Diagnosis | Forms of dementia

Diagnosis

In order to diagnose dementia, standardised test procedures are primarily considered the means of choice. Tests such as the Mini Mental State Test (MMST), the Montreal Cognitive Assessment Test (MOCA Test) or the DemTec Test can be used to assess attention, memory performance, orientation as well as arithmetic, linguistic and constructive skills. The probability of the presence of dementia can then be estimated on the basis of a scoring system. In addition, a detailed anamnesis (both an own anamnesis as well as an anamnesis of others, e.g. by relatives), a physical and a neuro-psychological examination are part of the classic diagnostics, as well as blood tests, brain water tests, imaging (CCT, MRT) of the head or brain and electroencephalography (EEG).

Therapeutic measures

Since the majority of forms of dementia are irreversible diseases of the brain, there are therefore no therapeutic options available for approx. 90% of dementia patients that would allow a complete cure. The only way to delay the progression of the disease and maintain independence for as long as possible is to use a suitable combination of psychotherapeutic, social therapeutic and medical treatment.

The dementia drugs are so-called antidementia drugs (e.g. Donepezil®, Galantamin® or Rivastigmin®), which are used primarily in Alzheimer’s dementia and act as central cholinergics. In addition, antidepressants (e.g. Citalopram®) for depressive symptoms or atypical neuroleptics (e.g. Risperidone®) for psychotic symptoms and sleep disorders can be used as supportive and symptom-relieving medication. Especially in vascular dementias, the therapy is primarily based on improving the blood supply to the brain tissue and thus reducing the cardiovascular risk.

Course of the forms of dementia

The course of a dementia disease can be divided into three stages: mild, moderate and severe dementia. The mild, initial phase of dementia is characterised by increasing forgetfulness (especially short-term memory is affected) and orientation difficulties, which are initially limited in time. At this stage, the affected persons are usually not restricted in their independence, but it may be noticeable that they frequently misplace objects or, for example, frequently go astray on weekdays.

Moderately severe dementia is in addition to the increasing memory problems, disturbances in communication, recognition, mobility and the ability to learn, so that complex action sequences are often difficult and independence is gradually restricted. In addition, there may also be a lack of orientation on a spatial and personal level and a disturbance in speech. If the dementia then progresses into the severe stage, there is usually a complete loss of recognition and memory as well as complete speech decay and usually also incontinence.

Those affected become bedridden and increasingly need help and care. In general, however, not every form of dementia is the same and not every patient must have the same symptoms. In addition, the forms of dementia can also differ considerably over time, so that some progress faster (e.g. vascular dementia) and others more slowly (e.g. Alzheimer’s dementia).