Demenz: Definition, Formen und Umgang im Alltag

Dementia is the umbrella term for various brain diseases that lead to a progressive loss of cognitive abilities. It is not a single disease, but a syndrome that can be triggered by a variety of conditions.

The definition of dementia encompasses a persistent and progressive impairment of memory, cognitive ability, orientation, language, judgement and social behaviour. These impairments must be severe enough to significantly affect daily life.

Dementia is not a normal part of ageing. Although the risk increases with age, forgetfulness alone is not a sign of dementia. The key factor is that several cognitive functions are affected simultaneously and the impairments persist for at least six months.

There are various forms of dementia that differ in cause, progression and symptoms:

Alzheimer’s dementia (approx. 60%)

Alzheimer’s disease is the most common form of dementia. It is caused by protein deposits (amyloid plaques and tau fibrils) in the brain that lead to the death of nerve cells. The progression is gradual: short-term memory is affected first, followed later by long-term memory and other cognitive functions.

Vascular dementia (approx. 15-20%)

Vascular dementia is caused by circulatory disorders in the brain, often as a result of strokes or chronic vascular diseases. The progression is often stepwise, with abilities deteriorating sharply after each event. Risk factors include high blood pressure, diabetes and smoking.

Lewy body dementia (approx. 10-15%)

In Lewy body dementia, protein clumps (Lewy bodies) accumulate in nerve cells. Typical features include strong fluctuations in cognitive performance, visual hallucinations and Parkinson-like movement disorders.

Frontotemporal dementia (approx. 5%)

Frontotemporal dementia primarily affects the frontal and temporal lobes of the brain. It often manifests through personality changes, disinhibition, apathy or conspicuous social behaviour. Memory often remains intact initially. This form occurs more frequently in younger people (under 65).

The course of dementia is typically divided into three stages:

Early stage

• Forgetfulness, particularly regarding recent events
• Difficulty finding words
• Orientation problems in unfamiliar surroundings
• Limitations in complex daily tasks (finances, cooking)
• Withdrawal from social activities

Middle stage

• Significant memory loss, including long-term memory
• Confusion regarding time and place
• Difficulty recognising people
• Behavioural changes: restlessness, aggression, anxiety
• Increasing need for support with personal hygiene and dressing
• Possible incontinence

Late stage

• Near-complete memory loss
• Family members are no longer recognised
• Loss of speech and communication ability
• Complete dependence on care
• Bedridden state and limited mobility
• Swallowing disorders and increased risk of infection

Everyday life with a person suffering from dementia presents great challenges for family members. The following tips can help:

• Structure and routine: A fixed daily schedule provides security and orientation. Regular meal, rest and activity times help those affected to find their way
• Simple communication: Use short, clear sentences. Maintain eye contact, stay calm and patient. Don’t correct or argue, but confirm and redirect
• Safety at home: Remove tripping hazards, secure the cooker, install night lights. Secure doors and windows if there is a tendency to wander
• Adapt activities: Encourage and adapt familiar activities such as cooking, gardening or singing. Don’t overwhelm the person, but promote remaining abilities
• Respect your own limits: Caring for a person with dementia is extremely demanding. Accept respite services such as day centres, Spitex or support groups
• Professional support: Don’t hesitate to accept help. The Alzheimer’s Association offers counselling, courses and self-help groups

Caring for a family member with dementia is particularly demanding — physically, mentally and in terms of time. In Switzerland, family caregivers are entitled to various support services:

• Care salary: Depending on the canton and level of care, you may receive compensation for family caregiving
• Helplessness allowance: Dementia patients with regular need for assistance are entitled to a helplessness allowance from AHV/IV
• Care credits: Family caregivers can claim AHV care credits, which have a positive impact on their pension
• Spitex and respite services: Professional support through Spitex or respite services relieves family members in daily life