Overview: What is dementia?
Dementia is the generic term for diseases that are associated with a decline in higher brain functions such as memory, language, visual-constructive abilities and abstract thinking. The term “dementia” comes from the Latin “de mens” and translates as “without mind”, “out of one’s mind”. Around 60 percent of all dementia patients suffer from Alzheimer’s dementia. Dementia occurs more frequently in old age. Only rarely do young people develop dementia. Every year, around 30,000 new cases are diagnosed in Switzerland. Due to the higher life expectancy of women, they are affected significantly more often than men. Women account for around 70 percent of all dementia cases.
Definition of dementia
Dementia is a brain disease that progresses chronically over at least six months with unimpaired consciousness and preserved sensory perception, which leads to an impairment of higher brain functions and impairs the ability to lead an independent life
At least two of the following areas are affected by dementia:
- Memory impairment
- Speech disorders (aphasia),
- Recognition (agnosia),
- Impairment in the execution of motor activities (apraxia)
- Restrictions in visual-constructive abilities
- Impairment of thought processes and judgment
Dementia: causes and risk factors
The cause of dementia is a brain disease, i.e. a neurological disorder in which nerve cells die (neurodegeneration) or blood flow to the brain is impaired.
- Alzheimer‘s dementia: At 60 percent, Alzheimer’s dementia is the most common form of dementia. Alzheimer’s is a neurodegenerative disease that progresses gradually and is characterized by memory impairment. The incidence of Alzheimer’s dementia increases with age.
- Vascular dementia: Vascular dementia is the second most common type of dementia. It is caused by a chronic circulatory disorder of the brain (arteriosclerosis), a stroke or a combination of these two factors. The most important risk factors are high blood pressure, diabetes, high cholesterol levels, obesity and smoking.
- Mixed forms: There are also mixed forms between Alzheimer’s dementia or the other forms of dementia mentioned below and vascular dementia.
- Frontotemporal dementia: Another neurodegenerative disease that can lead to dementia is frontotemporal dementia (FTD), formerly known as Pick’s disease. The focus here is less on memory disorders and more on behavioral and speech disorders. The age of onset is usually younger than that of Alzheimer’s dementia.
- Parkinson’s dementia: Over time, people with Parkinson’s disease can also develop signs of dementia, known as Parkinson’s dementia.
- Lewy body dementia / Lewy body dementia: As in Parkinson’s disease, pathological synuclein proteins are deposited in the brain in Lewy body dementia, but not primarily in the motor centers, but diffusely distributed. Patients with Lewy body dementia usually have milder Parkinson’s symptoms and often fluctuating cognitive performance in addition to limitations in higher brain functions.
- Prion diseases: In Creutzfeld-Jakob disease, incorrectly folded proteins are deposited in the brain nerve cells, often leading to rapidly progressing dementia.
Symptomatic impairment of higher brain functions
When diagnosing dementia, it is important to recognize conditions that cause limitations in higher brain functions but are not caused by a primary brain disease. This is particularly important as some of these conditions are treatable:
- Alcohol abuse: People who drink too much alcohol can suffer brain damage, particularly in the frontal and temporal lobes, which can also lead to severe memory impairment, known as Korsakov’s syndrome.
- Infectious brain diseases: Chronic inflammation of the brain, for example in HIV infection (AIDS dementia) or Lues infections (progressive paralysis).
- Space-occupying processes in the brain: Brain tumors or excess pressure in the cerebrospinal fluid system (hydrocephalus) can cause increasing restrictions in higher brain functions.
- Metabolic diseases and vitamin deficiency: Hypothyroidism, diabetes mellitus and other metabolic diseases as well as severe vitamin deficiency can cause a restriction of higher brain functions.
- Pseudodementia: Depression or other psychiatric illnesses can lead to a reduction in higher brain functions. Experts speak of depressive pseudodementia or dementia syndrome in depression. However, the symptoms of actual dementia are also negatively affected by depression.
Self-help groups
The exchange with people who are affected by the same disease can be a great support in coping with the disease. Advice on finding a suitable self-help group is available from Selbsthilfe Zürich. Self-Help Zurich and the University Hospital Zurich are cooperation partners in the national project “Health literacy thanks to self-help-friendly hospitals”.