What is dementia?

Dementia is a progressive brain dysfunction (in Latin 'dementia' means irrationality), which results in a restriction of daily activities, and in most cases leads to the need for long term care. Many diseases can result in dementia, the most common one being Alzheimer's disease.

How common is dementia?

In our society of longer lifetime, the probability of suffering from dementia increases with advancing age. Dementia predominantly occurs in the second half of our life, often after the age of 65 - some experts think that this is the 'price society has to pay' for our higher life expectancy, and therefore the term 'dementia' activates similar fears and repression mechanisms as 'cancer' or 'AIDS'.

The frequency of dementia increases with rising age from less than 2% for the 65-69-year-olds, to 5% for the 75-79 year-olds, and to more than 20% for the 85-89 year-olds. Every third person over 90 years of age suffers from moderate or severe dementia (Bickel, Psycho 1996, 4-8). About half of those affected by dementia suffer from Alzheimer's disease.

About 5% of people above 65 years of age, about 20% of those over 80 years and about 30% of those over 90 suffer from Alzheimer's disease.

The relatives share their fate with many people who are equally affected.

What are the most common causes of Alzheimer's disease?

The slowly progressing destruction of nerve cells in the brain leads to the previously mentioned symptoms of Alzheimer's disease. It is a natural phenomenon to loose a certain number of nerve cells during aging, but this loss occurs much more rapidly in people suffering from Alzheimer's disease. As a result, the brain of the patient does not function normally any longer.

In rare cases, the disease is caused by genetic changes (mutations) in the family. In these cases, symptoms usually occur before the age of 60 and progress rapidly. All currently known mutations result in an overproduction of a protein which destroys the nerve cells. In most cases the exact cause remains largely unexplained; interaction of several factors probably leads to the onset. Everybody is at risk of developing this disease. Several genetic factors are known to increase the risk, without themselves being the cause. These include a (normal) variant of the gene apolipoprotein E which encourages the deposition of the harmful protein.

The probability of developing Alzheimer's disease increases with advancing age. The probability is higher for women and for people having a lower standard of education.

What are the stages of Alzheimer's dementia?

Alzheimer's disease can take very different courses. It is a slowly unfolding, progressive disease which is accompanied over time by changes in the appearance of the patient. The disease is typically divided into three stages. In medical terms, Alzheimer's disease is divided into mild, moderate and severe, or early-stage, mid-stage and late-stage Alzheimer. The mild stage is typically characterized by impairments of mental abilities as well as mood swings. In the moderate stage, behavioral disturbances usually increasingly develop, whereas physical problems are dominant in the advanced stage. The individual course of the disease is, however, very variable.

Can dementia be treated?

There are a number of favorable conditions which can ease the situation of the patient and his/her relatives - these conditions concern in particular the actual care and the organization of the environment. Improvements can be achieved through physical, emotional and also mental activation.

As with numerous other diseases there is no cure for the illness, but medication can improve disease symptoms. There are a number of drugs on the market today for improving brain function. Typically antidementia or psychotropic drugs are prescribed.