Dementia: signs, symptoms and types

Medically reviewed: 24, January 2024

Dementia Overview

Dementia is an acquired dementia, a syndrome in which disturbances appear in a person’s cognitive activity: forgetfulness, loss of certain knowledge and skills and difficulty in acquiring new ones, persistent intellectual disorders, affective disorders, and a decrease in the patient’s volitional qualities are observed.

The development of this syndrome leads to disturbances in a person’s work and daily (household) activities.

Dementia is an umbrella term. There is no such medical diagnosis. This is a disorder that can occur in various diseases. It is important to understand that dementia is not the norm at any age. It is always necessary to find out the cause of dementia, if only because some types are curable.

What is dementia?

Dementia is the term given to a group of symptoms, which includes confusion, memory loss, problem-solving and poor concentration.

There are many diseases, which lead to dementia, the most common being Alzheimer’s disease, which accounts for approximately 60% of all cases.

People with dementia differ in terms of their signs and symptoms and the speed and extent to which their dementia progresses.

It is known that such condition usually occurs in older people. About 3 in 100 people over the age of 65 are affected and 10-15 in 100 people over the age of 80.

Dementia in people under 65 is known as early onset dementia (previously known as pre-senile dementia) and is rare, affecting only 1 in 1000 people. Most older people will never get this disease, and it is not a normal part of growing old.

Symptoms of dementia

The symptoms of dementia vary enormously, depending on the type of dementia and how far it has progressed. In most cases, the dementia progresses gradually and the early signs of dementia are subtle.

People with dementia usually experience:

• Confusion. This may include misunderstanding who or where they are.
• A significant reduction in memory. This may include forgetting people’s names or how to get home
• Problems with speech and language. Small differences of meaning are lost, language becomes simplified, and conversation becomes repetitive and often irrelevant.
• Loss of interest in the outside world. This may mean the person gives up interests and hobbies or is indifferent to social conventions and to the opinions of others.

Some forms of dementia may cause the individual to experience:

• Hallucinations
• Changes in personality
• Impaired judgement
• Lack of inhibition/ Inappropriate sexual behaviour
• Obsessional, repetitive behaviour
• Difficulties recognising familiar objects
• Disturbed sleep
• Sudden anger, aggression or inappropriate tearfulness
• Depression and bad temper
• Standards of personal care and hygiene may decline
• Physical deterioration, loss of appetite, loss of weight and high susceptibility to infection
• Wandering
• Incontinence.

Causes of dementia

After the age of 20, the human brain begins to lose nerve cells. Therefore, minor problems with short-term memory are quite normal for older people. A person may forget where he put his car keys or the name of the person he was introduced to at a party a month ago. Everyone has such age-related problems. As a rule, this does not interfere with everyday life. In dementia, these disorders manifest themselves much more strongly.

The progression of dementia is based on the death of brain cells from various causes:

• Organic brain shrinking (Alzheimer’s Disease)
• Lack of blood and therefore oxygen supply to these brain areas
• Head injury
• Pressure (such as from a brain tumor)
• Infection (such as in Aids)

Approximately 60% of cases diagnosed as dementia are due to the organic brain- shrinking disorder, Alzheimer�s disease and the cause is unknown.

After Alzheimer’s disease, the second most common type of dementia is vascular dementia (also known as multi-infarct dementia), which occurs as a result of lack of blood and oxygen to the brain in a series of tiny ‘strokes’.

Other types of dementia are rarer, and may be due to:

• Lewy body disease
• Pick’s disease
• Creutzfeld-Jakob disease (CJD)
• Dementia as part of a neurological (brain) illness such as Parkinson’s disease
• A brain tumor
• Fluid build-up- and water on the brain (hydrocephalus)
• A long period of excessive alcohol intake or drug intoxication
• Dementia may be misdiagnosed in some psychiatric conditions, such as depression or schizophrenia
• Dementia may occur some untreated organic disorders such as severe thyroid gland underactivity (see hypothyroidism), hormone deficiency and urine infections.
• Neurodegenerative and other chronic diseases
• Alzheimer’s disease
• Huntington’s disease (Huntington’s chorea)
• Vascular dementia
• Brain abscesses, hematomas
• Amyotrophic lateral sclerosis
• Spinocerebellar degeneration
• Hallerwarden-Spatz disease
• Infectious diseases
• HIV-associated dementia
• Viral encephalitis
• Progressive multifocal leukoencephalopathy
• Prion diseases
• Neurosyphilis
• Whipple’s disease
• Disorders of internal organs and metabolism
• Dialysis dementia
• Severe renal impairment
• Itsenko-Cushing syndrome
• Liver dysfunction
• Autoimmune diseases
• Multiple sclerosis
• Systemic lupus erythematosus
• Lack of various substances in the body
• Vitamin B1 deficiency (Haye-Wernicke syndrome)
• Vitamin B12 deficiency
• Folate deficiency
• Pellagra (vitamin B3 deficiency
• Other diseases and pathological conditions
• Down syndrome
• Post-traumatic dementia
• Interactions of some drugs
• Depression
• Mixed dementia

7 stages of dementia

Dementia free

Stage 1

At this initial stage, individuals exhibit no indications of dementia whatsoever, displaying normal cognitive functioning and maintaining mental well-being. Those who have not been diagnosed with dementia are categorized as being in stage 1, where any observable signs or symptoms are absent, such as memory impairment, behavioral disturbances, or any other characteristic manifestations that typically accompany the onset of dementia.

Stage 2

At this stage, patients may experience normal forgetfulness, which is commonly associated with the natural process of aging. However, it becomes challenging for doctors and loved ones to identify the symptoms of dementia. Consequently, the primary concern during this phase revolves around striking a delicate equilibrium between maintaining one’s independence and providing the necessary support and assistance.

Stage 3

Moderate decrease in cognitive activity. Signs of cognitive decline are noticeable at this stage. Recognizing the signs of early-stage dementia is of utmost importance to ensure early diagnosis and provide the necessary medical care. This stage is characterized by a range of symptoms, such as heightened forgetfulness, diminished performance, slight difficulty in verbal communication, and struggles in maintaining focus on routine tasks. It is crucial to identify these indications, as they can persist for approximately three years.

Early-stage dementia (duration about 3 years)

Stage 4

There is a moderate decrease in cognitive activity. Patients experience difficulty concentrating, forgetting recent events, and have difficulty managing finances, and moving alone to new places. People have difficulty communicating and may withdraw from friends and family. To maintain a satisfactory quality of life for individuals with mid-stage dementia, caregivers must diligently establish and adapt a comprehensive daily care plan.

This entails meticulously organizing routines, activities, and necessary assistance to cater to the unique needs and challenges that arise during this particular phase of the disease, which typically spans approximately four years. By regularly reviewing and modifying schedules as necessary, caregivers can effectively ensure that the essential standards of living are met and that the individual’s well-being is prioritized.

Stage 5

The person needs help to complete daily living. At this stage, the signs and symptoms of dementia are obvious. Short-term memory is completely lost, and confusion and forgetfulness are even more pronounced in everyday life.

Stage 6

In individuals suffering from this condition, there is a tendency for the patient to experience difficulty recalling the identities of their loved ones, while being able to retain memories of events that have transpired recently. Furthermore, their ability to effectively communicate with others is significantly compromised, leading to various cognitive symptoms such as delusions, obsessions, heightened anxiety, and restlessness.

Late-stage dementia (duration about 3 years)

Stage 7

Severe decline in cognitive functions. The individual cannot typically talk or interact and relies on help for even the most basic tasks, including walking. Although the specific manifestations may vary from person to person, these stages can serve as a general framework, enabling the patient’s family and friends to anticipate the progression of symptoms and understand when they are likely to occur.

Types of dementia

Taking into account the predominant damage to certain areas of the brain, four types of dementia are distinguished:

Cortical dementia

The cerebral cortex, a significant area of the brain that is greatly influenced, exhibits significant consequences in a range of conditions, including alcoholism, Alzheimer’s disease, and Pick’s disease, alternatively referred to as frontotemporal dementia.

Subcortical dementia

The subcortical structures within the brain experience negative consequences, ultimately resulting in the emergence and progression of numerous neurological disorders, including the manifestation of involuntary trembling in the limbs, muscle stiffness, gait disorders, and more. These conditions commonly manifest in individuals diagnosed with Parkinson’s disease, Huntington’s disease, and white matter hemorrhages, resulting in significant impairments to their overall physical and cognitive functioning.

Cortical-subcortical dementia

There is evidence of both the cortex and subcortical structures being affected in instances of vascular pathology.

Multifocal dementia

There are numerous instances where necrosis and degeneration occur in different regions of the central nervous system. The range of neurological disorders is extensive and varies based on the specific location of these lesions.

Alzheimer’s type dementia

The diagnosis of Alzheimer’s disease is determined regardless of when the initial symptoms of acquired dementia become noticeable. One of the risk factors that can contribute to the likelihood of experiencing negative outcomes is age, having relatives with this disease, atherosclerosis, hypertension, excess weight, diabetes mellitus, low physical activity, and chronic hypoxia.

There is also a condition known as traumatic brain injury (TBI) that can have devastating effects on an individual’s mental activity and cognitive functioning throughout their lifespan. Frequently, women tend to experience illness at a higher frequency compared to men. This disparity in health patterns between the genders often results in women falling sick more frequently than their male counterparts.

The initial indication of this condition is a noticeable decline in the ability to remember recent information, coupled with the ability to acknowledge and express dissatisfaction with one’s cognitive state. As time progresses, the memory impairments become more severe, leading to a peculiar phenomenon known as a “regression in time.” Initially, the patient starts to forget recent occurrences, gradually losing recollection of past events as well. Eventually, the patient reaches a point where they can no longer recognize their children, often confusing them with deceased family members from long ago.

Additionally, the patient struggles to recall even the most mundane details of their daily activities, yet possesses the uncanny ability to vividly recount memories from their childhood, as if those moments had transpired just recently.

In the later stages of Alzheimer’s disease, the clinical presentation is further characterized by the presence of emotional and volitional disturbances. This can manifest in patients displaying irritability and a tendency to engage in arguments, often demonstrating dissatisfaction with the words and actions of others, and becoming irritated by every little thing.

Other behavioral disorders may also be detected:

• vagrancy,
• intemperance, and indiscriminateness in food and sex,
• senseless disorderly actions, such as aimlessly moving objects from one location to another, can lead to a degradation in speech patterns.

This degradation is characterized by a simplification and impoverishment of language, as well as the occurrence of paraphasia, where individuals substitute forgotten words with other terms. In the advanced stage of Alzheimer’s disease, individuals experience a significant decline in cognitive abilities, resulting in the manifestation of delusions and behavioral disturbances. This deterioration in intelligence leads to a transformation in their demeanor, as patients become increasingly passive and unresponsive.

Their basic physiological needs, such as the consumption of fluids and food, diminish as the disease progresses. Communication becomes extremely challenging, with speech nearly vanishing altogether. Furthermore, as the condition worsens, patients gradually lose their ability to chew food and navigate independently, further limiting their autonomy and quality of life.

Alcoholic dementia

Alcohol-related dementia, commonly referred to as alcoholic dementia, is a cognitive impairment that arises as a consequence of excessive and prolonged alcohol consumption. It is primarily attributed to the prolonged, consuming alcoholic beverages in excessive amounts for a period exceeding 15 years or more.

In addition to the detrimental impact alcohol has on brain cells directly, the onset of dementia can also be attributed to the disruption of multiple organs and systems, as well as the occurrence of severe metabolic imbalances and vascular abnormalities.

The condition presents itself through identifiable alterations in personality (such as becoming cruder, losing moral compass, and experiencing social decline) in conjunction with a complete deterioration of cognitive functioning.

Following the complete cessation of alcohol consumption and the implementation of alcoholism treatment, there is a slim possibility of achieving partial recovery, although it must be noted that these occurrences are exceedingly uncommon. This scarcity can be attributed to the presence of a distinct pathological desire for alcoholic beverages, a decline in volitional capabilities, and a noticeable absence of motivation, all of which contribute to the inability of most patients to refrain from consuming liquids containing ethanol.

Regrettably, the prognosis for these individuals is highly unfavorable, as they commonly succumb to somatic ailments directly caused by their excessive alcohol intake. Additionally, it is not uncommon for these patients to meet their demise as a result of involvement in criminal activities or unfortunate accidents.

Diagnosis of dementia

As for dementia caused by atrophic processes in brain tissue, the prognosis is clear – it is impossible to cure it at this stage of medical development. Doctors can slow down and sometimes stop degeneration, but it is not possible to reverse changes that have already occurred. This is why it is so important to detect pathology as early as possible. In this case, effective therapy and rehabilitation can preserve most of a person’s inherent functions and abilities and prevent personality disintegration.

Condition is diagnosed if five mandatory signs are present for six months or more.

Memory impairments are identified based on a conversation with the patient, special research, and interviews with relatives.

At least one symptom indicates organic brain damage. These symptoms include the “three A” syndrome:

1. cognitive and sensory difficulties, individuals facing these conditions often struggle with accepting their condition and their perception of the world around them.
2. reduction in self-criticism and criticism of the reality they are surrounded by.
3. personality disorders such as unreasonable aggressiveness, rudeness, and a lack of shame may also be observed in individuals with these conditions, violation of family and social adaptation.
4. absence of symptoms characteristic of delirium (experiencing disorientation in both space and time, along with encountering vivid illusions and distorted beliefs).
5. presence of an organic defect, confirmed by instrumental studies (CT and MRI of the brain).

In this detailed exploration, we unveil the intricate steps involved in diagnosing dementia, shedding light on the evolving methodologies and the critical role of healthcare professionals in the diagnostic journey.

Clinical Evaluation: The First Line of Assessment Dementia

Diagnosis commences with a thorough clinical evaluation, often initiated by a primary care physician. The initial assessment involves a comprehensive medical history, including a detailed account of cognitive changes, functional impairments, and the onset and progression of symptoms. Informants, such as family members or caregivers, play a crucial role in providing valuable insights into the patient’s cognitive decline.

Cognitive Screening: The MMSE and Beyond

Cognitive screening tools, such as the Mini-Mental State Examination (MMSE), are frequently employed as a quick and standardized means of assessing cognitive function. However, due to their limited sensitivity, they are primarily used as initial indicators rather than definitive diagnostic tools. More in-depth cognitive assessments are often warranted for accurate diagnosis.

Neuropsychological Testing

Neuropsychological assessments offer a comprehensive evaluation of cognitive domains, including memory, language, executive function, and visuospatial abilities. These tests provide a detailed cognitive profile, aiding in differential diagnosis and identifying specific cognitive deficits associated with various types of dementia.

Brain Imaging in Dementia Diagnostics

Neuroimaging techniques, such as magnetic resonance imaging (MRI) and computed tomography (CT) scans, play a pivotal role in dementia diagnosis. These modalities can reveal structural brain abnormalities, including atrophy, infarctions, or the presence of brain tumors that may underlie cognitive decline.

Biomarkers: Unveiling Molecular Clues

In recent years, cerebrospinal fluid (CSF) and blood-based biomarkers have emerged as valuable tools for dementia diagnosis. Elevated levels of proteins such as beta-amyloid and tau in CSF, along with specific blood biomarkers, can provide insights into underlying neurodegenerative processes, aiding in the differentiation of dementia subtypes.

Genetic Testing: The Role of Familial Risk in getting Dementia

In cases of suspected familial or early-onset dementia, genetic testing can identify specific mutations associated with certain forms of the condition. Genetic counseling is an essential component of this diagnostic pathway, providing patients and families with critical information about hereditary risks.

Functional Imaging: Functional Correlates of Cognitive Impairment

Functional neuroimaging techniques, such as positron emission tomography (PET) and single-photon emission computed tomography (SPECT), assess brain activity and connectivity. These modalities can reveal functional changes that may not be apparent on structural imaging and assist in subtype differentiation.

Clinical Criteria and Differential Diagnosis

Established diagnostic criteria, such as those outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) or the International Classification of Diseases (ICD-10), provide a standardized framework for dementia diagnosis. These criteria assist healthcare providers in making accurate diagnoses and differentiating dementia subtypes.

Multidisciplinary Approach: Collaboration in Diagnosis of Dementia

Diagnosing dementia often necessitates a multidisciplinary approach involving neurologists, geriatricians, neuropsychologists, and radiologists. Collaboration among healthcare professionals is essential for a comprehensive evaluation and accurate diagnosis.

The diagnostic journey of dementia is a multifaceted and evolving process that demands meticulous assessment through clinical evaluation, cognitive screening, neuropsychological testing, neuroimaging, biomarker analysis, genetic testing, and clinical criteria application. The integration of these diverse methodologies, coupled with the expertise of healthcare professionals, paves the way for early and accurate dementia diagnosis, facilitating timely interventions and patient-centered care.

Dementia treatment

Dementia, a multifaceted syndrome characterized by cognitive decline and functional impairment, presents a formidable diagnostic challenge. Its myriad etiologies, overlapping symptoms, and the progressive nature of the condition necessitate a comprehensive and multi-modal approach to diagnosis.

Treatment of dementia depends, first of all, on the origin of the pathology, as well as the age and general health of the patient. For example, dementia caused by drug intoxication, if detected in time, can be reversible. The consequences of traumatic brain injury, especially in young people, can also be reversible, especially if timely assistance is provided and rehabilitation is completed. The same applies to vascular dementia. Drug-induced dementia may also go away with drug treatment, although usually not immediately. As for the treatment of alcoholism, the history of alcohol abuse plays a dominant role in the prognosis.

However, in all of these cases there is no, and cannot be, confidence that the patient will restore cognitive abilities, even with a young age, good health, and adequate treatment.

Most types of dementia cannot be cured. The exceptions are those dementias related to vitamin or hormone deficiency (which can be treated with supplements) and head injury (which may be treated through surgery).

An underactive thyroid gland (hypothyroidism) can be treated with thyroid hormone (thyroxine). Reduction of the blood supply to the brain due to cardiac or respiratory failure or anemia may also be to some extent treatable.

Alzheimer’s Disease cannot be cured. However, for some people in the early and middle stages of the disease, the drugs donepezil, rivastigmine or galantamine may help prevent some symptoms from becoming worse for a period of time.

Medical researchers are currently looking at other medical treatments including anti-oxidants, brain stem cell therapy and a vaccination to stop the build up of plaques in the brain (a hallmark of Alzheimer’s disease).

Alternative therapies i.e. non-medical interventions such as music therapy, aromatherapy and reminiscence therapy may be helpful to some people. It is also helpful to give the person the choice to be alone or with others.

It seems that gentle encouragement to use the brain and keeping the environment quite stimulating is a good idea. But it is important not to overwhelm people with demands that may only frustrate them if they can’t meet them.

Dementia medications for older adults are necessary to suppress symptoms, slow the progression of the disease, and stabilize a person’s condition. Most often, drugs are prescribed that affect brain activity and improve oxygen saturation in the brain.

Medication therapy

Drugs for the treatment of dementia in older people are divided depending on the stage and form of dementia; neuroprotectors (nootropics, antidepressants, antioxidants), NMDA antagonists, and acetylcholinesterase inhibitors are most often prescribed. Corticosteroids, anti-sclerotic drugs, and antiplatelet agents are also used.
Nootropics (Piracetam, Pyritinol, Amiridin, Akatinol, Cerebrolysin)

The main group of drugs for senile dementia, which are used for a long time (from 4-6 months, but most often for life). Their main function is to improve metabolism in nerve cells, which means strengthening thought processes and counteracting intellectual decline, loss of memory and speech.

Antidepressants

The drugs are used to treat people who have panic attacks, depression, apathy, anxiety, persecution mania, pathological phobias, and praecox in dementia (schizophrenic dementia). They are prescribed at the second and third stages of the disease, in case of severe symptoms, as they can have the opposite effect and provoke a deterioration in the patient’s condition. If possible, antidepressants are replaced with light sedatives on a natural basis.

Antioxidants

Help cells cope with lack of oxygen and nutrients, and neutralize free radicals. Mexidol for dementia is one of the most frequently used, it helps fight decreased concentration and cerebrovascular accidents.

NMDA antagonists (anesthetics)

These drugs help in the treatment of dementia by acting on cell membranes and helping the penetration of calcium, potassium, and sodium ions into them. Drugs containing NMDA antagonists are used for dementia caused by Alzheimer’s disease, Parkinson’s disease, and dementia with Lewy bodies.

Memantine is used to improve memory, increase concentration, and thinking processes, it reduces fatigue and apathy. In addition, this medicine helps fight depression, but it is gentle and rarely causes side effects. Ketamine, Dextromethorphan, and PCP are rarely prescribed by doctors due to their ability to cause hallucinations.

Acetylcholinesterase inhibitors (Rivastigmine, Galantamine, Donepezil)

Donepezil has been successfully used in the treatment of dementia with severe cognitive dysfunction.
It is quite effective but is applicable only at the first stage since in advanced cases the effect is reduced to almost zero. Galantamine has the most limited effect and affects only working memory and concentration; the drug also sometimes causes side effects in the gastrointestinal tract. Rivastigmine reduces the progression of dementia of the Alzheimer’s type, affects emotionality, and reduces manifestations of irritability, aggression, anxiety, and apathy.

Neuroleptics or antipsychotics (haloperidol, chlorprothixene Zentiva)

Drugs that help calm the patient, normalize his behavior, reduce aggressiveness, irritability, and suspicion, and stop psychosis manifested by hallucinations or delusions. Additionally, these medications lower blood pressure and body temperature. Neuroleptics are typical and atypical, while typical ones cause many side effects, although their effect is more pronounced. Atypical antipsychotics are easily tolerated and are aimed more at increasing concentration and gentle sedation.

Symptomatic drugs

• sedatives, sedatives;
• sleeping pills;
• painkillers.

Non-drug treatment options

Non-drug methods are effective only in the early stages of dementia with mild cognitive impairment or to prevent the disease. Quite often, doctors combine them with drug treatment.

Non-drug treatment includes following a special diet (“Mediterranean”) and systematic memory training.

The Mediterranean diet involves eating the following foods at least twice a week:

• vegetables;
• olive oil;
• seafood.

To prevent the condition, lifestyle changes are required: quitting smoking and other alcohol except wine, moderate physical activity, and maintaining social activity.

In addition, monitoring cholesterol and blood sugar levels is mandatory.

For systematic memory training and maintaining cognitive functions at the proper level, there is special cognitive training. Biofeedback (BFB) is widely used to maintain cognitive functions.

Features of the treatment of dementia in young people

Dementia affects people of any age (although it most often affects older people in their 60s and 70s), so it sometimes affects young people in their 30s and even younger. The selection of medications for them should also depend entirely on the stage and type of disease, but great attention should be paid to the psychological state. Young patients are more prone to depression, apathy, isolation, loss of interest in life, and avoidance of social life.

Therefore, it is recommended to use antidepressants prescribed by a doctor. Also, in case of disturbances in the perception of day and night, a mild sleeping pill is prescribed for patients with dementia. Young patients should visit a psychotherapist, engage in creativity, and moderate physical exercise. Mental stress is also very important, which slows down the development of the disease.

Caring for a person with dementia

Patients with advanced dementia require constant care. The disease greatly changes the life of not only the patient himself but also those who are nearby and care for him. These people experience increased emotional and physical stress. You need a lot of patience to care for a relative who at any moment can do something inappropriate, create a danger for himself and others (for example, throw an unextinguished match on the floor, leave a water tap open, turn on a gas stove and forget about it), react with violent emotions to any little thing.

Because of this, patients around the world are often discriminated against, especially in nursing homes, where they are cared for by strangers who often lack knowledge and understanding of the condition. Sometimes even medical staff behave quite rudely with patients and their relatives. The situation will improve if society knows more about dementia, this knowledge will help treat such patients with more understanding.

Are dementia and Alzheimer’s disease the same thing?

Alzheimer’s disease is a disease, and dementia is a syndrome, symptoms of impairment of the cognitive functions of the brain: speech, memory, spatial orientation, and the ability to remember and learn. Dementia does not always occur with Alzheimer’s disease. It can occur after injuries, other diseases, and conditions.

What doctor I need?

If it turns out that a decrease in cognitive functions has become a complication of any disease, highly specialized specialists may be involved in the treatment process:

• endocrinologist, if the cause of dementia is hypothyroidism or diabetes;
• an infectious disease specialist if the disorders are caused by encephalitis, meningitis, AIDS, or tuberculosis;
• narcologist, if dementia is the result of chronic alcoholism

Most neurodegenerative diseases are both neurological and mental disorders. This means that both neurologists and psychiatrists provide treatment. Having noticed the first signs of cognitive and psychoemotional disorders, most relatives of elderly people turn to their local therapist. And he already refers the patient further – to a psychiatrist or neurologist. They may also refer you to a doctor who specializes in diseases of the elderly.

A neurologist makes a diagnosis. The degree of dementia is determined by a psychiatrist. A neurologist rarely decides on his own if, in his opinion, the patient requires psychotropic drugs. In this case, the patient is prescribed a consultation with a psychiatrist. It establishes the degree of dementia. Makes decisions on prescribing psychotropic medications.

That is, if you notice memory impairment, changes in behavior, insomnia, or difficulties with the logical perception of yourself and what is happening around an elderly relative, go to any of these doctors with your problem.

Prognosis for dementia

The prognosis for dementia depends on the specific cause of the condition. When dementia is caused by factors such as traumatic brain injury or the presence of tumors or hematomas, the progression of the disease is typically halted. In some cases, symptoms may even be partially or completely alleviated due to the brain’s ability to compensate for the damage. However, during the early stages of the condition, it is challenging to accurately predict the extent of recovery. Extensive damage may result in successful compensation and the ability to continue functioning, while even minor damage can lead to severe dementia and disability, and vice versa.

In cases where dementia is caused by progressive diseases, the symptoms gradually worsen over time. Unfortunately, doctors are unable to completely halt the progression of the disease, but they can help slow it down by providing appropriate treatment for the underlying causes.

The primary objectives of therapy in these instances are to preserve the individual’s ability to take care of themselves and adapt to their changing abilities, extend their lifespan, ensure they receive proper care, and alleviate any distressing symptoms associated with the disease. Ultimately, death occurs due to the severe decline in essential bodily functions resulting from the patient’s immobility, their inability to perform basic self-care tasks, and the development of complications commonly experienced by individuals confined to a bed.

Prevention of dementia

Basic measures to prevent dementia:

• Quitting smoking and drinking alcohol.
• Healthy eating. Vegetables, fruits, nuts, grains, olive oil, lean meats (chicken breast, lean pork, beef), fish, and seafood are healthy. Excessive consumption of animal fats should be avoided.
• Fighting excess body weight.
• Moderate physical activity. Physical exercise has a positive effect on the cardiovascular and nervous system.
• Try to engage in mental activity. For example, a hobby such as playing chess can reduce the risk of dementia. It is also useful to solve crosswords and solve various puzzles.
• Avoid head injuries.
• Avoid infections. In the spring, it is necessary to follow recommendations for the prevention of tick-borne encephalitis, which is carried by ticks.
• If you are over 40 years old, have your blood tested annually for sugar and cholesterol. This will help to detect diabetes, and atherosclerosis in time, and prevent vascular dementia and many other health problems.
• Avoid psycho-emotional fatigue and stress. Try to get full sleep and rest.
• Monitor your blood pressure levels. If it periodically increases, consult a doctor.