Duration | Stages of dementia

Duration

The duration of the dementia illness is different in each case. No rules can be identified that predict how long the disease will last. What is certain is that the disease cannot be cured, but can only be delayed by taking some medication.

On average, each stage lasts about three years, so that, depending on the time of diagnosis, the life span of the disease is about 7 to 10 years. However, this varies from case to case and can be much shorter or longer. It also depends on the use and effectiveness of any medication that may be taken.

Diagnosis

The suspected diagnosis of dementia is usually made on the basis of the typical memory impairment. In which of the dementia stages the diagnosis is made varies, as the disease manifests itself differently in people and they are often able to cover up the symptoms or make up excuses for their forgetfulness. The doctor usually makes the diagnosis of dementia on the basis of neuropsychological tests. The patient must consent to these tests. The best known test for detecting dementia is the so-called Mini-Mental Status Test, also known as Mini-Mental State Examination (MMSE).

MMSE

The MMSE can be performed by a doctor or a psychologist. It is a conversation between doctor and patient, which lasts about 10 to 15 minutes and during which the patient has to perform various tasks. Different aspects are tested: Orientation, retentiveness, attention, arithmetic, memory, speech and motor skills.

Depending on the patient’s ability to follow the doctor’s instructions, he or she is awarded points or not. The sum of the points then allows a classification of the stages of dementia and allows an assessment of the course of the disease. A maximum of 30 points can be achieved. The normal range is from 30 to 27 points, followed by the gradations of mild (26 to 19 points), moderate (17 to 9 points) or severe (less than 9 points) dementia.

Therapy

There is no cure for dementia. Some treatment approaches can only delay the course of the disease. In addition to drug treatment, cognitive training, behavioural therapy or ergotherapy and muscle therapy are also available, depending on the progression of the disease.

However, the more advanced the dementia is, the less useful these treatment approaches are. Medication can only alleviate the symptoms of dementia. Depending on the individual occurrence, preparations for memory or concentration disorders can be administered, or those for depression.

For all drugs, the earlier they are given, the greater the probability that they will have a positive effect on the course of the disease. Since dementia patients often do not remember to take the medication regularly, other people are needed to remind them of it. In the early or middle stages, drugs belonging to the group of drugs known as acetylcholinesterase inhibitors can be given.

This inhibits the breakdown of a substance (acetylcholine) that is responsible for signal transmission in the brain. If the degradation is inhibited, more of this substance is available and memory can be retained longer. Possible drugs are donepezil, galantamine or rivastigmine.

Memantine can be given at a later stage. This allows learning ability and other cognitive performance to be maintained for longer, as the amount of another messenger substance in the brain (glutamate) is regulated. If depression due to dementia occurs, antidepressants are one way of helping patients. If aggression or sensory delusions are symptoms, neuroleptics work against them.