What is dementia? Causes, symptoms – and what you can do about it
As we get older, our general performance often declines. But if, in return, forgetfulness increases, we worry that it could be dementia - a disease that affects almost 1.6 million people across Germany. But of course, misplacing your car keys does not necessarily mean that you have dementia. Find out here what dementia is, how it can be recognized, what causes it and what can be done about it.
What is dementia and what types are there?
Dementia is the collective term for various diseases that result in a permanent impairment of brain function. The best known and most common form of dementia, at 60 percent, is Alzheimer's disease. Vascular dementia, Lewy body dementia and frontotemporal dementia are also the most common. In addition, around 20 percent of dementia patients have a mixed form of vascular dementia and Alzheimer's disease. In addition, there are so-called secondary dementias. These refer to dementia diseases that occur as a result of other diseases, such as vitamin deficiencies, thyroid diseases or addictions. Inflammatory diseases of the nervous system, such as multiple sclerosis, can also lead to dementia.
Protein deposits in Alzheimer's disease
Despite intensive research, the causes of Alzheimer's disease have not yet been fully clarified. Different protein deposits in the brain play a crucial role, causing nerve cells to die. In detail, these are so-called beta-amyloid plaques and tau fibrils. Beta-amyloid is a fragment of a larger protein that is normally broken down and transported away in a healthy brain. In Alzheimer's disease, this mechanism no longer works and the fragments attach themselves to the nerve cells to form indestructible clumps. This inhibits the supply of nutrients and oxygen to the nerve cells, and they begin to die. Tau fibrils are malformed protein fibers that also hinder the supply of nerve cells. So-called microtubules are normally formed from the tau protein. These are supply channels through which nutrients are transported into the interior of a cell.
Other types of dementia and their causes
In vascular dementia, nerve cells die as a result of circulatory problems. The cause of circulatory problems is damaged blood vessels or a series of small strokes. The greatest risk factors include high blood pressure, heart disease, diabetes and smoking. In Lewy body dementia, as in Alzheimer's, protein deposits form within the nerve cells in the form of so-called Lewy bodies. With this form of dementia, patients often experience hallucinations in the early stages. In contrast, memory is retained for longer than with Alzheimer's. Frontotemporal dementia is characterized by damage to the front areas of the brain, i.e. the frontal and temporal lobes. Personality changes such as severe mood swings or sudden inappropriate, tactless or embarrassing behavior are typical of this form of dementia.
Recognizing Dementia – Early Symptoms
It is quite natural that the ability to concentrate decreases and forgetfulness increases with age. So there is no reason to worry if you forget the name of an acquaintance. A characteristic of dementia is that memories disappear irretrievably and even entire sequences of actions, such as tying shoes, are forgotten. Typical symptoms are:
- memory problems
- declining comprehension
- disorientation
- mood swings
- behavioral and personality changes
- language problems
- Disturbances in the day/night rhythm
Anyone who notices these symptoms or is worried about their memory performance should see a doctor and have a neurological examination. This is the only way to identify dementia with certainty and differentiate it from normal, age-related fluctuations in performance or other illnesses such as depression.
Age as the most important risk factor for dementia
Dementia is primarily a disease of old age. As people get older, the likelihood of developing dementia increases. While the proportion of those affected is two percent in the 65-69 age group, it rises to 35 percent in those over 90. Around two thirds of those affected are women. The cause is thought to be the higher life expectancy of women. Hormonal factors could also play a role.
Does heredity also play a role in dementia?
Under certain unfortunate circumstances, Alzheimer's dementia can also be inherited. The so-called autosomal dominant Alzheimer's dementia is caused by a gene mutation. If one parent has this mutation, there is a 50 percent chance that their children will also develop dementia. However, these mutations are very rare and only account for less than one percent of all dementia cases. However, most forms of dementia are not hereditary. Nevertheless, genetic factors can influence the development of dementia: If first-degree relatives, i.e. parents, siblings or children, are affected by dementia, the probability of developing dementia yourself increases fourfold. These factors also increase the risk of dementia:
- low mental activity
- few social contacts
- heavy alcohol consumption
- Smoke
- traumatic brain injuries
- vitamin D deficiency
- diabetes
- high blood pressure
- long-term use of certain medications (e.g. antidepressants)
What can be done against dementia?
The best way to prevent dementia is to lead a generally healthy and active lifestyle. According to a study by Columbia University in New York, regular exercise and a healthy diet can reduce the risk of dementia by up to 60 percent. A healthy, varied diet includes plenty of fresh fruit and vegetables, as well as fresh fish, pulses and nuts. We have put together a detailed guide to brain-friendly nutrition for you on this page . An active lifestyle doesn't just mean exercising, it also means staying mentally active. Because if you don't use it, you lose it. Regularly meeting up with friends, going to the cinema, the theater or even restaurants provide new impressions and keep the brain active. Puzzle games and, above all, traveling and making music are real fountains of youth for the brain. Here you can find out more about how to keep your brain fit as you get older .
What treatment options are available?
Most forms of dementia are currently incurable. Treatment aims to delay the progression of the disease as much as possible and to alleviate existing symptoms. The drugs used for treatment are called antidementia drugs. Depending on the need, they inhibit or stimulate certain neurotransmitters in the nerve cells and alleviate the declining performance of the brain. In addition, there are various forms of therapy available, such as occupational therapy or music therapy. On the one hand, these serve to maintain the remaining abilities and, on the other hand, also help to improve the quality of life. For people in an early stage of the disease, there are also various rehabilitation options available that specifically target the respective symptoms. Both the health insurance companies and the treating doctors are happy to provide information about which rehabilitation options are available and which are financed.
Conclusion: Nutrition, activities and therapy options
Dementia encompasses various forms of age-related, degenerative brain diseases, which are primarily noticeable through increasing loss of memory and comprehension, as well as personality changes in those affected. Only a few forms of dementia are curable, but antidementia drugs and therapies tailored to the individual's needs can mitigate the course of the disease. The best prevention is a healthy lifestyle, with a balanced, fresh, nutrient- and vitamin-rich diet, combined with sustained mental and physical activity.
