Dementia is a chronic mental illness
Psychiatry, Psychosomatics & Psychotherapy
This can lead to personality changes and sudden mood swings. The symptoms of dementia depend on the type of illness, as there are different forms of dementia with different causes. Often these are incurable, progressive diseases, the course of which, however, can be alleviated.
A distinction is made between different forms of dementia. Some of the most common diseases are listed below:
- the pure Alzheimer's disease, with approx. 60% the most common cause of all dementias;
- the vascular dementia, with approx. 10-15% of all dementias:
The main cause of vascular dementia is damage to the vessels from arteriosclerosis. This leads to long-term circulatory disorders in the brain. People with diabetes (diabetes mellitus) or high blood pressure (hypertension) have a particularly high risk of changes in the small blood vessels in the brain, which is why these diseases must be treated consistently.
- Mixed forms of vascular and Alzheimer's dementia in approx. 20% of the cases.
- Dementia with Lewy bodies with approx. 10-15% of all dementias:
In dementia with Lewy bodies, in addition to Alzheimer's plaques and neurofibrils, other protein deposits, so-called Lewy bodies, are found in the nerve cells of the cerebral cortex. Lewy bodies in the nerve cells of the brain stem are characteristic of Parkinson's syndrome.
The appearance of dementia with Lewy bodies is very different from Alzheimer's disease. As with Alzheimer's disease, there is progressive dementia with memory disorders. However, in addition to detailed optical perception disorders ("visitors"), fluctuating impairments of mental abilities and alertness during the course of the day as well as spontaneous motor Parkinson's symptoms, patients tend to fall, faint and sudden loss of consciousness, delusions and hallucinations in other sensory areas. The optical-spatial disturbances are often more pronounced than in Alzheimer's patients. As with Parkinson's disease, it affects more men than women.
Neuroleptics (antipsychotic drugs) are poorly tolerated. In contrast, patients respond particularly well to treatment with (acetyl) cholinesterase inhibitors. Because of the dangers that patients face from taking neuroleptics and the particularly good response to (acetyl) cholinesterase inhibitors, it is important to diagnose dementia with Lewy bodies from Alzheimer's and Parkinson's syndromes.
- Fronto-temporal dementia: Fronto-temporal dementia is less common than Alzheimer's dementia (5%) and tends to affect younger patients (around 50 years of age). This form of dementia is caused by a shrinkage of the frontal lobe or the temporal lobe. A change in personality and a disturbance in the processing of emotions are particularly typical. In special cases, there may be an isolated, slowly progressive loss of speech (aphasia).
- Cognitive disorder in depression: Certain types of depression (in old age) can lead to unusually pronounced impairments to memory, concentration and thinking processes. Sometimes the resulting disorder has the effect of dementia. If these impairments are correctly recognized in the depressed patient and treated with antidepressant drugs, they can regress completely.
- other causes such as chronic alcoholism (Korsakow syndrome), traumatic brain injuries, brain tumors, hypothyroidism, inflammatory diseases of the nervous system (e.g. multiple sclerosis or AIDS);
Another form of subdivision speaks of primary and secondary dementia. The latter is a consequence of another organic disorder (e.g. stroke), i.e. a secondary phenomenon, whereas in primary dementia either no cause is known or the demented breakdown process itself is the root of the disease, such as in Alzheimer's dementia.
At the first signs of increased forgetfulness or the impression that the personal intellectual performance has changed significantly, those affected should consult a specialist in neurology or a neurologist. The family doctor can also initially be the first point of contact.
Correct diagnosis of the symptoms is important in order to rule out other causes (e.g. depression, organic diseases, etc.) and to start appropriate therapy. If you suspect dementia, you will be referred to a neurological specialist practice or a memory clinic. There special examinations and test procedures can provide information about a possible disease.
For most people, the news that they have dementia is a great shock that creates fear and uncertainty and raises many questions. You should talk to friends and family or other people you trust about your fears and worries.
Self-help organizations can also be very helpful in this situation. Self-help groups facilitate the exchange of information and experiences with other affected persons and also relatives, which can provide practical help with life and emotional support in coping with the disease.
Once diagnosed, it is also important to manage legal, health, and financial matters while you are still able to do so. People with dementia are usually fully capable of doing business at an early stage and can make provisions for themselves. The Federal Ministry for Families, Seniors, Women and Youth has put the website “Wegweiser Demenz” on the Internet in order to convey specific “help knowledge” on this aspect in particular. The website provides information, for example, about statutory benefits, rights, on-site assistance, but also volunteer offers for people with dementia and their relatives.
Dementia in general changes people as the disease progresses. Experiencing this can be very stressful not only for those affected, but also for relatives and the wider environment. The change can have many faces and it is important for the family to deal with the clinical picture and its prognosis as early as possible.
In order to make the togetherness as harmonious as possible and to limit misunderstandings, extensive clarification in this situation is very helpful. It is important that the environment learns to understand what is going on in people with dementia, what they need and how they react. In this way, at least some of the conflicts and burdens can be avoided.
Relatives should learn to accept the illness and how to deal with it. It is also important to get help and support when you need it. Caregiving relatives in particular should seek detailed advice on offers of help. The long-term care insurance funds provide information about the corresponding support offers on site.
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