Dementia
As we age, our bodies undergo biological decline, both somatically and mentally. From a psychological perspective, there is a progressive alteration of cognitive functions, with a decline in attention and memory performance, as well as a decrease in the efficiency of intellectual processes. Normal ageing makes us less mentally flexible with an impact on day-to-day functionality; but when the decline is so severe that it affects daily activities, social and family relationships, it may be a sign of a disease causing dementia.
Dementias are common conditions, with the incidence of degenerative dementias increasing with age, so that over the age of 65 about 10% of the population is affected.
1. Causes of dementia
Dementia involves the deterioration of nerve cells in the brain, This damage interferes with the ability…
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2. Symptoms of dementia
The clinical picture of dementia is based on dementia syndrome with variable manifestations depending on the type of dementia…
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3. Diagnosis
Diagnosing dementia and determining the type of dementia can be challenging. A diagnosis of dementia…
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What is dementia?
Dementias are a group of neurodegenerative diseases characterized by progressive and irreversible deterioration of cognitive functions, leading to global deterioration with decline from the previous level of functioning and progression to disability and multiple medical complications precipitating death. The main cognitive functions commonly affected in dementia are memory, attention, language, thinking and judgement, to which can be added personality changes, affective disorders and behavioural disorders.
1. What causes dementia?
Dementia involves the deterioration of nerve cells in the brain, which impairs their ability to communicate with each other. The brain has several distinct regions, each responsible for different functions (such as memory, judgment, behavior). The death of brain cells can lead to cognitive deficits characteristic of dementia.
Some causes of dementia are treatable, and in these cases, dementia is partially or completely reversible. These include: craniocerebral lesions, brain tumours, normotensive hypocephaly, cerebral haematomas, brain infections (meningitis, encephalitis, tuberculosis, parasitosis, HIV-AIDS, syphilis), endocrine disorders (hypothyroidism, sdr. Cushing’s disease), metabolic disorders (diseases of the liver, pancreas or kidneys that disturb the balance of chemicals in the blood: chronic renal failure, dialysis dementia, liver failure, chronic hypoglycaemia), hypoxia (insufficient oxygenation of the brain), vitamin deficiency (of the B group), toxic substances (alcohol, carbon monoxide, lead, mercury, manganese, pesticides, trihexyphenidyl, barbiturates, tricyclic antidepressants, lithium, digitalis, cocaine, etc.).
Unfortunately, most disorders associated with dementia are progressive (inducing a gradual decline in functioning), degenerative (progressing over time to worsening) and irreversible. The two major degenerative causes of dementia are Alzheimer’s disease (progressive loss of nerve cells with no known cause) and dementia vascular (loss of brain function following a series of strokes). Other types of progressive and irreversible dementia are: dementia with Lewy bodies, dementia associated with Parkinson’s disease, dementia fronto-temporal, Huntington’s disease dementia, Creutzfeldt-Jakob disease dementia.
Alzheimer's disease
Alzheimer’s disease is the most common irreversible cause of dementia, accounting for 50-70% of all dementia cases. It is not known exactly what causes brain deterioration, but the following types of changes have been shown to occur in the brains of Alzheimer’s patients:
- alterations in brain neurotransmission with decreased efficiency of neuromediators, especially acetylcholine (the main neuromediator involved in cognition) and increased glutamate activity in moderate and severe stages
- characteristic neurodegenerative lesions: deposits of β-amyloid in the form of senile plaques, fibrillary degeneration (formation of protein tangles inside neurons, made up of tau protein).
These lesions cause altered interneuronal communication, reduced effectiveness of healthy neurons and ultimately massive neuronal destruction.
Vascular dementia
Vascular dementia is the second leading cause of dementia, resulting from focal or diffuse lesions at cortical and subcortical level, a consequence of cardiovascular disease. Brain tissue destruction occurs through decreased or blocked blood flow through strokes that may be few in number but more extensive, or minor but multiple (multi-infarct dementia). The risk factors for vascular dementia overlap with the risk factors for stroke: atherosclerosis, high blood pressure, dyslipidaemia, cardiac arrhythmias, diabetes, obesity and smoking.
Evidence suggests that dementia with Lewy bodies, Parkinson’s disease and Parkinson’s disease dementia may be related to the same brain abnormalities underlying abnormal microscopic deposits, mainly composed of alpha-synuclein, a protein widely found in the brain but whose normal function is not yet known. The deposits are called Lewy bodies. The cause of Lewy bodies in the central nervous system is not known, but the symptoms appear to be related to disruption of nerve impulse flow between the striatum and neocortex due to the accumulation of Lewy bodies. In the brains of these patients, amyloid plaques and neurofibrillary tangles, lesions characteristic of Alzheimer’s disease, were also detected.
Frontotemporal dementia
Frontotemporal dementia is characterised by neuronal degeneration in nerve cells in the frontal and temporal lobes of the brain, areas associated with personality, behaviour and language. The causes of frontotemporal dementia involve a buildup of abnormal proteins in the brain. Abnormal protein toxicity causes brain cells to degenerate and the affected areas shrink over time.
Huntington's disease
Huntington’s disease is a genetically caused neurodegenerative disorder that causes irreversible neuronal destruction and is characterized bydementia, cognitive decline, poor muscle coordination and chorea. Huntington’s disease is caused by a mutation in a gene that produces a substance that interferes with normal brain metabolism. The Huntington’s disease gene encodes a protein called huntingtin and carries an extra segment with a specific sequence of repeating units. When the segment is very large, an erroneous protein is produced, with an overall destructive effect.
Creutzfeldt-Jakob disease
Creutzfeldt-Jakob disease is a degenerative brain disorder that leads to dementia and eventually to death. Creutzfeldt-Jakob disease and its forms belong to a large group of human and animal diseases known as transmissible spongiform encephalopathies. The cause of Creutzfeldt-Jakob disease and transmissible spongiform encephalopathies is thought to be a type of abnormal protein called a prion. Normally, proteins are harmless, but when altered, they become infectious and can adversely affect normal biological processes.
2. What are the symptoms of dementia?
The clinical picture of dementia is based on the dementia syndrome with variable manifestations depending on the type of dementia, the most common signs and symptoms being:
Cognitive symptom
- Memory disorders: difficulty recalling previously learned information and inability to accumulate new information. The first to be lost are recent events, while old memories can be preserved. Over time, long-term memory changes also occur.
- Thinking disorders: problems with abstract thinking, calculation disorders, loss of initiative, impaired organisation of daily activities, inability to make decisions.
- Speech disorders: the patient can’t find words, even for simple notions.
- Temporal-spatial disorientation that may initially manifest itself outside the home, and in the more advanced stages of the disease, the person may not be able to orient himself in his own home.
- Inability to perform various coordinated motor activities: the patient “doesnʼʼt know how to dress properly, how to unlock the door with the key, etc.
- Inability to recognise, identify and name common objects.
- False recognition: at first difficulty in recognising known physiognomies, followed by misidentifications, which can cause anxiety.
These symptoms may have a gradual onset, initially the sufferer develops certain strategies to hide their difficulties, but the decline progressively worsens.
Non-cognitive symptom
- Agitation and physical or verbal aggression.
- Psychotic disorders: hallucinations (usually visual) and delusions (of persecution, jealousy, abandonment, etc.).
- Affective mood disorders: initially depression and anxiety, which may be reactive to awareness of memory impairment, irritability, choleric states, states of exaggerated euphoria, emotional instability.
- Behavioural disorders: impulsive behaviour (acts of violence, dromomania, collecting unnecessary objects), sexual disinhibition (sexual comments, vulgar language, obscene gestures, rarely sexual aggression), neglect of personal hygiene and clothing, eating disorders: reduction or exaggerated increase in appetite, unhealthy eating, ingestion of inedible substances.
- Urinary and faecal incontinence, satisfying physiological needs in inappropriate places or in the presence of other people.
- Sleep disturbances, most commonly with reversed sleep-wake rhythm, daytime sleepiness with nocturnal insomnia, frequent awakenings associated with poor sleep quality.
Warning signs of onset of dementia
One or more of the manifestations below may suggest changes specific to cognitive impairment:
- Gradually developing memory loss
- Difficulties in carrying out daily activities
- Language and communication problems, word-finding difficulties
- Disorientation in time and space
- Impairment of judgement and reasoning
- Wandering things
- Changes in behaviour and personality
- Loss of motivation and initiative, narrowing of interests
- Mood swings
- Reduced medication compliance and recommendations
In the presence of such symptoms it is important to consult a psychiatrist because the course of the disease can be slowed down if intervention is taken in the early stages!!!
3. How is dementia diagnosed?
Diagnosing dementia and determining the type of dementia can be challenging. A diagnosis of dementia requires that at least two basic mental functions are affected enough to interfere with daily life. They are memory, language skills, attention span, reasoning and problem-solving ability and visual perception. A single test cannot diagnose dementia, so the diagnostic evaluation of a patient with dementia syndrome must include a range of tests that can help identify the problem.
The doctor will examine medical history and symptoms by insisting on the mode of onset, history, risk factors. In addition to the interview with the patient, it is mandatory to discuss with the patient’s family, possibly with other people who can provide comparative data on the pre-morbid level of cognitive functioning as well as the evolution of the patient’s symptoms over time.
General clinical examination is mandatory and may reveal signs pointing to the diagnosis of a general condition that accompanies dementia (e.g. a malignant tumour, a metabolic disorder, AIDS, hypothyroidism, severe anaemia, etc.).
Cognitive examination includes examination of attention and attention span, assessment of orientation ability, short and long term memory, praxis, language and executive functions. The main clinical entities from which dementia syndrome should be differentiated are depression, delirium, substance dependence syndrome.
Neurological examination can detect specific neurological signs that may point to primary neurological diseases associated with dementia (e.g. Wilson’s disease, Creutzfeldt-Jacob disease). Neurological examination is also very important to distinguish Alzheimer’s dementia from vascular dementia.
Psychiatric examination can detect non-cognitive disorders: psychiatric and behavioural symptoms often present from the early stages of development, including depression and psychotic phenomena, confusional states, obsessive episodes, anxiety, irritability, disinhibition, agitation, in order to ensure optimal management of the illness.
Psychological examination must be a mandatory part of the examination, with the application of tests to assess cognitive impairment as well as specific scales to assess mood, perceptual and behavioural disorders. Of these tests, it is advisable to perform the MMSE(Mini Mental State Examination) as well as the clock drawing test and other tests depending on the specifics of the situation. Assessment of cognitive function as well as assessment of daily activities through specific questionnaires is extremely important for diagnosis.
Laboratory tests can detect physical problems that can affect brain function such as vitamin deficiencies, especially vitamin B12, thyroid disorders, infectious diseases, immunological disorders, poisoning.
Examination of cerebrospinal fluid is sometimes indicated in infections or to determine markers of degenerative diseases.
Neuroimaging investigations (brain CT scans and brain MRI) are part of a complete diagnosis and are particularly useful for excluding other brain pathologies and to help establish the diagnosis of dementia.
Electroencephalographic (EEG) examination may sometimes be necessary in selected cases, providing information necessary for the aetiological diagnosis of dementia (e.g. in suspected Creutzfeldt-Jakob disease or encephalitis).
4. What is the course of dementia?
The clinical picture of dementia usually has a slow progressive course towards worsening. In degenerative types the course is continuous, while in vascular dementias it can be jerky, with episodes of acute strokes and partial remissions. Somatic and neurological co-morbidities may be associated during the course of the disease, which may influence brain function and precipitate the deterioration.
In the course of a dementia disorder, several developmental phases can be distinguished:
Initial Phase - Mild Dementia
It is diagnosed when the family finds that the patient has problems with memory and thinking. At this stage of the disease patients present:
- Impaired memory for recent events: the patient forgets, repeats, confuses things, places and people, asks the same question several times, has trouble learning new things. At this stage the patient shows a slight impairment of memory, sense of direction and cognitive abilities. Long-term memory is intact, remembering past events very well.
- Difficulties in solving complex problems or tasks, for example organising a family event or situations involving financial decisions.
- Personality changes – the sufferer becomes more withdrawn, may become irritable or even aggressive, things they once enjoyed gradually lose importance, social interaction decreases, plans for the future disappear.
- Difficulties in expressing oneself, difficulties in finding words, expressing ideas becomes more and more difficult.
- Loss of things or valuables.
- At this stage the patient maintains independence and the need for assistance with daily activities is minimal.
State Phase - Moderate Dementia
In the moderate form, patients become confused, the cognitive deficit progresses, and the moments when the patient is aware that they have a problem become increasingly rare.
At this stage of the disease patients may present:
- Deterioration of judgment and reasoning, worsening confusion. They have temporal and spatial orientation problems, they don’t know where they are, what day of the week or season. They are able to recognise their own possessions and may accidentally take things that do not belong to them. They may confuse people close to them, they may wander around the house. At this stage they can no longer be left alone.
- Memory loss is important. Patients forget details of personal history, address or phone number. Rehearse stories or make up fragments of stories to fill in memory gaps.
- They suffer significant changes in personality and behaviour, become suspicious, may develop delusions, especially of prejudice and jealousy, may have visual and auditory hallucinations, may have uncontrolled outbursts (shouting, hitting, threatening, accusing). Some people become agitated, restless towards the end of the day.
- They need help with daily activities. Assistance may be needed in choosing clothing for any occasion, maintaining personal hygiene, using the toilet. Some people may become partially incontinent.
End Stage - Severe Dementia
In the severe form, mental function is in continuous decline and the disease has a particular impact on mobility and physical abilities.
Patients present:
- Loss of verbal communication ability, can no longer speak coherently, although occasionally can say words or phrases.
- Requires daily assistance with dressing, using the bathroom, maintaining personal hygiene, serving meals and all other self-care tasks.
- They may become unable to walk, cannot mobilise without help, muscle rigidity and abnormal reflexes are present, sficteral incontinence occurs, swallowing reflex is lost.
- Towards the end, care becomes palliative, end-of-life care. The aim is to provide the patient with the support they need, respect and affection.
5. How is dementia treated?
The objectives of therapeutic intervention in dementia are to slow the progression of neurodegenerative processes, improve and stabilize cognitive decline, treat non-cognitive symptoms and behavioral complications, treat somatic comorbidities, prevent evolutionary risk factors, improve overall functionality in daily activities, maintain quality of life.
Both pharmacological and non-pharmacological interventions are useful in the management of cognitive and non-cognitive symptoms in dementia.
I. Pharmacological measures
Treatment of cognitive symptoms
A number of drugs have been shown to be effective in treating dementia. Antidementia drugs can temporarily slow the worsening of symptoms and increase the quality of life for both patients and their carers. Treatment should be initiated when the patient is diagnosed and is based on the stage of the disease.
There are two types of anti-dementia drugs that act on chemical changes in the brains of dementia patients:
Cholinesterase inhibitors
This type of medication is recommended in cases of light and moderated of disease, act in a similar way and provide similar benefits. They increase the amount of a chemical called acetylcholine, which modulates memory and learning processes. Clinical studies have shown a significant improvement in cognitive function and a reduction in non-cognitive manifestations with reduced caregiver stress in these patients.
Adverse effects for this class of substances are mild and transient, appear early in the course of treatment and frequently subside within a few days. These include nausea, vomiting, diarrhoea, muscle cramps, fatigue, dizziness. Caution should be exercised when administered to patients with bradycardia and atrial or ventricular conduction disturbances.
Glutamate modulators
It is recommended in the moderate and severe stages of disease.
Memantine works by blocking special types of receptors, called NMDA receptors, to which the neurotransmitter glutamate normally binds. Glutamate may play an important role in dementia by causing neuronal death when its concentrations are chronically high. By blocking NMDA receptors, memantine improves signal transmission in the brain and reduces the symptoms of the disease.
Clinical studies to date show that the drug is effective in treating key symptoms in patients with moderate and severe dementia, improves cognitive function and daily functioning, relieves behavioural disturbances and delays patients’ institutionalisation.
Most of the observed adverse effects were mild or moderate in severity. The most common side effects observed were dizziness, headache, constipation, drowsiness, slightly increased incidence of hallucinations.
Antidementia medication is used as long-term therapy. We recommend continuation of treatment in severe stages of dementia if the specialist, in collaboration with the family doctor and the family, observes the maintenance of a benefit. When patients in the terminal stages of dementia have lost almost all functionality and show no functional or cognitive improvement following treatment, the specialist may decide to stop treatment.
Interruptions in therapy should be avoided. Treatment for dementia should be continued during acute illnesses or hospitalizations. If it is absolutely necessary to interrupt the treatment, it is recommended to restart it as soon as possible. Although dementia drugs are generally well tolerated by patients with somatic comorbidities, necessary modifications will be made in patients with liver or kidney disease.
In case of adverse effects or lack of response to therapy, one preparation may be replaced by another.
Newly diagnosed patients should be evaluated after 2 months to determine tolerability and then monitor at least every 6 months. Subsequent assessments are needed to monitor cognitive, functional and behavioural effects (including stabilisation or slowing of progression), possible adverse effects or somatic, psychological, neurological co-morbidities.
Other types of medication that can be given to patients with dementia are:
They are drugs whose neurotrophic effects act at the level of the neuron and stimulate cell differentiation, support nerve cell functions and induce local protective and repair mechanisms. They are a mixture of neurotrophic and neuroprotective factors that ensure the survival of the nerve cell. These drugs have led to clinically relevant and statistically significant improvements in patients with dementia, neurodegenerative diseases, stroke, traumatic brain injury.
In patients with dementia they slow down the progression of neuronal degeneration, improve clinical symptoms and overall clinical impression, improve cognitive performance, increase patients’ autonomy, improve behavioural disorders. The therapeutic effect is long-lasting, lasting for at least three months after discontinuation; they have proven to be very safe drugs, with very rare and mild side effects.
Standardised extract of Ginkgo biloba has a relaxing effect on the vascular walls, increasing their elasticity and improving blood circulation, especially in the small vessels. The combination of active substances contained in the dry extract obtained from Ginkgo biloba leaves increases the tolerance of tissues, including brain tissue, to ischaemia. Ginkgo biloba leaf extract neutralises free radicals and increases neuroprotective activity.
Ginkgo biloba has stabilized and in some cases led to improved cognitive performance and social functioning in patients with dementia.
It can be given in mild to moderate cases of dementia. In addition, there are some ongoing clinical trials looking at the effectiveness of this treatment in preventing the onset of dementia in people with memory impairment.
Treatment of risk factors
Treatment of vascular risk factors in patients with Alzheimer’s disease or Alzheimer’s disease associated with cerebrovascular disease is recommended, as well as treatment of secondary prevention of strokes of all types, especially in vascular dementia to limit the cognitive deterioration of these patients (antiaggregants, statins, antihypertensives, etc.).
Treatment of cognitive symptoms
In the management of behavioural disorders, non-pharmacological approaches are recommended first to avoid overuse of medication and worsening of disability due to adverse effects.
Medication treatment of non-cognitive disorders is recommended only in situations where non-pharmacological approaches are not possible or have not been effective and is initiated when behavioural disorders become distressing for the patient or their carers, when the patient is dangerous to themselves and their entourage, when behavioural disorders interfere with the patient’s socialisation and quality of life.
The choice of medication should be made on an individual basis, in consultation with the family or carers about the possible benefits or risks of treatment. Treatment should be limited, regularly reviewed, directed at target symptoms to be identified, and its effectiveness evaluated at regular intervals.
Drugs used to treat behavioural disorders:
Antipsychotics
Antipsychotics are a group of drugs that are commonly used to treat people with mental health conditions such as schizophrenia and mania. They are also prescribed for behavioural symptoms occurring in dementia because, in some cases, they can eliminate or reduce the intensity of psychotic symptoms such as delusions and hallucinations, delusional ideas and may have a calming and sedative effect, being useful in psychomotor agitation, aggression and violent behaviour.
The use of atypical antipsychotics is recommended due to their lower adverse effect profile than classic antipsychotics.
Possible side effects include: sedation (drowsiness), increased risk of falling, parkinsonian syndrome, risk of stroke, risk of cardiovascular disorders, risk of death.
It is important to consider that antipsychotic drugs can help reduce behavioural symptoms, but due to side effects, this can be detrimental to the patient’s quality of life. Therefore, treatment with antipsychotics should be monitored, reviewed regularly and stopped after 12 weeks, except in extreme circumstances.
Antidepressants
Antidepressants are drugs used to treat depression and can also be an effective treatment for behavioural and psychological symptoms of dementia. They are recommended for patients with dementia and associated depression, and are also useful in reducing agitation and treating apathy (a general lack of interest and motivation).
Among the most common side effects are: digestive manifestations (nausea, vomiting), sedation or insomnia, restlessness, dizziness. Most of the time these effects occur when treatment is started and are insignificant and transient. The low adverse effect profile makes them safe and tolerable to take.
Anticonvulsants
Anticonvulsants are a group of drugs that are usually used to treat epilepsy, but are sometimes used for symptoms of aggression, agitation, emotional lability in people with dementia. They can be used as monotherapy or in combination with an antipsychotic.
Adverse effects limiting their use are hepatotoxicity and haematological effects.
Benzodiazepines
Benzodiazepines can be effective in the treatment of anxiety, agitation, insomnia. Benzodiazepines should not be used as first-line therapy for the management of behavioural disorders in dementia because of the adverse effects of long-term use: risk of dependence, withdrawal syndrome on discontinuation and worsening cognitive deficits. Their use should be limited to the management of acute symptoms that do not respond to other drugs.
Hypnotics
Hypnoticscan be useful in the treatment of insomnia. These should be combined with sleep hygiene measures aimed at dose reduction and time-limited use of medication.
II. Non-pharmacological measures
Objectives of non-pharmacological approaches are to slow cognitive decline, improve behaviour, maximise remaining skills, keep the patient safe at home for as long as possible, provide ongoing support and guidance to carers with the aim of increasing the quality of life for both patient and carers.
Of great importance is psychoeducation of family members and other carers, who need to know as much as possible about the condition, what realistic and achievable expectations they can have, how they can cope with the problems they may face as they arise.
A safe environment, proper nutrition, regular sleep, proper hygiene and prompt resolution of other medical conditions are important for the patient’s overall well-being.
Make the environment safe by tidying rooms, using locks on doors and cupboards, stabilising carpets or leaving carpets out, putting non-slip surfaces in the bath, providing the cooker with an automatic extinguisher, restricting access to objects that can accidentally injure, chemicals, medicines.
Measures to make orientation easier: calendars, lists, signs with drawings can be placed throughout the house to help them remember where different objects are, the bathroom or the kitchen, ensuring good lighting by placing night lights on at night.
Maintain proper nutrition by ensuring a healthy and correct diet.
Both bladder and faecal incontinence are managed by encouraging regular toilet visits and restricting fluids before bedtime. If incontinence is already present, pampers or absorbent underwear can be used.
Create a daily routine that includes enjoyable and useful activities for the patient as well as exercise.
Sleep disorders can be resolved by discouraging daytime sleep, exercising during the day, establishing a bedtime routine.
In moderate and severe forms, patients with dementia need constant supervision and care from family or a specialist carer (right to carer).
Patients with mild and moderate forms of dementia are recommended structured cognitive stimulation and cognitive rehabilitation programmes provided by appropriately trained and qualified medical and social staff. Cognitive behavioural therapy can be effective in reducing comorbid symptoms (depression, anxiety), reducing psychotic symptoms, managing behavioural disorders, improving self-efficacy, self-esteem and reducing self-stigma. Other useful approaches include: memory therapy, psychomotor exercises, multisensory stimulation, other forms of social therapy, occupational therapy, aromatherapy, therapeutic use of music, dance, animal assisted therapy, massage, etc.
Patients presenting with psychiatric and behavioural symptoms should be assessed, through a behavioural and functional analysis conducted by professionals with specific skills, to identify factors that may have generated, aggravated or ameliorated behavioural disorders. One of these is the assessment of pain, which often leads to unexpected behavioural changes.
In the severely progressive stages, it is recommended to be hospitalized in specialized medical institutions for the terminal care of patients with dementia, for an unlimited period of time, because of the total physical and mental dependence and the multiple medical complications that arise in this final stage of the disease.
What are the benefits of early diagnosis of dementia?
It is important to consult a psychiatrist in the presence of memory disorders, especially if they impact on daily functionality.
Early diagnosis of dementia helps both the patient and family members by obtaining information about the disease, getting appropriate treatment, setting realistic expectations and planning for the future.
Obtaining an accurate diagnosis is extremely important because conditions such as depression, thyroid disease, infections or side effects of medication can sometimes produce symptoms similar to dementia. An accurate diagnosis can also be beneficial because some causes of dementia are treatable and fully or partially reversible, depending on the nature of the problem. A thorough medical evaluation can lead to an accurate diagnosis and establishing appropriate treatment.
Early diagnosis involves maintaining independence for as long as possible, active patient involvement in decisions about treatment, health care and future planning. Allows the patient to make informed decisions about legal, financial and care issues and to make their wishes known to family and friends.
With a correct and early diagnosis patients and their families can benefit from advice and support. Families who understand the disease and the challenges that come with its progression are better able to support the person with dementia and get the right help.
Early diagnosis is extremely important for research. People with dementia can participate in clinical trialsand other research to help improve the diagnosis, treatment, care and prognosis of this condition.
Even though dementia is a progressive condition, treatment is more effective the earlier it is instituted earlier by slowing down the degenerative process, improving and stabilising the cognitive deficit and increasing the patient’s quality of life.
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