Dementia is a psychiatric syndrome that can be part of a wide range of psychiatric disorders. It is usually a progressive, chronic process in which various abilities are gradually lost. Dementia patients are often conspicuous by a deteriorating short-term memory.
Thinking becomes slower – cognitive abilities decrease – and emotional and social behaviour, simply understanding it, is forgotten. Finally, the process of forgetting also affects the areas of the brain that are responsible for speech or motor skills. The course of the process can vary from individual to individual, but is usually similar in the occurrence of the individual symptoms.
It is important whether it is an underlying degenerative disease or not. The most common disease with a dementia syndrome is Alzheimer’s disease. Alzheimer’s disease has a chronic course and continuously leads to a loss of the brain‘s abilities. Other common diseases include frontotemporal lobar degeneration (FTLD; the regression of parts of the frontal and temporal lobes of the brain) and vascular dementia (vascular = vascular).
Stadiums
A basic division into stages is difficult to make if the underlying dementia is not known. However, the further the disease progresses, the more abilities are lost. Which abilities are first unlearned or forgotten seems to have similarities in many cases of dementia.
Two different types of dementia are described: a continuously progressing disease or a dementia that gets worse in phases. In the case of a dementia which is characterized by relapses, there are often phases between these in which the patient feels better. Their deficits do not show up as strongly as before and most relatives hope for a cure or stagnation of the disease – but they are usually disappointed.
Early stage
In the first stage, mild dementia, the patient loses most of his short-term memory. While past experiences, dates or names can be retrieved without any problems, the affected persons often forget small, recently recorded information and agreements. The temporal orientation decreases, patients forget the day of the week or make mistakes in the date.
The constant search for misplaced objects becomes conspicuous and can be a first indication of incipient dementia. The patient is still able to manage the household on his or her own without the need for additional care, but is increasingly unable to find his or her way around in unfamiliar places. All symptoms gradually increase – the patients notice at first that something is wrong and try to make up for their deficits.
These first changes in the patient’s other health are experienced in full. This causes many feelings in those affected, which can range from fear, frustration and depression to anger and aggression. It is a widespread phenomenon that dementia patients in the early stages of the disease initially withdraw because they are ashamed of their shortcomings.
It is not uncommon for people who want to help the patients, most of whom are relatives, to be presented with a lack of understanding. It is important to be patient. Many people who develop dementia do not know this at the beginning and, for their own protection, may not want to admit to the illness if there is medical proof.
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