Recently, various movies are included in my class. While studying regarding ‘dementia’, one of the neurocognitive disorders, the eyes of the students watching a scene that can help them understand the symptoms in a related movie become moist, and the students presenting are choked up.
According to a report titled “Situation of Dementia in Korea 2019” published by the Central Dementia Center of the Ministry of Health and Welfare, the number of dementia patients is estimated to be 750,488 among the elderly population aged 65 or older, and the dementia prevalence was 10.2%. In other words, 1 in 10 people over the age of 65 suffer from dementia. The number of dementia patients is expected to continue to increase, exceeding 1 million in 2024, 2 million in 2039, and 3 million in 2050.
In terms of composition by type, ‘Alzheimer’s-type dementia’ accounted for 76.04% of the total, followed by ‘vascular dementia’ (8.57%). In addition, there is ‘Lewy Body Dementia’, which is characterized by many Parkinson’s disease symptoms, and ‘Frontotemporal Dementia’, which is characterized by behavioral and personality changes or language disorders.
Dementia is not always accompanied by memory impairment. In particular, in the case of frontotemporal dementia, personality changes occur first rather than memory impairment and disorientation in the early stages. Of course, due to the nature of dementia, damage to other cognitive functions follows the course of the disease, but unlike other types of dementia, abnormal behavior and personality changes are prominent. Therefore, it is often mistaken for other mental disorders in the early stages.
Such diverse types of dementia and the ever-increasing proportion of dementia patients reflect that we, who do not have dementia patients in our homes, are no longer ‘someone else’s business’ and are anxious beings who do not know when to shut up.
Dementia is divided into three stages, from early to late, according to the degree of progression. In the early stage when ‘recent memory decline’ begins, personal hygiene can be maintained and relatively social judgment is normally maintained, so early detection is often delayed. However, as it progresses, it becomes difficult to do basic daily activities such as driving, buying goods, and preparing food, and requires some help from people around you.
In the middle stage, symptoms such as memory loss and language ability, which were seen in the early stage, worsen, and social judgment is generally impaired. At this time, it often happens that you start to confuse people you know well and get lost even in familiar places. Often in movies and dramas, the scene where the main character with dementia acts passionately is also a symptom of this.
In the terminal stage, all intellectual abilities are severely damaged, and the ability to perform daily activities is severely reduced, and as the person cannot urinate or eat on their own, they spend most of the day lying down or mumbling to themselves, but they cannot understand what they are saying at all. In the end, you won’t be able to speak.
Dementia, which at some point has become a more feared disease than cancer in the elderly, is a disease that is difficult to accept not only for patients but also for their families. However, at the end of all the films reviewed through class time, scenes of family and spouse going through difficult processes together with love provide a momentary light. Among them, in the movie ‘Cassiopeia’, a young daughter says this to a mother who does not recognize her daughter because of her dementia. “It’s okay to forget. I’ll talk to you once more tomorrow,” she said. With this in mind, next time, I would like to talk regarding treatment methods that can be applied to patients with dementia in each stage.
Kim Eun-seong, professor at the Department of Occupational Therapy, Honam University
