Dementias: understanding, preventing and supporting
Dementia is a syndrome that affects memory, thinking and daily life. This health file will help you understand dementia, explore how to prevent its progression, and discover effective ways to support patients and their families.
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I. Definition
To better understand, prevent and support dementias, it is essential to know that the term dementia covers various conditions affecting memory, thinking, reasoning, behavior and daily functioning. It is not a single disease, but a syndrome with multiple causes. Most types of dementia are degenerative, meaning symptoms worsen over time and cognitive functions become increasingly impaired [1].
Key figures
- Alzheimer’s disease is the most common cause of dementia, responsible for 60 to 70% of cases [1].
- According to WHO, in 2021, 57 million people worldwide, more than 60% on whom were in low-and middle-income countries had dementia [1].
- Dementia is now the seventh leading cause of death worldwide, and one of the main causes of disability and dependence among older people [1].
- According to WHO, there are nearly 10 million new cases each year, meaning one new case every 3 seconds [1][2].
- The number of people with dementia is rising and could reach 78 million by 2030 and 139 million by 2050, according to the 2021 WHO report [3].
- Contrary to popular belief, dementia does not exclusively affect older people. Early-onset dementia (defined as the start of symptoms before the age of 65) accounts for up to 9% of cases [1].
II. Causes
Dementias are caused by damage to brain cells that prevents normal communication between them. This damage affects the mechanisms of thought, judgment, and learning, leading to a progressive deterioration of cognitive functions [4]. These lesions may result from various diseases or disorders:
- Alzheimer’s disease: caused by abnormal accumulation of two types of proteins that alter and destroy neurons [2].
- Vascular dementia: linked to poor blood flow to the brain due to strokes or repeated cerebral infarctions, leading to the death of certain brain cells [5].
- Lewy body dementia: caused by the abnormal presence of proteins (Lewy bodies) in nerve cells, affecting cognitive and motor functions [6].
- Frontotemporal dementias: due to degeneration of the frontal and temporal lobes of the brain, which regulate behaviour, emotions and language [7].
- Modifiable risk factors increase the likelihood of developing dementia: advanced age, high blood pressure, diabetes, smoking, physical inactivity, unhealthy diet, social isolation and low cognitive stimulation [1][4].
III. The main forms of dementia
Although certain symptoms are common to several types of dementia, each form is distinguished by specific causes and manifestations. The main forms include [4]:
- Alzheimer’s disease: accounts for 60 to 70% of cases [1]. It often begins with recent memory problems then spreads to other functions such as language, orientation, face recognition or decision-making. The progression is gradual [2].
- Vascular dementia: often occurs after a stroke or several small strokes. Symptoms may appear more suddenly and progress in stages, with impairments in attention, planning, or reasoning [5].
- Lewy body dementia: combines cognitive impairment, visual hallucinations and motor symptoms similar to those seen in Parkinson’s disease (stiffness, slowness of movement) [6].
- Frontotemporal dementia: occurs earlier (between the ages of 45 and 65). It causes marked behavioral changes (disinhibition, loss of empathy, impulsivity) or progressive language disorders, depending on the affected brain area[7].
IV. The symptoms
Symptoms of dementia vary depending on its type and stage of progression. They usually appear gradually and tend to worsen over time. There are generally three stages of progression, each associated with characteristic clinical signs [4]:
Phase 1: the initial phase, which corresponds to the onset of the first symptoms, which are generally mild and relatively subtle [4]:
- Recent memory loss
- Vocabulary problems with difficulty finding words
- Thought disorders
- Frequent loss of objects
- Difficulty following conversations or making decisions
- Difficulty performing daily tasks
Phase 2: the intermediate phase, characterized by worsening symptoms, making patients’ daily lives increasingly difficult [4]:
- Difficulty learning new information
- Trouble recognizing loved ones or objects
- Language disorders
- Confusion in space and time
- Repetitive or unusual behaviors
- Psychosis in about 10% of people reaching this stage
Phase 3: the advanced phase, also known as the severe phase, where brain function is almost completely impaired, making normal life extremely difficult for patients and their families [4]:
- Total dependence on others for daily activities
- Inability to remember loved ones or one’s own reflection in the mirror
- Severe language impairment
- Partial or total loss of mobility
- Aggressive behavior, anxiety, hallucinations or apathy
V. Prevention and treatment
To date, there is no cure for dementia. However, it is possible to act on certain risk factors to prevent or delay its onset and to implement strategies to slow the progression of symptoms.
According to the World Health Organization, up to 40% of dementia cases could be prevented or delayed through healthy lifestyle habits [1].
Prevention
Several simple, accessible measures can help protect cognitive health [1]:
- Engage in regular physical activity
- Stimulate the brain through intellectual activities (reading, memory games, learning)
- Maintain an active social life to preserve mental well-being
- Avoid tobacco and limit alcohol consumption
- Adopt a balanced diet
- Monitor and treat cardiovascular risk factors: high blood pressure, diabetes, cholesterol
Treatments
Although no curative treatment currently exists, certain approaches can relieve symptoms and improve quality of life [1]:
- Specific medications can temporarily help preserve cognitive functions or manage behavioral disorders.
- Personalized support is essential: psychological support, home help, adapting daily adjustments and support for loved ones and caregivers.
Conclusion
In conclusion, dementia remains a subject that is still too stigmatized, which accentuates the isolation of those affected. However, a better understanding of these disorders and a caring approach would improve their quality of life. It is essential to talk about it, fight against preconceived ideas, and consult a healthcare professional at the first signs. Finally, adopting a healthy lifestyle remains one of the best ways to reduce the risks. Prevention begins with information.
POI 1090-07/25
Sources
[1] https://www.who.int/fr/news-room/fact-sheets/detail/dementia
[2] https://alzheimer-recherche.org/quest-ce-que-la-maladie-dalzheimer/
[3] https://www.who.int/fr/news/item/02-09-2021-world-failing-to-address-dementia-challenge