1 In 10 Adults 65 or Older in the US Suffer from Dementia
Dementia is a category of progressive brain disorders characterized by a loss of memory and a decline in other cognitive functions which is severe beyond the normal loss of aging. The typical symptoms are a gradually worsening impairment in memory and thinking skills such as spatial orientation, comprehension, language, and judgment.1 It is a common condition among older adults, with around 1 in 10 people aged 65 or older in the US estimated to suffer from dementia.2
It is important to understand the difference between dementia and Alzheimer's disease, as these two conditions are often confused. Dementia refers to the symptoms of declining cognitive performance, which can be caused by a variety of factors. Alzheimer's disease refers to a particular cause of dementia which is characterized by the loss of neurons and synapses in the cerebral cortex of the brain. Alzheimer's disease is the most common cause of dementia, thought to be the cause of 60 to 70% of dementia cases.1
What causes dementia?
It is not known why some people develop dementia and some do not. The leading theory is that genetic factors influence the development of the condition, but other relevant factors may include dietary and lifestyle factors including an increased risk of dementia among obese people and those suffering diabetes.3 The clearest risk factor for dementia is age, as it is a condition which affects just 5% of the population over 65 but 20 to 40% of those older than 85.4
How common is dementia?
Current estimates are that between four and five million people in America have dementia, making it one of the most common mental health issues among older adults. It is also one of the most expensive diseases to treat due to the high level of care required by dementia sufferers, with estimates from 2010 stating that the costs of treating dementia were up to $215 billion per year. That’s more than the costs of treating heart disease ($102 billion) or cancer ($77 million)5 combined.
However, there are signs that the prevalence of dementia is declining. A study from 2016 found that the rate of dementia in people over 65 fell from 11.6% in 2000 to 8.8% in 2012, which represents a decline of nearly a quarter.6 Even as the population ages, the number of dementia suffers may drop in the future. It is not clear exactly what has contributed to this decrease, but experts theorize that it could be due to better treatments for physical conditions like high blood pressure and diabetes, both of which can increase the risk of dementia. Other relevant psychological and social factors include higher rates of education, more intellectual stimulation in later life, and an increasing awareness of the importance of exercise and hobbies, all of which may protect against the development of dementia.7
The effects of dementia
As there are many different kinds of dementia, the exact progression of the condition is quite variable. However, there are some symptoms which are common among various types of dementia. The most common symptoms are problems with memory, in addition to problems with visual-spatial ability, language, attention, and problem solving. The condition is progressive, meaning that it becomes more severe over time.
These symptoms manifest in the early stage of the condition, which includes forgetfulness, losing track of time, and getting lost even in familiar places. In the middle stage of dementia symptoms can include increased forgetfulness such as forgetting people's names, getting lost at home, having problems with communication, and requiring help with personal care. During this stage behavioral changes such wandering aimlessly or repeating questions and comments can be observed.
In the late stage of dementia, sufferers become highly inactive and dependent on others. Sufferers may be unaware of the time or place that they are in, may not recognize themselves or family members and friends, require more help with self-care, and have problems with balance and walking. The behavioral changes will become more profound and may include aggression.1
Treatments for dementia
Unfortunately, there is currently no treatment which can cure dementia or prevent it from getting worse over time. However, support and interventions can be offered to improve the quality of life of people suffering from dementia.
According to the World Health Organization, the main goals of dementia care include first trying to diagnose the condition as early as possible so that support can be offered in managing it. Further goals are to optimize physical health and cognition by encouraging activity, such as taking exercise which may help to slow the progression of symptoms, and promoting social interactions to improve well-being. Behavioral changes and psychological symptoms also need to be identified so that they can be managed, and so that caregivers can be supported and kept informed.1
Caring for someone with dementia
Caring for someone with dementia is challenging due to both the broad range of symptoms that the sufferer may have to contend with, and due to the behavioral changes which can be upsetting for family and friends to see. Caring for a person with dementia requires patience and the willingness to overcome communic
ation and memory problems by speaking clearly, being willing to answer questions or explain issues multiple times, and asking simple, answerable questions.8
Another challenge faced by caregivers is that a person with dementia will have some days when they are more aware and more like their 'old self', and some days when they struggle profoundly with tasks that they can normally complete. It is not possible to predict when a sufferer will have a good day or a bad day, so caregivers need to be prepared for either possibility. There are also practical issues of routine which dementia sufferers will need assistance with, such as dressing, washing, using the bathroom, eating, and drinking sufficiently.
For more information on caring for a person with dementia, the National Center on Caregiving offers advice at: https://www.caregiver.org/caregivers-guide-understanding-dementia-behaviors