Patients with Dementia1 can have difficulties with cognitive functions such as memory, language, reasoning, planning, recognising, or identifying people or objects.
This decline is beyond what might be expected from normal aging. Dementia can eventually impair the ability to carry out everyday activities such as driving, household chores, and even personal care such as bathing, dressing, and feeding.
The probability of suffering from dementia increases with age. Dementia mostly occurs in the second half of life, often after the age of 65.
Dementia usually progresses slowly. Making an accurate diagnosis in the early stages of dementia can therefore be difficult. Several visits with a physician over a certain period of time may be needed. It is important to confirm a diagnosis of dementia in order to:
Eliminate other conditions that can cause dementia-like symptoms, such as depression
Discuss treatment
Enable the patient to participate actively in planning his or her future
Arrange support for the patient and his/her family
Alzheimer's disease accounts for about 50-70% of all dementia cases
Dementia can be caused by one medical condition or by multiple medical problems. Some types of dementia can be cured partially or completely with treatment. The degree of reversibility often depends on how quickly the underlying cause is detected and treated. Other types of dementia are irreversible and cannot be cured, most notably dementia due to Alzheimer's disease.
Alzheimer's disease accounts for about 50-70% of all dementia cases2, and vascular dementia accounts for between 15-20%. While Alzheimer's disease is the most common type of dementia, the term dementia is not synonymous with Alzheimer's disease. Dementia is a broader term and refers to brain syndromes resulting in problems with memory, orientation, judgment, and communication.
Alzheimer's disease
Alzheimer's disease (AD) is a progressive, degenerative brain disease that gradually destroys a person's memory and ability to learn, reason, make judgements, communicate, and carry out daily activities, such as bathing and eating3. AD is neither infectious nor contagious. It is a terminal illness, which causes a general deterioration in health.4
AD primarily affects older people, and, in most cases, symptoms appear after 65 years of age. However, AD is not a normal part of aging. As people age, it is common to experience minor changes in memory and thinking. Yet there are several differences between normal aging and AD:
Memory loss
As we get older, we might sometimes forget part of an experience (e.g. "What did I have for breakfast yesterday?"). Eventually, we may recover the desired information, especially when prompted. In contrast, people with AD forget the entire experience (e.g. "I can't remember yesterday morning at all") and cannot recall the information at a later time. Moreover, older people can use notes and reminders such as grocery lists to help them remember. People with AD have more difficulty using such aids because they may forget how to use such a list—or even that they have a list.
Planning, organising, and comprehension difficulties
Usually, older people have no difficulties following verbal or written instructions, particularly when these instructions include several steps, such as following a recipe. In contrast, people with AD become less and less able to follow directions as their disease progresses.
Personal Care
Despite the physical complaints that appear with age, like stiffness or pain, older people are generally able to take care of themselves (e.g. dressing, bathing, going to the bathroom). In contrast, people with AD lose the ability to perform these tasks.
AD is a slowly unfolding, progressive disease that can be divided into three stages. As the disease progresses, individuals may also experience changes in personality and behaviour, such as anxiety, suspiciousness and agitation, delusions or hallucinations. Practical difficulties with daily tasks such as dressing, washing, and going to the toilet gradually become so severe that the person can become totally dependent on others. The mild stage or early stage of AD is typically characterised by impairments of mental abilities as well as mood swings. In the moderate stage or mid-stage, behavioural disturbances increasingly develop. In the later stages physical problems become dominant. The individual course of the disease is, however, very variable.5
There is no known cure for AD6. The current standard of care consists of symptomatic treatments, which can be divided into pharmacological, psychosocial, and caregiving.
