dementia

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Martina Feichter studied biology with an elective subject pharmacy in Innsbruck and also immersed herself in the world of medicinal plants. From there it was not far to other medical topics that still captivate her to this day. She trained as a journalist at the Axel Springer Academy in Hamburg and has been working for since 2007 - first as an editor and since 2012 as a freelance writer.

More about the experts All content is checked by medical journalists.

Dementia is a persistent or progressive impairment of memory, thinking or other brain functions. The cause for this can be different. There are different forms of dementia such as Alzheimer's disease and vascular dementia. Read more about the topic here: What is dementia (definition)? What forms are there? How do you recognize dementia? How is it diagnosed and treated?

ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. F03F02F01G31F00G30

Dementia: Brief Overview

Important forms of dementia: Alzheimer's disease (45-70% of all dementias), vascular dementia (15-25%), Lewy body dementia (3-10%), frontotemporal dementia (3-18%), mixed forms ( 5-20%)
Symptoms: With all forms of dementia, mental performance is lost in the long term. Further symptoms and the exact course vary depending on the type of dementia.
Affected: Mainly people over 65 years of age. Exception: frontotemporal dementia, which begins around the age of 50. Most dementia patients are women because, on average, they get older than men.
Causes: Primary dementias (such as Alzheimer's) are independent diseases in which nerve cells in the brain gradually die - the exact reason for this is unknown. Secondary dementias are the result of other diseases (such as alcohol addiction, metabolic disorders, inflammation) or medication.
Treatment: medication, non-drug measures (such as occupational therapy, behavioral therapy, music therapy, etc.)
Can Dementia Be Cured? Primary dementias cannot be cured. However, the right treatment can delay the course. Secondary dementia can sometimes be cured if the cause is identified and treated early on.

What is dementia

The term dementia does not refer to a specific disease, but to the common occurrence of certain symptoms (= syndrome), which can have a wide variety of causes. In total, the term encompasses more than 50 forms of disease (such as Alzheimer's disease and vascular dementia).

Common to all forms of dementia is the persistent or progressive impairment of memory, thinking and / or other brain functions. Often there are additional symptoms (e.g. in interpersonal behavior).

Primary and Secondary Dementia

The term "primary dementia" includes all forms of dementia that are independent clinical pictures. They originate in the brain, where more and more nerve cells die.

The most common primary dementia (and the most common dementia in general) is Alzheimer's disease. In second place is vascular dementia. Other primary forms of dementia are frontotemporal and Lewy body dementia.

"Secondary dementia" refers to dementia that are caused by medication or other diseases, such as alcohol addiction, thyroid diseases or pronounced vitamin deficiencies. Secondary forms of dementia are rather rare - they make up about ten percent of all dementia cases.

There are also mixed forms of dementia disease processes, in particular mixed forms of Alzheimer's disease and vascular dementia.

Pseudodementia is not "real" dementia and is therefore neither one of the primary nor one of the secondary forms of dementia. It is a symptom - usually of major depression.

Cortical and subcortical dementia

Another classification of the clinical pictures is based on where the changes occur in the brain: cortical dementia is associated with changes in the cerebral cortex (Latin: cortex cerebri). This is the case with Alzheimer's disease and frontotemporal dementia, for example.

Subcortical dementia, on the other hand, describes dementia diseases with changes below the cerebral cortex or in deeper layers of the brain. These include subcortical arteriosclerotic encephalopathy (SAE), a form of vascular dementia.

However, this classification is not without problems because there are numerous mixed and transitional forms. For example, dementia with Lewy bodies can manifest itself either as a cortical or as a mixed form.

Dementia Syndrome

The term dementia syndrome is often equated with "dementia". It is understood as a general intellectual decline, for example memory and orientation disorders as well as language disorders. The patient's personality often changes over time.

A distinction must be made between pseudodementia and dementia syndrome. This term encompasses temporary cerebral disorders that are simulated by inhibition of thought and drive. Most often, pseudodementia develops in the context of severe depression. If the depression is treated properly, the symptoms of pseudodementia will usually subside.

You can find out more about dementia syndrome and pseudodementia in the article Dementia syndrome.

Senile dementia and senile dementia

Because older people in particular suffer from dementia, it is often referred to as senile dementia. However, this term is not to be equated with "senile dementia": the latter means "senile dementia of the Alzheimer's type" (SDAT) - a manifestation of Alzheimer's disease in old age. In contrast, there is present Alzheimer's disease, which usually occurs in the fifth or sixth decade of life.

Today, present and senile dementia of the Alzheimer's type are usually collectively referred to as Alzheimer's disease or dementia of the Alzheimer's type (DAT).

Dementia: symptoms

In the case of dementia, mental performance is lost in the long term. In detail, the symptoms of dementia depend on which disease it is exactly - such as Alzheimer's or vascular dementia.

Dementia: "Enjoy your life!"

Three questions for

Dr. med. Radka Cerny,
Specialist in neurology and psychotherapy
1
Can you stop dementia?

Dr. med. Radka Cerny
There is no cure for dementia. According to the latest studies, there is currently no substance on the market that really improves thinking or memory and / or slows the course of the disease. What is very possible, however, is to maintain the well-being of the sick and their relatives. Good care, if necessary pain relief, sleep aids and therapy for behavioral disorders help.
2
Should those affected be told the diagnosis?

Dr. med. Radka Cerny
Personally, I am very careful with the diagnosis of dementia. Apparent dementia can also hide severe depression, for which there is certainly medical help. From my point of view, it is problematic to make a serious diagnosis when there is no sensible therapy or cure. During the course of treatment, one can observe how the disease is progressing and, if necessary, name the diagnosis of dementia.
3
Do you have any special advice for those affected or their relatives?

Dr. med. Radka Cerny
If you are affected, move around a lot, cultivate friendships and hobbies, and try to do something meaningful for as long as possible! Enjoy your life! If you, as a relative, talk to the doctor about treatment and accommodation options at an early stage, you will understand the disease better and be able to provide targeted help. While taking care of everything, pay attention to your own needs and treat yourself to a change and time out.
Dr. med. Radka Cerny,
Specialist in neurology and psychotherapy
In her practice in Munich, the neurologist also offers her own head consultation, in which more comprehensive differential diagnostics are used to get to the bottom of memory and concentration disorders.

Alzheimer's disease

The onset of dementia symptoms in Alzheimer's (and many other forms of dementia) are problems with the short-term memory: those affected become increasingly forgetful, often misplace things and find it difficult to concentrate. Sometimes common terms suddenly no longer come to mind during a conversation. Orientation problems in unfamiliar surroundings are also the first signs of dementia of the Alzheimer's type.

Advanced dementia symptoms in Alzheimer's patients affect long-term memory. Patients find it increasingly difficult to remember the past. At some point they can no longer recognize people close to them. In the late stages of dementia, patients also degrade physically and need help with all activities.

The brain shrinks in Alzheimer's

In Alzheimer's disease, nerve cells die. This causes the brain to slowly shrink.

Read more about the symptoms, causes, diagnosis and treatment of this most common form of dementia in the Alzheimer's disease article.

Vascular dementia

Vascular dementia is the result of circulatory disorders in the brain. The symptoms of dementia are often similar to those of Alzheimer's. However, the exact clinical picture of vascular dementia depends on where in the patient's brain the circulatory disorders occur and how pronounced they are.

Possible symptoms include problems with listening attentively, speaking coherently, and finding one's bearings. These signs of dementia are also present in Alzheimer's disease, but they often appear earlier and more violently in vascular dementia. In addition, memory can be retained longer in vascular dementia.

Other possible signs of vascular dementia include gait disorders, slowing down, bladder emptying disorders, difficulty concentrating, changes in personality, and psychiatric symptoms such as depression.

You can read more about the symptoms, causes, diagnosis and treatment of this second most common form of dementia in the article Vascular Dementia.

Lewy body dementia

Lewy body dementia also manifests itself with dementia symptoms similar to Alzheimer's disease. However, many patients show hallucinations (hallucinations) in the early stages of the disease. In return, the memory is usually retained longer than with Alzheimer's.

In addition, many people with Lewy body dementia show symptoms of Parkinson's disease. These include stiff movements, involuntary tremors and an unstable posture. That is why those affected sway and fall more frequently.

Another peculiarity of this form of dementia is that the physical and mental condition of the patient sometimes fluctuates greatly. At times those affected are enterprising and wide awake, then again confused, disoriented and withdrawn.

You can read more about symptoms, causes, diagnosis and treatment of this form of dementia in the article Lewy Body Dementia.

Frontotemporal dementia

Frontotemporal dementia - also known as Pick's disease or Pick's disease - shows a completely different course. Typical dementia symptoms are changes in personality and often strange behavior: Those affected are usually easily irritable, aggressive and behave tactlessly or embarrassingly. Excessive eating and apathy are also possible.

Due to the conspicuous and unsocial behavior of many patients, a mental disorder is often first suspected instead of dementia. Typical dementia symptoms such as memory problems only appear in the advanced stages of Pick's disease. In addition, the patient's language becomes impoverished.

You can read more about symptoms, causes, diagnosis and treatment of this rarer form of dementia in the article Frontotemporal Dementia.

Difference: Alzheimer's & dementia of a different kind

"What is the Difference Between Alzheimer's & Dementia?" Some people affected and their relatives ask themselves this question on the assumption that there are two different clinical pictures. In fact, as mentioned above, Alzheimer's is just one form of dementia, and by far the most common. So, correctly, the question should be what the difference is between Alzheimer's disease and other forms of dementia - such as vascular dementia.

A typical difference between these two most common forms of dementia relates to the onset and course of the disease: Alzheimer's usually begins insidiously and the symptoms slowly worsen. Vascular dementia, on the other hand, often sets in suddenly and symptoms increase in spurts.

So much for theory - in practice, however, it often looks a little different. Each type of dementia can develop differently from patient to patient, which makes it difficult to differentiate between the various forms of the disease. There are also mixed forms, such as Alzheimer's and vascular dementia. Those affected show features of both forms of dementia, which is why a diagnosis is often difficult.

You can read more about the similarities and differences between important forms of dementia in the article Difference Between Alzheimer's and Dementia?

Dementia: causes and risk factors

In most cases of dementia, it is a primary disease (primary dementia), i.e. an independent disease originating in the brain: In those affected, nerve cells gradually die off and the connections between the nerve cells are lost. Doctors speak of neurodegenerative changes here. The exact cause varies depending on the type of primary dementia and is often not fully understood.

Alzheimer's dementia: causes

In the most common form of dementia, so-called plaques form in the brain. These are deposits of a diseased protein (beta amyloid). Doctors suspect that these plaques contribute to or at least promote Alzheimer's disease.

It is not known exactly why the plaques form. Rarely - in about one percent of cases - the causes are genetic: Changes in the genetic material (mutations) lead to plaque formation and the outbreak of disease. Such mutations make Alzheimer's dementia hereditary. In the vast majority of cases, however, you don't know exactly why someone has Alzheimer's.

Vascular dementia: causes

In vascular (vessel-related) dementia, circulatory disorders in the brain lead to the death of nerve cells. For example, they can be the result of several small strokes (due to vascular occlusion) that occur simultaneously or at different times in one region of the brain ("multi-infarct dementia"). Sometimes vascular dementia also arises from major cerebral hemorrhage, for example in high blood pressure patients.

Less common causes of vascular dementia are, for example, vascular inflammation and genetic diseases.

Lewy body dementia: causes

In Lewy body dementia, protein residues of the transport protein alpha-synuclein, which, among other things, regulate the release of dopamine, are deposited in the nerve cells of the cerebral cortex. These so-called Lewy bodies impede communication between the nerve cells. Why they develop is mostly unknown. The disease is very rarely genetic.

Frontotemporal dementia: causes

In frontotemporal dementia, nerve cells in the frontal and temporal lobes of the cerebrum gradually die off. Again, the cause is largely unknown. Some of the cases are genetically determined.

Secondary dementia: causes

The rare secondary dementias are caused by other diseases or drugs. They can be triggered, for example, by alcohol addiction, thyroid disorders, liver diseases, infections (e.g. HIV encephalitis, neuroborreliosis) or a vitamin deficiency. Medicines are also possible causes of dementia.

Risk factors for dementia

Older age and a corresponding genetic predisposition increase the risk of dementia. Other risk factors are, for example, high blood pressure, diabetes mellitus, cardiac arrhythmias, high cholesterol levels, depression, traumatic brain injuries, smoking, excessive alcohol consumption and obesity.

People with little mental, social, and physical activity are also more prone to developing dementia.

Dementia: examinations and diagnosis

The fact that one often forgets something in old age is not necessarily a cause for concern. However, if your forgetfulness persists or even increases for months, you should see your family doctor. He can refer you to a specialist (neurological practice or memory clinic) if you suspect dementia.

Anamnesis interview

The doctor will first ask you about your symptoms and your general state of health. He will also ask if you are taking any medications, and if so, which ones. Because many preparations can temporarily or permanently worsen brain performance. During this anamnesis interview, the doctor also pays attention to how well you can concentrate on the conversation.

The doctor often also talks to close relatives. He asks her, for example, whether the patient is more restless or aggressive than before, is very active at night or has hallucinations.

Cognitive dementia tests

The doctor can use various tests to determine whether you have dementia and how severe it is. Frequently used dementia tests are for example the watch test, MMST and DemTect. They are easy to perform and do not take much time. However, their informative value for mild and questionable dementia is limited. In addition, these short cognitive tests are not suitable for differentiating between the various dementias.

Watch test

The clock test helps to identify dementia at an early stage. To do this, however, it is always combined with another test: the result of the watch test alone is not sufficient for a diagnosis.

The clock test is very simple: Enter the numbers 1 to 12 in a circle, exactly as they are arranged on a clock face. You should also draw the hour and minute hands in such a way that a specific time results (for example 11:10 am).

During the evaluation, the doctor checks, for example, whether the numbers and pointers are drawn in correctly and the digits are easy to read. From errors and deviations, he can infer a possible dementia. People with the onset of dementia often place the minute hand incorrectly but the hour hand correctly.

Watch test

If a patient cannot correctly record a clock face or a time, this is an indication of dementia.

You can read more about this test procedure in the watch test article.

MMST

The abbreviation MMST stands for "Mini Mental Status Test". It is a very commonly used dementia test. You have to fill out a simple questionnaire that tests various brain functions such as memory, attention and arithmetic. Your orientation skills are also tested with questions such as "What is the time of year?" or "Which town are we in right now?". Each answer is assessed with a number of points.

At the end of the test, all points scored are added together. The severity of dementia is estimated based on the result. With regard to Alzheimer's - by far the most common form of dementia - a distinction is made between the following stages of dementia:

MMST 20 to 26 points: mild Alzheimer's dementia
MMST 10 to 19 points: moderate / moderate Alzheimer's dementia
MMST <10 points: severe Alzheimer's dementia

You can find out more about the process and the evaluation of the "Mini-Mental-Status-Test" in the article MMST.

DemTect

The abbreviation DemTect stands for "Dementia Detection". The approximately ten-minute test tests various cognitive abilities such as memory. For this purpose, ten terms are read out to you (dog, lamp, plate, etc.), which you then have to repeat. The order does not matter. It counts how many of the terms you could remember.

In another exercise, you should list as many things as possible that can be bought in a supermarket. This checks the semantic fluency of the word.

Points are awarded for each task. At the end of the test, you add up all the points. The overall result can be used to estimate whether and to what extent your cognitive performance is impaired.

Read more about this test procedure in the DemTect article.

Physical examination

A physical exam is important to rule out other medical conditions as the cause of the suspected dementia symptoms. You can also determine your physical condition in this way. For example, the doctor measures your blood pressure, checks your muscle reflexes, and how your pupils respond to light.

Laboratory tests

The diagnosis of dementia also includes blood tests. The blood count is created and various blood values are determined (electrolytes such as sodium and potassium, fasting blood sugar, blood sedimentation, urea, vitamin B12, thyroid values, gamma-GT, etc.). In this way, it can be determined whether there is a possible secondary dementia, which is triggered, for example, by a thyroid disease or a lack of vitamin B12.

In some cases, more extensive laboratory tests are necessary, for example if the dementia patient is noticeably young or the symptoms are progressing very quickly. Then the doctor orders, for example, a drug screening, urine tests and / or a test for Lyme disease, syphilis and HIV.

If the anamnesis and previous examinations suggest an inflammatory brain disease, a sample of the nerve fluid (liquor) should be taken from the lumbar spine (lumbar puncture) and analyzed in the laboratory. This can indicate Alzheimer's disease: Characteristic changes in the concentration of certain proteins (amyloid protein and tau protein) in the CSF indicate with a high degree of probability Alzheimer's disease.

Imaging procedures

Imaging studies of the brain are used to rule out treatable causes of dementia (such as a tumor). They also help to differentiate between the various forms of primary dementia (Alzheimer's, vascular dementia, etc.).

Computer (CT) and magnetic resonance tomography (MRT, also known as magnetic resonance tomography) are mainly used. Sometimes, however, other examinations are also carried out. This includes, for example, an ultrasound examination of the neck vessels if vascular dementia is suspected. In unclear cases of Lewy body dementia, a nuclear medical examination can be useful (positron emission tomography = PET, single photon emission computed tomography = SPECT).

Genetic examination

If it is suspected that the dementia is hereditary, the patient should be offered genetic counseling and testing. The result of the genetic test has no influence on the therapy. However, some patients want to know exactly whether they actually carry a disease-causing gene or not.

Dementia: treatment

Despite various treatment options for dementia, the disease is usually not curable (exception: some secondary dementias). Instead, therapy aims to relieve symptoms and slow the progression of the disease. This helps the patient to lead an independent and self-determined life for as long as possible.

Dementia therapy consists of drug treatment and non-drug measures. An individually tailored therapy plan is created for each patient. The patient's personality and wishes should be taken into account, especially when choosing non-medicinal measures. The earlier the therapy is started, the greater the chances of success of the treatment.

Dementia drugs (antidementia drugs)

So-called anti-dementia drugs are mainly used in drug-based dementia therapy. They influence various messenger substances in the brain. This enables them to maintain the mental performance of the patient. However, antidementia drugs usually only work for a limited time.

Antidementia drugs have been tried primarily in the treatment of Alzheimer's disease. Approved representatives are acetylcholinesterase inhibitors and the glutamate antagonist (NMDA antagonist) memantine.

Acetylcholinesterase inhibitors (such as donepezil or rivastigmine) block an enzyme in the brain that breaks down the neurotransmitter acetylcholine. This messenger substance is important for communication between nerve cells. It is not produced in sufficient quantities in Alzheimer's patients, which contributes to the symptoms. Acetylcholinesterase inhibitors can compensate for this neurotransmitter deficiency in the early and middle stages of Alzheimer's disease. Then patients can cope better with their everyday life again. In addition, brain functions such as thinking, learning and remembering are retained longer.

Acetylcholinesterase inhibitors are also often used for other forms of disease such as Lewy body dementia and mixed forms.

The glutamate antagonist memantine blocks the docking points for the neurotransmitter glutamate in the brain. Its concentration can be increased in Alzheimer's disease, for example, which in the long term destroys the nerve cells. Memantine (neuroprotection) protect against this irreversible nerve damage. They are used in the middle and late stages of Alzheimer's disease.

Preparations based on the medicinal plant Ginkgo biloba are often recommended for dementia. They are considered to be less effective, but can be used as a supplement.

Other drugs for dementia

When people find out that they have dementia, they often develop a depressive mood. The death of brain cells themselves can also be responsible for depression. In such cases, the doctor may prescribe antidepressants. They have a mood-enhancing and stimulating effect.

Some patients become aggressive and restless, suffer from hallucinations or paranoia. Such symptoms can be relieved with neuroleptics (such as risperidone, melperon or pipamperon). The use of these drugs is carefully examined and limited in time due to the strong side effects.

In vascular dementia, risk factors and underlying diseases that can lead to further vascular damage should be treated. This includes, for example, the administration of antihypertensive drugs for high blood pressure and lipid-lowering drugs for elevated blood lipid levels (such as increased cholesterol levels).

Behavior therapy

The diagnosis of dementia triggers insecurity, anxiety, depression or aggressiveness in many people. As part of behavior therapy, a psychologist or psychotherapist can help those affected to cope better with their illness. Behavioral therapy is therefore particularly suitable for patients in the early stages of dementia.

Cognitive training

Cognitive training can slow down the progression of dementia, especially in the early and middle stages of the disease. Mental (cognitive) skills are trained, for example memory, attention and orientation. In individual or group therapy, for example, patients have to guess terms, name colors and add rhymes. The cognitive training should be designed for each patient in such a way that it is neither under- nor overburdening.

Autobiographical work

In the early to middle stages of dementia, autobiographical work can be useful: In discussions (individual or group therapy), the patient should use photos, books and personal items to build on previous positive experiences and talk about them. This autobiographical work keeps the memories of a dementia patient alive from their previous life and strengthens the feeling for their own identity.

Reality orientation

In the reality orientation, the patients train to orient themselves spatially and temporally and to better classify people and situations. The time orientation can be supported with clocks, calendars and pictures of the seasons. In order for patients to find their way around more easily (e.g. in their home), the various living rooms (bathroom, kitchen, bedroom, etc.) can be marked with different colors, for example.

The reality orientation makes sense in all stages of the disease. It can be trained individually or in groups.

Music therapy

The point of music therapy for people with dementia is based on the fact that music can evoke positive memories and feelings. In the early stages of dementia, patients can - individually or together - play an instrument (drum, triangle, glockenspiel, etc.) or sing. In advanced dementia, at least listening to familiar tunes can calm a patient down or relieve their pain.

Occupational therapy

So that patients in the early to middle stages of dementia can cope with everyday activities such as shopping, cooking or reading the newspaper for as long as possible, they should regularly practice these activities with a therapist.

In the middle to severe stages of the disease, dancing, massages and touch stimuli can encourage physical activity. This can bring joy to the patient and improve his or her well-being.

Milieu therapy

Milieu therapy is about making the patient's environment suitable for dementia. Those affected should feel safe and comfortable in their living space. The rooms should therefore be designed as appropriately as possible. For example, smooth wood and soft fabrics are perceived as very pleasant by most patients. Well-known scents (such as room scents) and favorite flowers can bring joy to patients, calm them down or cheer them up and wake up fond memories.

Care planning: dementia

Sooner or later dementia patients need help in everyday life, for example with dressing, washing, shopping, cooking and eating. Patients and their relatives should therefore deal with the topic as early as possible and take care of planning future care.

Important questions that need to be clarified are, for example: Can and will the dementia patient stay in his or her own apartment? What help does he need everyday? Who can provide this help? What types of outpatient care are there? If care at home is not possible - what alternatives are possible?

You can read everything you need to know about topics such as family care, outpatient nursing staff and nursing homes in the article Care planning: Dementia.

Dealing with dementia

When one's own mental performance declines noticeably, it is frustrating and frightening for many of those affected. Relatives too often find it difficult to cope with dementia and its consequences.

Dealing with dementia requires above all patience and understanding - both from the patient and from the relatives and caregivers. In addition, a lot can be done to slow down mental decline. This includes exercising your existing cognitive skills regularly, for example by reading or doing crossword puzzles. Other hobbies such as knitting, dancing or building model airplanes should also be pursued - with necessary adjustments if necessary (such as lighter knitting patterns or simpler dances).

Last but not least, dementia patients also benefit from a balanced diet, regular exercise and a structured daily routine.

You can read more tips for everyday life with dementia in the article Dealing with dementia.

Help with dementia

There are many different associations, institutions and organizations that provide information and support to people with dementia and their families. These include, for example, the German Alzheimer's Society, the German Seniors League and the "Friends of Old People" association.

Anyone who would like to remodel their own home in a meaningful way for an elderly person or person with dementia can contact the Federal Working Group Housing Adaptation e.V. for tips and information. If a move to a retirement or nursing home is necessary, Heimverzeichnis.de offers help in finding a suitable facility.

You can find more about these and other contact points for dementia patients and their relatives in the article Help with dementia.

Dementia: disease course and prognosis

With every form of dementia, mental performance is lost in the long term. The personality of the patient is also irreversibly affected.

In individual cases, however, the course of dementia can vary greatly from patient to patient. It mainly depends on the type of disease. For example, vascular dementia often occurs suddenly and worsens in stages. In most cases, however, dementia begins insidiously and progresses slowly.

In addition, a dementia patient can sometimes have "good" and sometimes "bad" days. The patient's condition can also vary over the course of the day. For many of those affected, dementia is stronger in the evening than during the day.

The behaviors of dementia patients are also very different. Some patients become increasingly aggressive, while others remain friendly and calm. Some patients remain physically fit for a long time, while others become bedridden.

Overall, the following applies: The course of dementia can vary greatly from person to person. It is also difficult to predict.

Influence the course of dementia

There is no cure for dementia. With activation, employment and human attention, the quality of life of dementia sufferers can be significantly improved. In addition, the right therapy (medication and non-drug measures) can help to temporarily stop the course of dementia or at least to slow it down.

Dementia: prevention

Many factors favor dementia. If it is possible to avoid or at least reduce these risk factors, this will help prevent dementia.

For example, one should treat high blood pressure, elevated blood lipid levels and obesity - not only with medication, but also with the right lifestyle. For example, a Mediterranean diet seems to protect against dementia: it contains a lot of fruit and vegetables, fish, olive oil and whole grain bread. On the other hand, pork and dairy products should only be consumed in moderation.

The brain and the rest of the body benefit from regular exercise at any age. Physical activity stimulates blood circulation and metabolism in the brain. As a result, the nerve cells are more active and network better. Sport and exercise in everyday life also lower blood pressure and cholesterol levels and prevent obesity, diabetes, heart attacks, strokes and depression. In addition, regular exercise keeps the blood vessels healthy, which protects against vascular dementia. However, physical activation is not only suitable for prevention: dementia patients also benefit from it.

"Brain training" is also recommended: like the muscles, the brain should also be challenged on a regular basis. For example, cultural activities, mathematical puzzles or creative hobbies are suitable for this. Such mental activity at work and at leisure can reduce the risk of dementia.

If you want to prevent dementia, you should also maintain social contacts. The more you socialize and exchange ideas with other people, the more likely you are still mentally fit even in old age - an important protection against dementia.

Additional information:

Books:

The heart does not become demented: Advice for carers and relatives (Udo Baer and Gabi Schotte-Lange, Beltz Verflag, 2017)
Understanding Alzheimer's and dementias: diagnosis, treatment, everyday life, care (Wolfgang Maier, Jörg B. Schulz, Sascha Weggen and Stefanie Wolf, TRIAS Verlag, 3rd edition 2019)