At an advanced age, many people experience disturbances in thinking, memory, intelligence and speech, provoked by changes in the molecular exchange between cells in the cerebral cortex caused by various reasons. And the more pronounced these changes are, the more difficult the senile dementia, called dementia in medicine, is. At the same time, an elderly person loses not only his existing knowledge, experience, ability to learn, but also his own personality.
We will discuss further in the article about how dementia occurs, how many years have lived with this diagnosis, and how different types of this pathology look like.
Classification of Dementia
Noticing that an elderly person living nearby has changing habits, character and ability to communicate, relatives begin to worry, fearing the worst case scenario - total dementia, which, as a rule, turns out to be a harbinger of the near death of a loved one. Is it so? How fast is brain aging?
To understand this, it is necessary to determine what kind of dementia had to face. In medicine, there are different classifications of this pathology. And since it is not an independent disease, depending on the underlying problem that caused it, the following types of dementia are shared:
- Atrophic type of ailment (provoked by Alzheimer's or Peak disease), which occurs against the background of the initial degenerative reactions that occur in the central nervous system cells.
- Vascular, caused by atherosclerosis and hypertension. It occurs in connection with circulatory disorders in the brain.
- Mixed type - the development of this pathology has mechanisms similar to both the atrophic form and the vascular one.
Causes of Dementia
The described problems can begin to have a destructive effect both as a result of the natural aging process of the body, and as a result of diseases of internal organs, thyroid ailments, neurological and vascular pathologies (such as ischemia, arterial hypertension, atherosclerosis, etc.).
Intoxication with alcohol or narcotic substances can also push the body to pathological changes. Chronic poisoning by toxic chemical compounds in the workplace also has a destructive effect.
Strokes, tumors, and head injuries are also capable of breaking neural connections, which will eventually lead to dementia.
True, there have been recorded cases when the causes of dementia lie not in the process of natural aging or the listed diseases, but in taking medications. In such cases, the process is reversible if the quantity is limited or canceled.
Alzheimer's Dementia
Most often, the causes of the development of senile dementia are hidden in the organic damage to those areas of the brain that are responsible for human thinking and memory. And the most common among them is Alzheimer's dementia, that is, dementia that arose as a result of degenerative processes in neurons and the destruction of synaptic connections.
During this disease, amyloid (protein) plaques, as well as neurofibrillary tangles, form on the nerve cells of the patient’s brain, which ultimately causes the death of these cells. Pathological sites atrophy as a result of these processes, and damage eventually takes over the entire brain, and this process, alas, is irreversible.
How does Alzheimer's dementia develop
All stages of dementia in Alzheimer's disease are characterized primarily by an increase in short-term memory impairment, and as they progress, by a narrowing of the circle of interests, insufficient resourcefulness, carelessness, passivity, slow thinking and motor reactions, and irritability.
Later, patients discover a lack of understanding of the events taking place around them, they can repeat what has been said for a long time, inadequately relate to those around them, uncritically - to themselves. And over time, they may develop paranoid ideas and hallucinations.
Total dementia in this case is accompanied by muscle stiffness and impaired control of urination and bowel adjustment. Epileptic seizures are possible.
How many people live with dementia of this type depends on many reasons, and on average it is about 6 years, but the process can last all 20. Death, as a rule, is caused by intercurrent (accidental) diseases caused by dementia.
Alzheimer's disease, according to statistics, is the cause of dementia in 70% of recorded cases. But, unfortunately, not only this pathology can push to the beginning of the development of dementia.
Vascular dementia: causes and symptoms
Against the background of cerebrovascular accident, vascular dementia develops. In older people, as already mentioned, it can provoke atherosclerosis, hypertension, cerebral ischemia, arrhythmia, heart defects, heart valve pathology or an increased blood lipid level. By the way, in the male part of the population, the predisposition to the vascular form of dementia is one and a half times higher than in women.
At the initial stage of the disease, symptoms are expressed by irritability, increased fatigue, sleep disturbances, lethargy, and headaches. Absent-mindedness and depressive experiences at the same time become systematic.
In the future, the patient noticeably impaired memory. This is expressed in disorientation, as well as in forgetting names, dates and so on.
By the way, how the dementia develops, how many years patients with this diagnosis live, directly depends on whether there was a stroke in their history. In this case, life expectancy is greatly reduced. The neurological symptoms of this pathology are: hemiparesis, rigidity, impaired speech, swallowing, walking and urination.
Is it possible not to miss the appearance of dementia? Signs of the disease
Unfortunately, it is almost impossible to catch the initial stages of the impending dementia, as this is a long and slow process that can stretch for 10-15 years. The person gradually worsens the memory of what happened recently, but memories of long-standing events are preserved.
Dementia in older people is mainly manifested by a loss of learning ability and quick wit. It is becoming increasingly difficult for patients to navigate in space and time. And soon it turns out that it is already quite difficult for them to select the right words, and their speech is noticeably impoverished. By the way, no less problems arise in the process of operating with numbers.
It is interesting that some people at the same time are able to hide signs characteristic of dementia for a long time, avoiding complex actions (for example, checkbook calculations). And their markedly reduced interest in reading and any kind of activity betrays them. Those who cannot rebuild their lives find themselves in a difficult situation, since they have reduced opportunities for fulfilling everyday duties - a person now and then forgets important things or does them wrong.
How dementia begins
Of course, the development of dementia and life expectancy with this disease depend on many reasons: health status, previous illnesses, personal characteristics, relationships of others and much more. But if we talk about the signs of the disease as a whole, then we can highlight some common features of changes occurring in a person:
- Most often, changes in the nature of the patient become especially noticeable. His individual personality traits are exacerbated, for example, frugality grows into stinginess, and perseverance into stubbornness.
- It is becoming increasingly difficult for a person, or rather impossible, to change the established view of events. He develops conservatism.
- Thought processes are getting worse.
- Often, the listed symptoms are followed by violations of moral norms of behavior (patients with dementia lose their sense of shame, the concept of duty, their spiritual values and vital interests are leveled).
Over time, noticeable changes in the state of memory begin, as well as violations in the temporal and spatial orientation. True, the features of behavior, gestures and speech of a particular person remain unchanged for a long time.
The last stage of dementia
As you know, the most rapid extinction of the patient occurs in the last, severe stage of the disease. The development of dementia at this time is characterized by trembling of the fingers, impaired coordination and gait, and exhaustion. The patient’s speech becomes abrupt, and information about himself becomes fragmented.
An elderly person in this state can no longer take care of himself, eat and observe basic hygiene rules without assistance. In most patients, there is a violation of the urination process. It can be either stagnant processes or uncontrolled urine output.
The ailment shortens the lives of those who are sick with it, due to the fact that in a severe stage of dementia, the patient is no longer able to report ailments to the doctor, moreover, elderly people most often do not develop fever or leukocytosis as a response to the infection. The doctor in this situation has to rely only on his insight and experience, but, unfortunately, any joined infection can cause the death of such a patient.
Features of the course of senile dementia
Interestingly, the so-called senile, or senile, dementia in older people sometimes demonstrates a clear dissociation between apparent dementia and preserved forms of behavior. The patient remains unchanged the previous manner of holding, gestures, correct speech, lively intonations. All this often misleads an outsider. He thinks that he is talking with an absolutely healthy person, and only a randomly asked question discovers that an old man talking so interestingly, telling a lot of examples from the past, is not able to say how old he is, whether he has a family, where he lives and with whom speaks now.
Senile dementia in the elderly in most cases is not accompanied by psychotic conditions that are inherent in the vascular form of this disease. This, of course, greatly facilitates the life of the patient himself and his relatives, since such a patient does not cause serious trouble to his environment.
But often in this category of patients there are signs of psychosis, which are accompanied by insomnia or inversion (time shift) of sleep. These patients may experience hallucinations, suspicion worsens, mood swings from tenderness to aggression occur.
And to provoke all these severe symptoms can changes in blood sugar, pressure drops and other health problems. Therefore, it is very important to protect the elderly dementia from all kinds of diseases, wearing both a chronic and acute form.
Why does senile dementia occur?
For what reason senile dementia appears in the elderly, why in these cases the human brain begins to age faster than normal, until it is completely unclear.
Some researchers believe that in old age there are violations of the immune regulation, which causes autoimmune processes. And the autoantibodies resulting from this damage the brain cells. Cerebrospinal fluid, which normally contains immunocompetent cells that play a protective role, greatly changes their ratio and properties in old age, which leads to pathological changes in the central nervous system.
Dementia in the elderly is also due to a genetic factor. It was found that the risk of the disease increases by 4.3 times in those families where there have already been cases of this pathology. Somatic diseases can reveal the symptoms of this mildly senile dementia, change its picture and accelerate the pace, while the timely elimination of these ailments can in some cases lead to a slower development of dementia.
Life expectancy of patients with a diagnosis of dementia, at what age to expect it
Researchers at Cambridge University have established the life expectancy of patients with an established diagnosis of senile dementia. How many years live such patients, according to scientists, largely depend on external factors, but on average it is 4.5-5 years.
By the way, statistics confirm that dementia aged 60 to 69 years occurs in about 2% of cases, and after 80 years, up to 20% of older people are affected. By the age of 90, the risk of getting sick rises to 45%.
Although it should be noted that the figures given are very approximate, since a rather large percentage of elderly people do not fall under the supervision of psychiatrists, because they do not have psychotic conditions, and it all comes down only to problems with memory, intelligence and small mood swings. Such patients are in families, it is quite convenient to care for them, and they do not create big problems for relatives.
Speaking about how many people with dementia live, it should be emphasized once again that there are very few deaths from this diagnosis. These include only those who died from accidents related to the characteristics of this disease. Basically, death occurs from a stroke or heart attack, most often accompanying the vascular form of the disease.
What is the prognosis of dementia
Being more and more common in elderly people, the described pathology is mostly irreversible, and modern medicine, unfortunately, can only slow down the process or relieve unpleasant symptoms that occur with a diagnosis of dementia.
It’s hard to say exactly how many years have lived with this disease, since, for example, with the rapid progression of the vascular form, a fatal outcome is possible in a few months. The cause in this case is most often associated diseases in the form of sepsis (in bedridden patients) or pneumonia.