Dementia – forms, symptoms, signs, treatment and courseDementia is not an independent clinical picture, but an umbrella term for various diseases that affect the
Progressively impairing mental performance. The best-known form of dementia is Alzheimer's disease. In Germany, about 1.6 million people affected by dementia, the majority of whom are elderly.
The most important facts in brief
Dementia is an umbrella term For various diseases that limit mental performance; the best-known form is Alzheimer's disease – In addition to a loss of cognitive functions psychological complaints, personality and behavioral changes occur – The Causes of dementia are not precisely known. All primary forms of dementia have in common that nerve cells in the brain gradually die off. – Dementia is not curable and leads to the need for care, but the course of the disease can be controlled with the help of medicinal and non-pharmacological measures delay.
Definition: What is dementia??
A certain degree of forgetfulness is normal, especially at an advanced age. But people with dementia are not simply forgetful. In addition to a disturbance of short- and long-term memory, they also suffer from a progressive loss of numerous other higher brain functions, especially of:
– ability to learn, think and abstract – ability to pay attention and concentrate – linguistic abilities – temporal and spatial orientation – social and emotional abilities
There are about 1.6 million dementia patients in Germany, most of them over 65 years of age. Women are more likely to develop the disease than men due to their longer life expectancy.
What forms of dementia exist?
Dementia is not a disease in its own right, but the generic term for various diseases of the brain that impair mental capacity.
The most common forms of dementia include:
Alzheimer's disease, which is the most common cause of dementia, accounting for about 60 percent of all cases. – the
Lewy Body Dementia (also Lewy body dementia) with a share of 10 to 15 percent. – the vascular dementia with a share of 10 to 15 percent. – the frontotemporal dementia (Pick's disease) with a share of 5 percent.
The various forms of dementia cannot always be clearly distinguished from one another. For example, about 20 percent of people suffer from a mixed form of Alzheimer's and vascular dementia.
Important to know!
Only primary dementia is due to damage to the brain. In a Secondary dementia On the other hand, a physical illness, such as depression, thyroid disease, malnutrition, or alcohol dependence, leads to a loss of mental abilities.
What are the causes of dementia?
The causes of dementia differ depending on the form of dementia in question. What they all have in common is that the nerve cells in the brain or in certain brain regions gradually die off. The reasons for this neurodegeneration are often not clearly understood.
– In Alzheimer's disease and Lewy body dementia, certain abnormally altered proteins are deposited on and in the nerve cells. Scientists suspect that they contribute to the demise of nerve cells. – Vascular dementia is based on a permanent circulatory disorder in the brain. The cause is often vascular calcification (arteriosclerosis), which can lead to one or more strokes. Blood vessels become clogged and can no longer supply nerve cells with sufficient oxygen and nutrients.
Are there external factors that influence the risk of dementia?
In addition to a genetic predisposition that cannot be influenced, there are different Risk factors, that increase the likelihood of dementia, but also various factors that may be protective.
People with underlying diseases such as diabetes or high blood prere have an increased risk of vascular damage, which can lead to vascular dementia. Consistent treatment of these underlying diseases is therefore particularly important.
What are the symptoms of dementia?
In the course of dementia, those affected experience various cognitive, psychological and physical symptoms.
Which symptoms occur depends essentially on the respective form of dementia. In frontotemporal dementia, for example, the nerve cells in the frontal and temporal lobes, which are important for emotions and social behavior, perish. Personality and behavioral changes such as apathy, irritability, tactlessness, and disinhibition are the main symptoms of dementia. Memory disorders often appear later. Are less pronounced than in other forms of dementia.
Diagnosis: How does the doctor recognize dementia??
The diagnosis of dementia is made in several steps.
1) Patient interview (anamnesis)
The doctor asks, for example, about the patient's symptoms, previous illnesses or whether he or she is taking medication. During the conversation he pays attention to the attention-. The patient's ability to concentrate.
2) Dementia tests
They provide the physician with information about the mental capacity. Important dementia tests are for example
– The clock test, which asks the person to draw a clock with 12 numbers, two hands, and a specific time, and – The Minimal Mental Status Test (MMST)with simple questions and prompts that test spatial and temporal orientation, memory, attention, recall, and language skills.
3) Physical examination and laboratory tests
They serve to exclude other diseases, especially those that can trigger secondary dementia. Important laboratory values include blood salts, blood sugar, and thyroid, liver, and kidney values.
4) Imaging techniques
Examinations such as magnetic resonance imaging (MRI) and computed tomography (CT) help the doctor to distinguish between the different forms of dementia and to rule out other diseases.
Lump-sum care allowance: tax benefits 2021/ 2022
Relief amount: care and household help
Extraordinary expenses in the tax return
How does the doctor treat dementia?
Dementia is not curable. The aim of treatment is to maintain the mental capacity and independence of those affected for as long as possible.
Drug treatment for dementia
Various active substances are available for drug therapy. Which agents the doctor uses depends on the form of dementia.
Anti-dementia drugs influence various messenger substances in the brain. They counteract memory loss and improve thinking ability. Antidepressants are used for depression or anxiety states. Neuroleptics help against delusions or hallucinations. Agitation states. Alleviate sleep problems.
In vascular dementia, the focus is on treating the underlying disease that causes the vascular damage. How does dementia progress. What are the consequences?All primary forms of dementia are considered incurable. The destruction of the nerve cells cannot be reversed. Progresses inexorably over time. Thus the complaints also increase more and more. Affected persons therefore become increasingly dependent on other people as the disease progresses, depending on the form of dementia and the individual course of the disease, up to and including complete need for care.
Roughly, dementia can be divided into three stages:
Stage 1 (mild dementia): The primary symptom is forgetfulness. Affected persons forget names, events and appointments and frequently misplace objects. Orientation also causes initial difficulties. Affected person has trouble planning and organizing things. Independent living is still possible, help is only required in individual cases for complex activities.
Stage 2 (moderate dementia): Disturbances of short- and long-term memory accumulate, motor weaknesses are added. Everyday tasks such as dressing, grooming or preparing meals cause problems, as does orientation in familiar surroundings. Many sufferers are restless and restless, their sleep-wake rhythm becomes confused, irritability, mistrust and aggression increase. Those affected are increasingly dependent on help.
Stage 3 (severe dementia): Affected individuals require ongoing care and supervision. They are now also physically deteriorating more and more. Further symptoms occur, such as psychotic symptoms (for example, sensory delusions), loss of speech, stiffening of limbs and incontinence.
How and how quickly can you die from dementia?
In most cases, the cause of death from dementia is not the dementia itself. Instead, affected persons die as a result of the disease. Many patients suffer from malnutrition, for example, or become bedridden in the course of the disease. Both can have a negative impact on the general state of health. Lead to greater susceptibility to infections.
Up to 57 percent of all dementia patients die from lung problems, especially pneumonia, and cardiovascular disease is also a common cause of death in dementia, accounting for up to 48 percent of all deaths.
It is very difficult to make reliable statements about life expectancy in the case of dementia. This is because it depends on numerous factors, such as the age at the time of diagnosis, the severity of the disease, the form of dementia and the general state of health.
On average, doctors estimate a life expectancy of about three to seven years after diagnosis, but some patients live considerably longer.
Can dementia be prevented?
There are no measures or medications that can prevent dementia. Nevertheless, many of the risk factors can be treated with medication or influenced by a healthy lifestyle. These include, for example, high blood prere, diabetes, smoking, alcohol consumption and obesity. A mentally and physically active lifestyle, for example through memory training, and social contacts can also reduce the risk of dementia.
When dementia leads to the need for care
Sooner or later, dementia patients need help in coping with everyday life. For relatives, it is therefore important to deal with the topic of care at an early stage and to clarify the following questions:
– Can the patient still remain in his or her own home?? – What assistance is required for this? – What options are offered by outpatient care? – What are the alternatives to home care in an advanced stage of the disease?? – Who pays for outpatient or inpatient care?
The German Federal Ministry for Family Affairs, Senior Citizens, Women and Youth offers interested relatives comprehensive information on the disease, on how to deal with typical everyday situations and on support services in the form of the Dementia Guide.
Dealing with those affected: Tips for relatives
Dealing with dementia patients is not always easy for relatives and caregivers. The following tips have been shown to work:
– Speak slowly and clearly, repeat important information. – Do not engage in discussions. – Don't take accusations personally. – Try to remain calm, patient and understanding and take the feelings of the person with the illness seriously. – Engage with your loved one, talk to them, give them a sense of belonging and let them participate in life with shared activities such as singing, painting or crafting. – Strive for a fixed daily routine, avoid changes in the person's environment and provide a quiet, stress-free environment. – Make sure you eat a healthy, balanced diet, stay hydrated and maintain adequate personal hygiene.
Caring for dementia patients places a massive burden on family caregivers. Do not hesitate to seek psychosocial help yourself if necessary. Support groups can also provide important support.
FAQ – Frequently asked questions about dementia
– What is the difference between dementia and Alzheimer's disease??
Dementia and Alzheimer's disease are not two different clinical pictures. Instead, the term "dementia" is an umbrella term for various conditions that affect brain performance. One of them is Alzheimer's disease.
The first sign of dementia is memory impairment: Affected persons forget names, events, appointments and misplace objects. Complex daily tasks can cause them difficulties, but they are still able to live independently.
No, forgetfulness does not necessarily mean dementia. A certain degree of forgetfulness is normal, especially in old age. Other illnesses and external factors such as stress and lack of sleep can also negatively affect our memory in the short term. It is best to consult a doctor if forgetfulness persists or increases for a long time.
Dementia is usually diagnosed by an experienced specialist such as a neurologist or psychiatrist.
Risk factors for dementia that can be influenced include high blood prere, diabetes, smoking, alcohol consumption and obesity. A mentally and physically active lifestyle and social contacts can reduce the risk of dementia. Many patients are cared for by relatives. Assisted by outpatient care services. Relief is also provided by day care facilities that look after those affected during the day. In case of illness or vacation, short-term care is possible in appropriate inpatient facilities. An alternative to care at home is placement in assisted living communities or nursing homes.
Yes. However, in order to receive the benefits, an application must be submitted to the nursing care insurance fund. The level of benefits depends on the care level, and this in turn depends on the remaining degree of independence.