How do I recognize dementia?
introduction
Around 200,000 people across Germany develop dementia every year. The greatest risk factor for suffering from dementia is age; almost a third of those over 90 years of age are affected by dementia. There are various causes for dementia, most of which are incurable.
However, as there are, on the one hand, forms of dementia that can be completely cured by eliminating the cause and, on the other hand, the natural progression can often be slowed down by therapy, dementia should always be diagnosed. To do this, it is important to recognize the warning symptoms.
causes
Causes for the Development of dementia are there many.
The most common form dementia is the Alzheimer's dementia. The Deposition of protein plaques to a downfall of Neurons of the brain.
The second most common form of dementia is the vascular dementia, which are based on a Circulatory disorder of the brain tissue arises. The defining risk factor for this type of dementia is a increased pressure in the arterial vessels (arterial hypertension), which damages this and eventually becomes a Undersupply of tissue can lead.
About the cause of the Frontotemporal dementia is still little known. Possible risk factors are the occurrence of frontotemporal dementia in one family member and a previous traumatic brain injury.
The Lewy body dementia is like Alzheimer's dementia by a increased protein deposition, the so-called Lewy bodies.
In addition to the classic dementias, there is also Other diseaseswhich often be associated with dementia. Since these are treated differently, it is of great importance to recognize them or these as causes of a Rule out dementia. Diseases that can be associated with dementia symptoms are for example the Parkinson's disease, Chorea huntington, normal pressure hydrocephalus, but also one depression or hormonal dysfunction like a Hypothyroidism.
How do I recognize Alzheimer's dementia?
The Alzheimer's dementia is a cortical dementia, that means it is primarily the Cerebral cortex affected. Are typical creeping restrictions of the person concerned.
Classic early symptomswho can help identify dementia are one Disturbance of memory and spatial thinking. That too Thinking and judgment is often impaired. It can do this too Concentration and attention problems come.
That is characteristic so-called good facade, the fact that those affected are initially able to do theirs To cover up difficulties well. The long-term memory is mostly in Alzheimer's dementia still intact at the beginning, but then also deteriorates. Often it is language affected in the course.
How do I recognize vascular dementia?
The vascular dementia is a subcortical dementia. Here, brain areas are more likely to be affected, which below the cerebral cortex lie. These changes lead to a general slowdown and one Disturbance of wakefulness and alertness as well as a change in mood, motivation and motor skills.
Memory problems mostly stand not in the foreground. A typical early symptom is one Slowdown, in contrast to the Alzheimer's form is the Facade bad from the start, those affected appear sick and impaired.
How do I recognize Lewy body dementia?
The Lewy body dementia is a mixed cortical and subcortical dementia. A variable course is typical for this form of dementia with good and bad days. It can too Hallucinations of seeing and Parkinson-like symptoms such as hand tremors or muscle stiffness.
How do I recognize frontotemporal dementia?
In frontotemporal dementia, the frontal and temporal lobes are predominantly affected, which leads to changes in the areas that are located there: First, changes in personality and drive are noticeable. It usually begins with disorders of social behavior: norms and rule violations are ignored and no longer perceived as such. Later, there are increasing disturbances in memory and orientation.
Read more about this under Memory loss.
How do I recognize end-stage dementia?
One speaks of an end stage of dementia when the mental abilities of a person have been almost completely lost and thereby an increasing limitation of physical functions manifests itself, which in the end can also lead to death.
The time it takes for dementia patients to reach this terminal stage and how long this phase lasts depends on the type of dementia. For example, dementia that is due to circulatory disorders is much slower than Alzheimer's disease.
As mentioned above, in the end stage of dementia, most of the memory is usually lost. This process also affects the personality of the patient and many traits that were previously characteristic of people are lost, which is often very difficult for many relatives. This mental breakdown process is usually followed by the first physical changes. In most cases, this initially affects food intake and there is increasing immobility. Since the patients usually only lie in bed from this point on, the muscles break down, which also affects the chewing and respiratory muscles. This means that shallow breathing often leads to severe respiratory diseases such as pneumonia. If this physical breakdown process increases, in the end, basic body functions can no longer be maintained and death occurs.
You might also be interested in: Course of dementia
diagnosis
In order to recognize dementia, the person affected or their relatives must first notice a change. This should be described to the doctor as precisely as possible. Based on the prevailing symptoms, an attempt can be made to divide dementia into different categories (cortical, subcortical, frontal). It should be noted that these categories are only descriptions and can have numerous causes.
Detailed internal, neurological and psychiatric examinations as well as a blood control of numerous parameters are of great importance. Since numerous diseases and also drugs can be associated with dementia, it should be determined whether such a cause is possibly present.
This should be supplemented by a nerve water puncture, as some diseases that lead to dementia can only be recognized by this. In addition, it can provide further information about the presence of a neurodegenerative disease, especially Alzheimer's dementia.
In addition, an imaging of the head should be performed if dementia is present. The standard here is the MRI examination, if this cannot be carried out on the affected person, for example due to a pacemaker, a CT examination should be carried out. This imaging has two important functions. On the one hand, other, possibly treatable causes of dementia can be discovered in around 5% of all dementias. On the other hand, the dementia can be classified more precisely using the image.
Read more about this at: Symptoms of dementia
Can you recognize dementia in the blood?
There are currently no laboratory tests that can reliably detect dementia.
The rise in some blood values, for example certain fats, can give an initial indication, but these are too unspecific to be able to derive a diagnosis from them. However, a lot of research is currently being carried out on this topic in order to be able to detect dementia before the first symptoms appear and to be able to take preventive measures. For example, the first Alzheimer's laboratory tests are currently being tested in studies that could lead to a diagnosis three years before symptoms appear. However, it may take a few years before these can be used on a large scale.
You might also be interested in: Blood test
Dementia tests
As part of the neuropsychological diagnosis of dementia, three tests in particular have proven to be effective, on the one hand to test whether dementia is present and on the other hand to try to classify the severity of the dementia and make it comparable.
The best-known test is the so-called mini-mental status test, which is also abbreviated as MMST. Among other things, it tests memory, concentration, orientation and general understanding of language. Depending on the patient's performance, up to 30 points can be awarded. If the value achieved is between 10 and 26 points, one can assume the presence of dementia. Even lower values indicate the presence of more severe disorders.
Another test is the number connection test, which primarily tests the ability to concentrate. In this test, the test person should connect a sheet of numbers in ascending order. The result of this test depends on the time it took the patient to complete the task.
The third test is the so-called clock mark test. As the name suggests, the test person should first draw the dial on a sheet of paper with an already existing circle. Then the hands should be drawn to a given time. Usually this is no longer possible for dementia patients.
Read more about this under: Dementia test and Dementia
MRI diagnostics
Depending on the type of dementia, different abnormalities appear in the brain, which can be made visible by an MRI. Probably the most noticeable sign that is common to almost all forms of dementia is the presence of so-called brain atrophy, i.e. the loss and breakdown of brain tissue. This process causes the total volume of the brain to decrease as the dementia progresses, and the folds of the brain become clearer on MRI. Furthermore, certain forms of dementia can lead to circulatory disorders, which then show up as small infarct areas in the MRI, as they absorb less contrast agent compared to the surrounding tissue.
Read more about this: MRI of the brain
