Dementia: What Is It?

2023 Author: Wallace Forman | [email protected]. Last modified: 2023-08-25 11:04

Dementia: what is it?

It is estimated that around 130,000 people in Austria suffer from some form of dementia. Since most of the sick, around 75 percent, are cared for in the family environment - by their spouse or children - around four times as many people are directly or indirectly affected. Alzheimer's is the most common form of degenerative dementia.

Dementia occurs mainly in older people. Due to the growing proportion of old people, a significant increase in dementia is expected in the population over the next few decades.

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• Frequency is age-dependent
• Forms of dementia
• Symptoms
• Other causes of illness
• Treatment & care

Frequency is age-dependent

The frequency (prevalence) of dementia begins to increase significantly with advanced age.

• In the 65 to 69 age group, around 7 out of 1,000 women and 6 out of 1,000 men suffer from dementia.
• In the 85 to 89 age group, around 140 out of 1,000 women and around 90 out of 1,000 men are affected by dementia.

Most elderly dementia patients (around 60 to 80 percent) suffer from Alzheimer's disease.

Forms of dementia

A pathological change in the brain (primary dementia) can be caused by a degenerative change (shrinkage) of the brain or by a chronic disruption of the blood supply (vascular causes), but a combination of both causes is also possible.

• Degenerative dementia: e.g. Alzheimer's dementia, Lewy body dementia, frontotemporal dementia, Parkinson's dementia, dementia in Huntington's disease
• Vascular dementia: as a result of a stroke or several small strokes, subcortical arteriosclerotic encephalopathy.

Science assumes that the various forms cannot be clearly separated and often occur in a mixed form. The types of dementia are also often difficult to differentiate based on symptoms. The most common form of dementia is Alzheimer's dementia, with around 60 to 80 percent of all cases. Vascular dementia alone or in a mixed form with Alzheimer's disease occur in around ten to 20 percent of cases.

Symptoms

• Memory deterioration.
• Impairment of mental functions, such as language, ability to think, judgment, local and temporal orientation, etc. In certain forms of dementia (such as Parkinson's disease) the motor skills are also affected.
• Impairment of everyday activities or basic activities, e.g. washing, dressing, personal hygiene, etc.
• Chronically progressive course (deterioration) with personality changes or behavioral problems.

Other causes of illness

In so-called secondary dementia, there is no pathological change in the brain but another main disease. In these cases, the symptoms of dementia, especially the leading symptom of forgetfulness, may recede after the actual underlying disease has improved or healed.

Examples of secondary dementia symptoms:

• Alcoholism,
• Poisoning e.g. by trichlorethylene, carbon monoxide or heavy metals,
• adverse drug effects (interactions, overdoses),
• Insufficient nutrition (e.g. vitamin or iron deficiency) or insufficient fluid intake,
• Infections and inflammation with a high fever,
• Organ diseases (e.g. vascular or heart diseases, thyroid hormone disorders or underactive thyroid with thyroid hormone deficiency, diseases of the pancreas),
• Epilepsy,
• multiple sclerosis,
• Neurosyphilis,
• Inflammation of the brain (encephalitis)
• Brain tumor,
• Concussion, traumatic brain injury,
• psychological causes (anxiety, depression, grief, loneliness, mental inactivity) as well
• Social causes (retirement, conflicts, loneliness, rejection, prolonged stress).

Treatment & care

Degenerative dementias such as Alzheimer's disease cannot be cured. An important goal of treatment is to maintain mental performance and everyday skills for as long as possible and to alleviate behavioral disorders and other accompanying symptoms. Depending on the stage of the disease, the skills and needs of the patients change.

In order to find the right treatment, good cooperation with the treating doctor is important, in which the caregivers also play a very important role. In addition to drugs, various non-drug measures, such as targeted training in everyday activities, help to improve the quality of life of those affected.

The tasks of the treating doctor include (in addition to the diagnosis):

• Selection of medication,
• Suggestions for non-drug therapy measures,
• Information and education about the disease, its course as well as support and care options,
• Follow-up and adjustment of therapy.