty with language comprehension and expression
- Impaired judgement and decision-making
- Disorientation (difficulty identifying time, place, or people)
- Emotional and behavioural changes:
- Mood instability, irritability, or anxiety
- Social withdrawal and loss of interest in activities
- Repetitive or compulsive behaviours
- Impact on daily functioning:
- Unable to independently manage dressing, eating, or finances
- Increased risk of wandering or accidents
Treatment and Management
Dementia currently has no cure, but comprehensive management can slow progression and improve quality of life. This includes:
- Medication: cholinesterase inhibitors and NMDA receptor antagonists can improve cognitive function and daily performance for Alzheimer’s disease and some other dementia types
- Non-drug interventions: cognitive training, regular exercise, and social activities help maintain thinking abilities and emotional stability
- Environmental and care support: creating a safe home environment, assisting with daily activities, and providing family education
Caregiver wellbeing matters too. Looking after someone with dementia is an enormous undertaking, and caregivers are at risk of exhaustion, anxiety, and depression. We encourage caregivers to make use of community support services (such as day care centres and respite care), and to seek mental health support if they are feeling overwhelmed. With the right professional support, appropriate treatment, and the loving presence of family, people living with dementia can maintain a dignified and meaningful quality of life within the limits of their condition.
