Dementia is defined as a clinical syndrome characterized by the existence of several cognitive deficits of sufficient intensity to interfere with the person’s usual social functioning, produced by various diseases. Alzheimer’s disease is the main cause, accounting for 50% to 60% of cases, but we cannot forget vascular dementia, related to previous strokes, or Lewy body dementia, among others.
More than 40 million people suffer from dementia, which increases with age.
Age is the main risk factor for the onset of dementia, which justifies its exponential increase in view of the progressive aging of the population: it is estimated that 10% of people over 70 years of age, 25% over 85 years of age and almost half of nonagenarians have cognitive impairment. Thus, according to the WHO, more than 40 million people worldwide are living with dementia, a figure that will double by 2030 and triple by 2050. For this reason, dementia represents a major challenge of aging, both at the level of the individual and the stigmatization and social exclusion it generates, as well as at the level of the family and society itself. But not only age carries a higher risk of dementia, but also a family history of dementia, cardiovascular risk factors (diabetes, cholesterol or high blood pressure), the level of schooling of the person and / or social situation are elements to consider as other risk factors for developing dementia.
What are the symptoms of dementia?
Dementia can present itself in different ways depending on each patient but, in general, there are some main symptoms common to most patients, and some psychological and/or behavioral symptoms that will not always appear. The main symptoms of cognitive impairment are amnesia, usually of recent memory, and attention problems. Instrumental functions such as language, praxia and/or gnosias are usually affected in the more advanced stages. Psychological symptoms such as anxiety or depressive mood may be present in the dementia syndrome. Delusions and/or hallucinations are frequent in more advanced stages. Also mania, apathy or personality changes themselves force us to think of dementia as a possible diagnosis. Also, people with dementia may present behavioral disorders, either with a sleep inversion, which may include endless erratic wandering, or with restlessness or psychomotor agitation by way of continuous undressing, or irritability, without forgetting the possible sexual disinhibition. All these situations, logically, usually overwhelm the family and / or primary caregivers, and justify consulting your doctor specialist in Geriatrics.
Can dementias be treated and cured?
Regarding treatment, it is important to keep in mind that, at present, dementia cannot be cured, but there are drugs to improve cognitive symptoms and, especially, there are drugs to control behavioral symptoms. However, it is important to emphasize non-pharmacological treatment, as it is essential for the management of the dementia patient, with therapies based on reality orientation, reminiscence, psychomotor and/or interaction with animals, which are usually performed in specialized centers.
Finally, we should not forget the ethical and legal aspects, since we are dealing with people who have lost their ability to express their will and their relatives and / or environment will be the ones who will decide for them. For this reason, before any recent diagnosis of dementia, we must assess whether it is appropriate to disclose the diagnosis to the patient himself, with the aim of promoting the drafting of the Advance Directive, where the patient can reflect the priorities related to his health for the time when he no longer has the capacity to express himself and depends on third parties, avoiding conflict situations. Likewise, at a legal level, and with the aim of guaranteeing their rights, it is advisable to initiate the legal procedures related to the figure of a guardian to represent them.
Age cannot be fought and dementia is directly related to it. However, a commitment to active and healthy aging, together with the results that may be obtained in the future from the multiple research being conducted worldwide, confirm the challenge of our society to combat one of the major diseases of our century: dementia.