Things to know | DementiaHere you can learn how to recognize dementia, what types of dementia there are and how to live an independent life for as long as possible despite the disease. Your loved ones should also be aware of the clinical picture and understand how best to manage daily life together with dementia.
– What is dementia?? What causes. There are different forms of dementia? – What is Alzheimer's disease? – What is the course of progressive Alzheimer's dementia?? – What are the causes of Alzheimer's disease? – How to prevent Alzheimer's dementia? – What is vascular dementia?? – How to recognize dementia? – How is dementia medically diagnosed? – Are there therapy options for dementia?
What is dementia?
The essential characteristic of dementia is the deterioration to the point of loss of mental abilities. At the beginning of the disease, short-term memory and retentiveness are often impaired; as the disease progresses, the contents of long-term memory that have already been memorized also disappear. Those affected lose more and more of the skills and abilities they have acquired throughout their lives.
Dementia is much more than a "simple" memory disorder. In the course of their development, there is also an increasing impairment of attention, language, comprehension, thinking and orientation. Thus, a dementia disease shakes the whole being of the person – his perception, his behavior and his experience. A large number of different causes are described for dementia diseases. Basically, a distinction is made between primary. Secondary forms of dementia.
Secondary dementias are sequelae of other underlying diseases, such as metabolic diseases. Vitamin deficiencies and chronic intoxication caused by alcohol or medication. These underlying diseases are treatable. Partly even curable. Thus, a regression of the symptoms of dementia is often possible. Early diagnosis is particularly important for the differentiation and timely treatment of these dementias.
However, this only accounts for about ten percent of all cases of the disease. Up to 90 percent have a combination of both conditions. dementias that are generally irreversible. Since the introduction of the new concept of need for care in 2017, people with dementia have been. provides special support for their relatives: People suffering from dementia now have equal access to all long-term care insurance benefits. What causes. There are different forms of dementia?Alzheimer's disease is estimated to be the most common form of irreversible dementia, accounting for about 60 to 65 percent of all cases. Vascular dementia accounts for about 20 to 30 percent of all dementias. About 15 percent have a combination of both diseases. Other forms of dementia are found in only 5 to 15 percent of patients.
According to estimates, Alzheimer's disease is the most common irreversible form of dementia, accounting for approximately 60 to 65 percent of all cases.
Vascular dementia accounts for about 20 to 30 percent of all dementias. In about 15 percent a combination of both diseases is present. Other forms of dementia are found in only 5 to 15 percent of patients.
What is Alzheimer's disease??
Alzheimer's dementia is a degenerative disease of the brain, in the course of which nerve cells of the brain are irreversibly destroyed. The disease progresses differently in each person. However, three basic stages can be identified, which merge smoothly into one another. It takes between three and ten years from the first symptoms to death in most cases. The expected duration of the disease becomes shorter and shorter the later in life the disease occurs. Characteristic is their insidious, almost imperceptible onset. In the beginning, slight memory lapses and mood swings occur, and the ability to learn and react decreases.
In addition, there are initial speech difficulties. The patients use simpler words and shorter sentences or stop in the middle of a sentence and can no longer finish their thought. Local and temporal orientation disorders become noticeable. Those affected become less active. Increasingly closed to new things.
At this stage, the patients are consciously aware of the changes that are taking place within them. Many of them react with anger, fear, embarrassment or dejection.
As the disease progresses, the symptoms become obvious; at this point at the latest, work and driving have to be given up. Those affected are increasingly dependent on the support of other people for everyday activities such as personal hygiene, going to the toilet or eating and drinking. This stage is characterized by a severe disturbance of the memory – close relatives can no longer be named, the sense of time and place is lost and the language becomes unclear and empty of content.
What is the course of progressive Alzheimer's dementia??
Later, some people with Alzheimer's dementia can barely control their emotions, sudden mood swings, aggression, and depression increase.
In the late stages, dementia patients are completely dependent on care and support from other people. Family members are no longer recognized, communication with words is impossible. Increasingly, physical symptoms such as difficulty walking and swallowing occur. Control over the bladder and intestines decreases. In isolated cases, epileptic seizures may also occur. Bedriddenness increases the risk of infections. The sick often die from complications, such as pneumonia.
What are the causes of Alzheimer's disease??
The causes of Alzheimer's disease have not yet been sufficiently researched. However, a number of changes in the brain are known to occur in Alzheimer's patients. Thus, the disease causes the death of nerve cells. The destruction of their connection to each other. This is associated with a decrease in brain mass (brain atrophy). In addition, protein deposits (plaques or fibrils) are observed in the brain, as well as a reduction in a messenger substance that is important for memory (acetylcholine). These changes, however, do not provide any information about why the disease develops. An important research approach is therefore the search for so-called risk factors.
Genetic factors as the sole cause of the disease are only present in less than two percent of cases. Overall, therefore, they play a minor role in the development of Alzheimer's disease. Dementia in first-degree relatives – parents, children or siblings – only slightly increases individual risk. The risk is somewhat higher after severe head injuries.
The older people get, the greater the risk of developing dementia. While in the age group of 65 to 70 years less than three percent suffer from Alzheimer's dementia, at the age of 85 years about one in five and from 90 years already one in three is affected.
How to prevent Alzheimer's dementia?
Even though the causes of Alzheimer's dementia are not yet sufficiently known, it can be deduced from corresponding studies that, for example, physical exercise and a balanced diet, mental activity and social participation reduce the risk of developing the disease in old age. Recent studies also indicate an increased risk of disease due to obesity, high blood prere, smoking, excessive alcohol consumption, diabetes, depression, and the presence of hearing loss.
Since the neurobiological disease process begins 15 to 30 years before the onset of clinical symptoms, prevention is particularly relevant from middle age onwards.
What is vascular ("vascular") dementia??
In vascular dementias, nerve tie death occurs as a result of circulatory problems in the brain. It depends on the extent of the circulatory disorder, how pronounced the dementia is.
A special form of vascular dementia is "multi-infarct dementia". In this case, repeated small local circulatory disturbances lead to the death of brain cells. The symptoms of the disease are similar to those of Alzheimer's, but often physical symptoms such as numbness and paralysis or other abnormalities are also present.
Characteristics of the course of vascular dementias include a comparatively sudden onset, gradual deteriorations and marked fluctuations in performance, even within the same day.
The main causes are considered to be factors that generally increase the risk of vascular diseases, such as high blood prere, heart disease, diabetes mellitus (diabetes) and smoking. In order to prevent the disease, it is also important in this case to take sufficient physical exercise, eat a balanced diet, refrain from smoking and treat the underlying diseases.
How to recognize dementia?
Not every impairment of mental capacity must in itself be an alarm signal. Lack of drive, however, can develop even before the onset of "forgetfulness." If someone has always enjoyed sports and now repeatedly expresses unwillingness to go to weekly training, this could already indicate the development of dementia, although other explanations such as a depressive disorder should also be considered. If memory lapses occur regularly and are accompanied by other symptoms such as speech or orientation difficulties, a doctor should be consulted urgently to clarify the situation.
It is often not easy to persuade people who are supposedly suffering from dementia to visit a doctor. Particularly in the early stages of the disease, many patients try to hide their handicap from others and cover up memory deficits with the help of mnemonic notes. Sometimes they react aggressively or dismissively when relatives ask them about problems or mishaps. In such a case, it helps to document the behavior of the affected person over a longer period of time. As many people as possible should be involved, such as relatives, neighbors or friends. On the basis of such a list, a doctor can make a preliminary diagnosis, which gives certainty as to the further course of action.