Therapy of dementia
There are many different therapeutic approaches that aim to stabilize or even improve mental performance. In the most common form of dementia, neurodegenerative dementia, drugs that inhibit enzymes that normally cleave acetylcholine must be mentioned. Such drugs are called acetylcholinesterase inhibitors.
This has the consequence that more of this messenger substance is present. Normally, acetylcholine is produced by nerve cells to transmit information, but since many nerve cells die in Alzheimer’s dementia, a deficiency of this messenger substance occurs. This deficiency is compensated by the administration of the medication.
Typical representatives of this group of drugs are rivastigmine and galantamine. Memantine is another group of drugs. These reduce the glutamate level and thus the number of dying nerve cells.
However, it should be noted that these drugs can halt the progression of dementia, such as Alzheimer’s, for about a year. However, a cure is not yet possible. Studies show that mental and physical demands as non-drug therapy have a supportive effect.
In the case of vascular dementia, the focus is on reducing the risk of renewed vessel occlusion. Thus, blood pressure should be brought to a normal level and blood thinners should be used. In the secondary form of dementia, the treatment consists of treating the original disease. For example, by administering vitamin preparations in case of vitamin deficiency, or drug withdrawal.
Diagnosis of dementia
The diagnosis of dementia is first and foremost based on the history of the disease, the medical history. Here the attending physician asks about the specific symptoms of the disease. He collects the information by talking to the patient and his relatives.
During contact with the patient, the doctor has standardised neuropsychological test procedures at his disposal, such as the mini-mental status test and the watch test. These tests ask for the criteria necessary for the diagnosis of dementia. Depending on the form of dementia, an imaging procedure of the head, such as computer tomography or magnetic resonance imaging, can also provide information.
Prognosis of dementia
In principle, the cure for dementia is currently not possible. However, drug and non-drug therapy, such as special brain performance training, can improve the patient’s quality of life. Secondary forms of dementia are an exception. The underlying diseases can be cured more often and the dementia symptoms can be eliminated. Since most dementia diseases are associated with old age and the patient dies on average ten years after diagnosis, life expectancy is hardly affected.
Can I prevent dementia?
Studies prove the protective effect of physical and mental activity, so the probability of mental performance impairment can be significantly reduced. A healthy diet also has a positive effect. In order to avoid vascular occlusion and thus a lack of oxygen in the brain, an elevated blood pressure should be lowered as early as possible, as this can be the cause of arteriosclerosis (hardening of the blood vessels).
