Microsoft Word - IJHHS IMAM 23rd ASC 2022


  
 

 S33

Challenges in Managing Early Dementia with Multimorbidities in Primary Care  
  
Choong Siaw-Mei1, Lee Ping Yein2, Aneesa Abdul Rashid3  
  
Dementia is one of the most common disabling illnesses associated with aging. About 6.1% of the 
worldwide population aged 65 years old and above suffers from dementia. Early-onset dementia (EOD) 
refers to dementia becoming clinically manifested before the age of 65. The prevalence rate of early 
dementia is 40-100/100,000 in developed countries.  Primary causes such as Alzheimer's disease, is the 
most common cause (50-75%), followed by vascular dementia (20-30%).   

This case illustrates a 57-year-old lady with underlying diabetes mellitus, hypertension and 
dyslipidaemia who came for follow-up in the primary care clinic. Her husband complained that she had 
been having forgetfulness for the past 3 years. This included difficulty in remembering specific routes 
and she even got lost while driving home. Otherwise, she was still able to manage her basic daily 
activities including bathing, eating, dressing, grooming and toileting, hence the husband thought that 
this was common in aging and did not need any intervention or treatment. Her physical examination 
was unremarkable apart from her MMSE score was 22 out of 30 points, suggestive of mild dementia. 
The patient was subsequently referred to geriatrics and psychiatry. Her CT scan of the brain showed the 
presence of a multifocal infarct. The diagnosis of vascular dementia based on the multiple vascular risks 
and radiological findings was made even though there were physical neurological deficits.   
  

This case highlights the challenges in the diagnosis and screening of dementia in primary care. 
A multidisciplinary approach, an essential role of the family medicine specialist in providing holistic, 
continuous, coordinated, and comprehensive care to the patient is the cornerstone in managing patients 
with this diagnosis.  
  
Keywords: Dementia, Cognitive impairment, Vascular dementia, Silent stroke, Multimorbidity  
  

1. Klinik Kesihatan Pasir Panjang, Taman Pasir Panjang, 71250 Port Dickson, Negeri 
Sembilan  
2. E-Health Unit, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur  
3. Department of Family Medicine, Faculty of medicine & health sciences, Universiti 
Putra Malaysia, 43400 Serdang,  

 

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Correspondence to: Aneesa Abdul Rashid, Associate Professor and Medical Lecturer, Department of 
Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, 
Malaysia, aneesa@upm.edu.my 

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DOI: http://dx.doi.org/10.31344/ijhhs.v7i70.535