What are the first warning signs and symptoms of diseases

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From: Caroline Gehrmann


Dementia is on the rise worldwide. Experts expect the number of cases to increase significantly over the next few decades. How to recognize the first signs of dementia, what are the forms and what are the causes.

Bremen – This is a development that does not only concern experts: dementia is on the rise. According to a study published in the journal The Lancet Public Health, the number of dementia cases worldwide is expected to triple. In Germany, too, there are more and more people with dementia, including among young people. The German Alzheimer Society recently reported this. Demographic development is likely to drive the numbers higher over the next three decades – which, however, is also due to better diagnostics. But what exactly characterizes dementia? And what are the first signs of the disease?

Dementia symptoms: how to recognize the first signs

There are a number of signs that point to the diagnosis of dementia early on. At this point, however, it is particularly important to differentiate symptoms from other neurological conditions such as depression, as they sometimes cause similar symptoms and impairments. Dementia (from the Latin demens “spiritless”) is, according to the German Federal Association for Psychiatry and Neurology a “disease-related, acquired performance loss of higher brain function”. As a result, cognitive abilities are gradually lost. It becomes increasingly difficult for those affected to recognize familiar people and places, as well as to orient themselves, to have language skills, to think in a planned way and to have emotional and social skills.

Personality changes and sudden mood swings are common early in the disease. The distinction with other diseases is particularly important here, because depression, for example, can also express itself in a similar way. Here there is a risk of confusing the symptoms of the disease with each other. In any case, however, if you notice mood swings or cognitive disturbances in yourself or others, it is especially important to seek medical attention. Because such symptoms require a thorough medical examination and should be treated accordingly if necessary.

At the onset of dementia, symptoms are still mild and not permanent

At the beginning, ie in the early stages of the disease, the first mild symptoms appear, which may indicate dementia. They are also mostly temporary, so they are often overlooked. This includes:

  • oversight
  • temporal orientation becomes more and more difficult, we often “get bogged down” and we forget what time it is
  • we can no longer orient ourselves in familiar places and we often get lost
  • (Source: World Health Organization WHO)

Dementia symptoms and behavioral changes often appear early and are therefore not associated with the disease until after the fact. However, as the disease progresses, the symptoms worsen and become more obvious. The patient then forgets recent events, meetings or conversations. They don’t remember names or get lost in their own homes. Communicating becomes more and more difficult for them and they often need help to take care of themselves. The behavior then changes much more noticeably. Affected people often wander aimlessly or repeatedly ask the same questions.

What is dementia and how does it develop?

At first, short-term memory and retention are often impaired. In the subsequent course, the content of long-term memory, which is imprinted much more deeply, also disappears. As a result, sufferers increasingly lose the skills they have acquired over the course of their lives. The majority of dementia diseases are currently not curable. Therefore, the therapy of such “irreversible” dementia is primarily aimed at improving the quality of life of those affected and their relatives as much as possible.

About 1.6 million people in Germany suffer from dementia. Hearing loss increases the risk of developing a disease. © Ute Grabowsky/imago-images

In the very advanced stage of the disease, the abilities of those affected are so limited that they are basically completely dependent on others. Even friends and relatives no longer recognize them and their sense of time and place is completely lost. They then often behave aggressively towards others and are also severely restricted in their movements.

Dementia can have a variety of causes, with Alzheimer’s disease being the most common at 60-65%.

Symptoms of dementia depend on the type of disease. Because there are different forms of dementia, each with a different cause. The most common is Alzheimer’s disease. It represents 60 to 65% of all dementias. This makes it the most common primary form of dementia.

Age is the greatest risk factor for Alzheimer’s dementia. It increases steadily from the age of 65. One in five people over the age of 85 is affected. In extremely rare cases, it can also occur in people under the age of 65, in which case it is a presenile form of Alzheimer’s disease. A cure is currently not possible. However, the progression of the disease can at least be halted by medication.

Signs and symptoms of dementia: calcification of blood vessels can also lead to dementia

Dementia occurs relatively frequently, with a proportion of about 10 to 15%, because the blood vessels are damaged by calcification. In the long term, this leads to circulatory disorders in the brain, which then cause the symptoms of dementia. It’s vascular dementia. People with diabetes or high blood pressure are particularly at risk. Therefore, these underlying diseases should always be treated consistently and lifestyle adjusted accordingly.

Diabetic and hypertensive patients in particular have an increased risk of dementia

Mixed forms of vascular dementia and Alzheimer’s occur in approximately 20% of cases. Other forms of dementia are less common, for example dementia with Lewy bodies, in which, in addition to the deposits typical of dementia, other deposits form in the nerve cells of the cerebral cortex, called Lewy bodies. They are also characteristic of Parkinson’s disease.

Fronto-temporal dementia is less common than Alzheimer’s disease with 5% of cases. It is caused by a narrowing of the frontal lobe in the brain. What is striking here is that young people around 50 are more likely to be affected. Typical signs are character changes and difficult emotional processing. Sometimes there may also be a gradual loss of speech.

Some dementias are reversible if the underlying disease is treated

However, a smaller proportion of dementia, about ten percent, can be treated because they are the consequence of other underlying diseases. These are the so-called secondary forms of dementia. These include the Federal Ministry of Health depending on metabolic diseases, vitamin deficiencies or chronic symptoms of intoxication caused by alcohol or drugs. If these underlying conditions are treated appropriately, the symptoms of dementia also improve, so the condition is “reversible” in these cases.

What is the difference between dementia and Alzheimer’s disease?

Dementia (from Latin demens = “mindless”, “out of mind”) is the umbrella term for neuronal diseases that typically result in the loss or drastic deterioration of several mental abilities. It can be caused by various diseases that damage the brain. It is often caused by circulatory disorders in the brain.

Alzheimer’s disease is one of the causes of dementia. At around 60%, this is the most common. During the disease, the nerve cells die and the connection between them is destroyed. Not much is known about the exact causes of the disease. There is a decrease in brain mass and protein deposits in the brain called plaques. Genetic factors play only a minor role in its development.

Anyone who knows the causes and risk factors of dementia can prevent it in a targeted way

Although dementia cannot be prevented in most cases, the onset of symptoms can at least be delayed. For this, it is not only necessary to know the risk factors, but above all to avoid them. But you can also do much more actively to stay symptom-free for as long as possible. A Finnish research team has determined that personal lifestyle also has a major influence on the development of dementia.

Above all, an unhealthy diet with a lot of ready meals, refined sugar, alcohol and bad fats has an adverse effect. People who frequently eat industrially processed foods and baked goods are more likely to develop dementia. Even those who do little exercise have a greater risk of losing their mental capacity. An active lifestyle with regular exercise and a Mediterranean-inspired diet can prevent dementia.

It can also reduce the risk of many other diseases such as stroke, diabetes, heart attack or cancer, as studies have shown that eating less sugar and meat is key to a long life. Mental activity, nurturing and maintaining social contacts also protect against dementia – and are fun too.

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