Stages of dementia

introduction

Dementia is a slowly progressing disease that is associated with a loss of mental performance. This is due to dying nerve cells. The disease progresses differently depending on the patient, but cannot be stopped permanently. Depending on which symptoms occur and how severe the dementia is, dementia stages are divided.

For general information see also: The dementia

Course of dementia stages

Early stage

The early stage of dementia expresses itself differently in every person, as it can start from different starting points in the brain. At this stage, the short-term memory is mainly affected. This becomes noticeable as forgetfulness in the fact that new information is more difficult to remember, for example appointments are forgotten, questions are repeated and overall it is difficult for those affected to follow conversations. In contrast, long-term memory, especially biographical memory, is usually not yet impaired, so memories of childhood and adolescence are preserved for a long time. However, there are increasing problems with finding words, since individual words do not occur to the patient and he then paraphrases them. Thinking is also made more difficult, so that complex relationships can be more difficult to understand.

In the early stages of dementia, those affected can still find their way around their familiar surroundings so that everyday things can still be done, but it is increasingly difficult for them to orientate themselves in new surroundings, such as on vacation. Orientation in time is also limited, as is orientation and perception in general. Therefore, decisions are becoming increasingly difficult and it is also difficult for patients to make judgments. Depending on the extent to which orientation is restricted, driving or other activities can no longer be carried out, for example.

But since the brain is still largely intact, those affected notice the loss of mental abilities very clearly in most cases. Often this is very uncomfortable for them and they are ashamed of it. Many try to cover up the symptoms by making excuses for forgetfulness or withdrawing altogether. But fear, aggression, and frustration about memory loss can also be a result. Therefore, depression can also arise due to dementia.

You might also be interested in: Symptoms of dementia

Middle stage

Upon reaching this stage, too everyday actions in familiar surroundings are more difficult. Even small changes in your environment, such as suddenly appearing clouds in the sky, can lead to Disorientation to lead. Those affected need in everyday life increasing help from relatives or caregivers. Over time, they also take over all the usual processes, such as getting dressed or washing. in the further course it can lead to urinary incontinence come. The already existing mental deficits continue to progress and that too Long-term memory is gradually being affected. This is noticeable by the fact that names of familiar people are forgotten or mixed up. Understanding also gets worse, as does that Language more limited becomes. Orientation in space and time can be so restricted that winter clothing is put on in summer or that those affected confuse night and day. This loss of awareness can even increase Hallucinations and delusions to lead. It can happen that affected persons perceive themselves as significantly younger than they actually are and want to go to work, for example.Some see people who are not there, such as their parents, even though they have already passed away.

The personality is also increasingly changing. Certain character traits can recede, others can be more pronounced or even changed completely. Often there are also Mood swingsthat take place very abruptly. Despite all the symptoms, in rare cases patients at this stage of Perceived by outsiders as healthy become.

Late stage

In the last of the dementia stages, those affected are no longer able to take care of themselves. you are dependent on relatives and nursing staff. Both mental and physical abilities are getting worse and worse. New information can no longer be saved and close relatives are often no longer recognized. The Progressive dementia is also reflected in the language noticeable. The patients speak only a few words, which are often a repeat of what they have heard. Often they fall silent over time. The physical limitations make themselves noticeable in the fact that those affected initially only walk in small, tripping steps, later not at all. Often they only move when prompted and over time it becomes impossible to sit upright. Since the reflective movements also decrease, arise at possible falls often serious injuriesbecause they can no longer support themselves. If the physical limitations progress further, so will that Chewing and swallowing difficult and the patients have fecal incontinence and urinary incontinence. They work in the late stages of dementia Affected often apathetic, but still perceive moods and feelings of the environment. Those affected try to express their feelings, but these are usually difficult to understand. Most of the time, the attempts are limited to themselves repetitive movements, like nodding or waving.

Since the patients in the late stage of dementia are mostly bedridden and thus prone to infections, one is Pneumonia the leading cause of death.

Duration

The Duration of the dementia illness is in any case individually different. No rules can be found that predict how long the disease will last. What is certain is that the disease is not curable, only itself delay with some medication leaves. The average is Each stage lasts about three yearsso that, depending on the time of diagnosis, the result is a lifespan of around 7 to 10 years. However, this differs from case to case and can take much shorter or longer. Additionally it depends on the Use and effectiveness of any medication taken from.

diagnosis

The suspected diagnosis of dementia is usually made based on the typical poor memory. In which stage of dementia the diagnosis is made varies, as the disease manifests itself differently in different people and they are often able to cover up the symptoms or to invent excuses for being forgetful. The doctor usually makes the diagnosis of dementia based on neuropsychological tests. The patient must consent to this. The best-known test for recognizing dementia is the so-called Mini-Mental Status Test, also called Mini-Mental State Examination (MMSE).

Read more about this under: Dementia tests

MMSE

Of the MMSE can from one Doctor or a psychologist be performed. It's about a Conversation between doctor and patientwhich lasts about 10 to 15 minutes and during which the patient perform various tasks got to. Various aspects are tested: Orientation, memory, attention, arithmetic, remembering, language and motor skills. Depending on the ability of the patient to follow the doctor's instructions, he or she receives points or not. The sum of the points then leaves a Staging of dementia to and allows one Assessment of the course of the disease. A maximum of 30 points can be achieved. Of the Normal range is from 30 to 27 points, then there are gradations of mild (26 to 19 points), moderate (17 to 9 points) or severe (less than 9 points) dementia.

therapy

The Dementia disease let yourself not heal. With some treatment approaches, the Course only delayed become. Next drug treatment also offer themselves depending on the progression of the disease cognitive training, behavior therapy or occupational and muscle therapy on. However, the more advanced the dementia, the less useful these treatment approaches are.

With Medication can only relieve the symptoms of dementia become. Depending on the individual appearance, so can Preparations for memory or concentration disorders administered or which against depression. For all drugs, the earlier they are given, the higher the likelihood that they will have a positive effect on the course of the disease. Because dementia sufferers often do not think about that Taking medication regularly, other people are necessary to remind them.

in the early or middle stage can drugs of the active ingredient group of the so-called Acetylcholinesterase inhibitors are given. This prevents the breakdown of a substance (Acetylcholine) inhibited who for the Responsible for signal transmission in the brain is. Will the Degradation inhibited, so more of this material is available and the Retention can be retained longer. Possible drugs are Donepezil, Galantamine or Rivastigmine.

In one later stage can be memantine are given. This will be Maintain learning and other cognitive skills longerbecause the amount of another messenger substance in the brain (Glutamate) is regulated.

At occurring depression because of dementia, antidepressants are one way to help patients. If Aggression or hallucinations Symptoms are so act Neuroleptics on the other hand.