What makes a person who they are? Their memories, their experiences, their abilities and their feelings. All of this is stored in the brain. When the brain becomes diseased, many of these stored things are deleted. What makes a person who they are becomes less. This can take various forms: Grandpa no longer remembers his experiences during the war and Grandma no longer knows how to cook.
Depending on which memories and abilities are lost, those affected are more or less restricted in their daily lives. How quickly the various dementia diseases progress differs individually from patient to patient, just as the areas that are affected first. So some people with dementia at the beginning of their illness can only barely remember things from long ago, which barely affects their daily life, while others forget how to operate everyday objects.
Definition
In medicine, the diseases colloquially referred to as dementia are referred to as dementia syndrome. These are neurodegenerative diseases, which means that nerve cell functions in the brain are disrupted and neural connections are lost. This can occur due to circulatory disorders or damage from protein deposits. Accordingly, there are different forms of dementia syndrome, such as Alzheimer's, vascular dementia or frontotemporal dementia.
The consequences depend on the affected brain area and can range from deterioration of mental and intellectual abilities, to changes in personality and social behavior, to loss of speech and motor skills.
First signs and symptoms
The diagnosis of dementia syndrome is complex and time-consuming. Nevertheless, there are some signs that relatives of those affected usually notice if they persist over a longer period of time.
- Forgetfulness
Affected individuals forget a lot, for example, where they put their house key. Often they find the items they are looking for in unusual places, such as in the refrigerator. Those affected find it difficult to follow conversations because they forget what their conversation partner said. Sometimes they also lose the desire to read because they cannot remember the content of what they read.
- Confusion
Affected individuals no longer find their way in their local environment and, for example, no longer know how to get to the supermarket.
- Language deficits
Affected individuals often forget individual words. In conversations, simple words don't come to mind.
- Loss of motivation
Affected individuals increasingly lose the desire to do anything. Everything feels too exhausting to them and they would prefer to do nothing at all.
If these or similar symptoms are noticed in someone in your immediate environment, you should first observe the symptoms. If they persist over a period of 6 months or even worsen, advise the affected person to see a doctor.
Causes
The exact causes of dementia syndrome have not yet been fully clarified. The following risk factors are associated with the development of dementia disease:
- Age
- Arteriosclerosis
- High blood pressure
- Diabetes
- Chronic inflammatory reactions
- Mitochondrial damage
In particular, age appears to have a major influence on the probability of disease: While only 1.6% of people aged 65 to 69 years develop dementia, this figure rises to 40.95% in those over 90 years old. Two-thirds of people with dementia are over 80 years old(1).
When examining the risk factors more closely, it becomes apparent: All have a possible common trigger: oxidative stress. What exactly is oxidative stress?
Oxidative stress is caused by so-called free radicals. Free radicals are byproducts of normal metabolism. They are molecules that lack an electron. They therefore attempt to steal an electron from other molecules. If they succeed, they in turn leave behind a molecule with a missing electron: a new free radical. This creates a chain reaction of oxidation.
Fortunately, the human body has so-called antioxidants, molecules with an additional electron, which can neutralize free radicals by donating their additional electron. However, if the number of free radicals in the body increases, for example through greatly accelerated metabolism (exercise) or unhealthy external influences (nicotine, alcohol, UV rays, environmental toxins), the body's own antioxidants are no longer sufficient to neutralize them. The result: oxidative stress develops.
Age as a major risk factor for dementia can also be easily explained in this regard: As we age, the body produces fewer and fewer antioxidants. The result: oxidative stress increases.
Oxidative stress leads to cell damage and consequently means that cells can no longer perform their functions properly or at all. Through their attack on healthy body cells, free radicals impair, for example, the immune system, hormone production, the mitochondria, leading to cell death, and the signal transmission of neurons. Furthermore, oxidative stress promotes arteriosclerosis by free radicals damaging the HDL protein, which normally has the task of transporting cholesterol out of the bloodstream so that no deposits and thus arteriosclerosis can form. Through the cell damage that free radicals cause, inflammation develops in the body; sustained oxidative stress thus directly leads to chronic inflammation.
Inflammation is nothing other than a defense reaction of the body. They signal to cells that danger is looming and cause them to act differently than they normally would. Some cells, for example, send out signals during inflammation that increase the permeability of vessels, so that help in the form of the body's own defense substances can arrive faster. The first aid that arrives in inflammatory reactions are the so-called neutrophil granulocytes. They are the body's own defense substances that can kill cells. However, they make no distinction between disease-causing pathogens and cells in their environment. You can imagine it as if the body were firing wildly with a flamethrower, destroying sick cells but also healthy cells in the immediate vicinity.
When inflammation becomes chronic, it is bad for health (silent inflammation or constant state of war). On the one hand, the body's vessels remain permeable, the body's doors are always open, so the emergency doctor can always come, but also burglars and other dangerous intruders; on the other hand, the body, in its fight against intruders, constantly destroys healthy cells as well. Chronic inflammation in the brain has the same consequences.
Through their damaging effect on the mitochondria, the powerhouses of the cells, free radicals cause cells (including brain cells) to be supplied with less energy. Additionally, they disrupt signal transmission between individual cells, which in the brain quickly leads to the performance reduction typical of dementia diseases and later to the death of individual nerve cells.
Arteriosclerosis, also promoted by oxidative stress, can lead to dementia syndrome by impairing blood circulation to the brain and preventing brain cells from being properly supplied. The result: They lose their function and eventually die.
Oxidative stress and antioxidants
We have learned that oxidative stress and its consequences are a very important factor in the development of dementia.
The best remedy against oxidative stress is antioxidants. Antioxidants protect other molecules from oxidation, i.e., from having an electron torn away from them by free radicals and thus becoming free radicals themselves. By donating their additional electron without becoming a free radical themselves, antioxidants interrupt the health-damaging chain reaction of oxidation in the body. However, antioxidants also have the ability to regenerate other antioxidants, i.e., molecules that have already donated their additional electron to neutralize a free radical, by supplying them with an additional electron again, so that the molecules can act antioxidatively again and resume their radical scavenging.
Tips for relatives
Dementia diseases and their consequences affect the entire family. Relatives often experience the illness of a family member as an emotional rollercoaster—on one hand they feel sadness and compassion, on the other hand anger, desperation, and disappointment when they are treated unkindly by the affected person or no longer recognized. Therefore, open communication about the disease as well as detailed information about its symptoms and consequences is important.
Caring for a person with dementia can be very demanding and can quickly become overwhelming. Relatives should therefore accept any help they receive. This is the only way they can remain patient in dealing with the affected family member and have enough energy for the challenges of everyday life. Health insurance and long-term care insurance companies usually provide information about all possible support options.
The disease often changes the personality of those affected and makes them aggressive and unfriendly. Relatives should show respect for the affected persons and take them seriously, but also know when they should take what is said with humor.
When communicating with people with dementia, relatives should focus on maintaining a good relationship rather than arguing over individual facts. People with dementia forget things without being aware of it and are firmly convinced of their version of the facts. Relatives should therefore not try to convince people with dementia of reality, but instead focus on having a pleasant conversation. Short sentences and simple words improve comprehension and support good communication. Since people with dementia often forget words, relatives should give them sufficient time and listen patiently.
People with dementia should be regularly reminded of upcoming appointments or events. Since people with dementia are often confused and disoriented, relatives should always name things concretely. Instead of asking “What do you want to do?”, they should ask “Do you want to watch TV or listen to the radio?”; instead of saying “Put your jacket on.”, they should offer help: “Put on the red jacket hanging next to the door. It is cold outside.”
Moderate exercise and a balanced diet are important for those affected and for their relatives alike. Since people with dementia are often no longer able to take care of this themselves, relatives take on an important task here.
Important: talk to your GP about changes at an early stage.
(1) Alzheimer Europe. EuroCoDe: Prevalence of dementia in Europe. Statistisches Bundesamt. Genesis-Online Datenbank. Fortschreibung des Bevölkerungsstandes: Tabelle 12411-0012
The content of this article is for general information only and does not replace medical or pharmaceutical advice. Food supplements are not a substitute for a varied and balanced diet and a healthy lifestyle.
