Dementia is a slowly progressing disease that is accompanied by loss of mental capacity. This is due to dying nerve cells. The disease progresses at different speeds depending on the patient, but cannot be stopped permanently. Depending on which symptoms occur and how pronounced the dementia is, stages are subdivided in the case of dementia.
Course of dementia Stages
The early stage of dementia manifests itself differently in each person, as it can originate from different points in the brain. In this stage, it is mainly the short-term memory that is affected. This manifests itself as forgetfulness in that new information is harder to remember, for example appointments are forgotten, questions are repeated and overall it is difficult for people affected to follow conversations.
In contrast, long-term memory, especially biographical memory, is usually not yet impaired, so that memories of childhood and adolescence are retained for a long time. However, there are increasing problems in finding words, as the patient cannot think of individual words and paraphrases them. Thinking is also becoming more difficult, so that complex relationships are more difficult to grasp.
In the early stages of dementia, the affected persons still find their way around in their familiar surroundings, so that everyday things can still be done, but it is becoming increasingly difficult for them to orient themselves in new surroundings, such as on holiday. Their temporal orientation is also limited, as is often their orientation and perception in general. Therefore, decisions are becoming increasingly difficult and patients also find it difficult to judge.
Depending on the extent to which orientation is restricted, for example, driving a car or other activities can no longer be performed. However, since the brain is still largely intact, the affected persons notice the loss of mental abilities very precisely in most cases. Often this is very unpleasant for them and they are ashamed of it.
Many try to cover up the symptoms by inventing excuses for forgetfulness or by withdrawing completely. But fear, aggression and frustration about the memory loss can also be a result. This is why depression can also be caused by dementia.
When this stage is reached, everyday activities in familiar surroundings become more difficult. Even small changes in their environment, such as suddenly appearing clouds in the sky, can lead to disorientation. The affected persons increasingly need help from relatives or caregivers in everyday life.
In time, they will also take over all the usual procedures, such as dressing or washing. In the further course of the disease, urinary incontinence can occur. The already existing mental deficits continue to progress and the long-term memory is also gradually affected.
This becomes noticeable by forgetting or confusing names of familiar people. Also the understanding becomes worse, just as the language becomes more limited. Orientation in space and time can be so severely restricted that winter clothes are put on in summer or that those affected confuse night and day.
This loss of perception can even lead to sensory illusions and delusions. It can happen that affected persons perceive themselves as much younger than they actually are and want to go to work. Some see people who do not exist, such as parents, even though they have already died.
The personality is also increasingly changed. Certain character traits may recede, others may become more pronounced or even change completely. In addition, mood swings often occur very abruptly.
Despite all the symptoms, it can happen in rare cases that patients in this stage are perceived as healthy by outsiders. In the last stage of dementia, the affected persons are no longer able to take care of themselves. They are dependent on relatives and nursing staff.
Mental as well as physical abilities become increasingly worse. New information can no longer be stored and even close relatives are often no longer recognised. The progressive dementia is also noticeable in speech.
Patients speak only a few words, which are often a repetition of words heard. Over time, they often become completely silent. The physical limitations become noticeable by the fact that the affected persons at first only walk in small, tripping steps, later not at all.
They often only move when asked to and even sitting upright becomes impossible over time. Since the reflective movements also diminish, serious injuries often occur in the event of falls, as they are no longer able to support themselves. If the physical limitations continue to progress, chewing and swallowing also become increasingly difficult and patients show fecal incontinence and urinary incontinence.
In the late stages of dementia, the affected persons often appear apathetic, but still perceive moods and feelings of the environment. The affected persons try to express their feelings, but these are usually difficult to understand. These attempts are usually limited to repetitive movements, such as nodding or waving. Since patients in the late stages of dementia are usually bedridden and thus susceptible to infection, pneumonia is the main cause of death.
