Dementia is a neurological condition characterized by the progressive loss of cognitive abilities. At the beginning of the disease, short-term memory and retention are often impaired; as the disease progresses, the contents of long-term memory that have already been memorized also disappear. As a result, people with the disease increasingly lose the skills and abilities they have acquired throughout their lives.

However, dementia is much more than just a memory disorder. As it progresses, there is also an increasing impairment of attention, language, comprehension, thinking and orientation. Dementia thus shakes a person's entire being - their perception, behavior and experience.

A number of different causes of dementia have been described. A basic distinction is made between primary and secondary forms of dementia. Secondary dementias are secondary symptoms of other underlying diseases, such as metabolic disorders, vitamin deficiencies and chronic intoxication caused by alcohol or medication. These underlying diseases can be treated and in some cases even cured. It is therefore often possible to reverse the symptoms of dementia. Early diagnosis is particularly important for the differentiation and timely treatment of these dementia diseases.

However, this only accounts for around ten percent of all cases of the disease. Up to 90 percent are primary dementias, which are usually irreversible.

According to estimates, Alzheimer's disease is the most common irreversible form of dementia, accounting for around 60 to 65 percent. This is followed by vascular dementia, which accounts for around 20 to 30 percent. Around 15 percent have a combination of both diseases. Other forms of dementia are found in only 5 to 15 percent of sufferers.

Alzheimer's dementia is a degenerative disease of the brain in the course of which nerve cells in the brain are irreversibly destroyed. This form of dementia progresses differently in each person. It is characterized by a gradual, almost imperceptible onset and a continuous worsening of symptoms.

In vascular dementia, the brain tissue is damaged due to changes in the blood vessels supplying the brain. This is a circulatory disorder in the brain. The main causes are factors that generally increase the risk of vascular disease, such as high blood pressure, heart disease, diabetes mellitus (diabetes) and smoking. To prevent the disease, it is also important in this case to take sufficient physical exercise, eat a balanced diet, avoid smoking and treat the underlying diseases.

For the majority of dementia diseases, there is currently no therapy that leads to a cure. Therefore, the main aim of treatment is to improve the quality of life of those affected and their relatives.

The medical treatment of Alzheimer's patients targets, among other things, the neurotransmitter acetylcholine in the brain. Drugs are used to inhibit the enzyme that ensures the natural breakdown of acetylcholine. Another drug-based approach is to block the effect of the neurotransmitter glutamate, which is also thought to play a harmful role in the disease process. For some of those affected, such medication leads to an improvement in memory and the ability to concentrate.

Sometimes they also delay the progression of symptoms. However, they cannot delay or stop the actual disease process taking place in the brain.

There are also a number of medications that can alleviate the accompanying symptoms of dementia, such as restlessness, sensory illusions, anxiety or sleep disorders. Drug treatment should always be carried out by doctors who are familiar with nervous disorders in old age.

Medication is not the only treatment method that plays an important role in alleviating symptoms and improving quality of life. For example, psychotherapy can be useful in the early stages of the disease in order to cope with the diagnosis.

Many treatments are aimed at training the patient's remaining abilities and strengthening their self-esteem. It is important to focus on the existing abilities and needs of those affected, to take their life history into account and to avoid pressure to perform.

Due to their illness, those affected are less and less able to adapt to their environment and consciously organize their everyday lives. Their well-being therefore depends to a large extent on how the environment adapts to their impairment.

Status: 15.10.2024