Dementia

Relieving symptoms

Dementia is one of the most common and most consequential neuropsychiatric diseases in old age. In Germany, nearly one million senior citizens are currently suffering from this decline in their mental capacity. Orientation, judgement, but also language and ability to calculate as well as parts of the personality are gradually destroyed. This is quickly noticeable in everyday activities such as washing, cooking or shopping.

At Schoen Clinic, we're specialised in dementia diseases. Based on a detailed diagnosis, we offer you the optimal treatment for you. We help you delay the symptoms and maintain your quality of life as long as possible.

Causes & symptoms

Forms of dementia

Alzheimer’s disease (about 50 – 60% of cases)
The massive loss of nerve cells, which is usually most pronounced in the temporal and parietal lobes of the brain, is characteristic of the disease.

Vascular dementia  (about 5 – 20% of cases)
This affects the blood vessels supplying the brain. Cause are either infarctions in the supply area of large brain-supplying blood vessels or arteriosclerosis. The symptoms differ, depending on the location of the damage in the brain.

Frontotemporal dementia (about 5 – 15% of cases)
Group of diseases with loss of nerve cells in the frontal lobes or anterior parietal lobes of the brain. A distinction is made between three sub-forms, all of which often slowly begin from the age of about 50: 
  • Frontotemporal dementia
    slowly progressive personality change and loss of social skills 
  • Semantic dementia
    Difficulty understanding the meaning of words and objects 
  • Primary progressive aphasia
    Difficult to pronounce words correctly
Lewy body dementia (about 5 - 15% of cases)
Characteristic are movement disorders in the sense of Parkinson's symptoms, a significantly fluctuating mental capacity and the early occurrence of visual hallucinations. In addition, there is a pronounced hypersensitivity to drugs used to prevent hallucinations. Often, falls, short-term unconsciousness and disorders of the autonomic functions with low blood pressure and incontinence occur.

Mixed dementia (about 10 – 15% of cases)
Mixed form between Alzheimer’s dementia and vascular dementia. In addition to the typical Alzheimer’s symptoms, circulatory disorders can be detected in the brain.

Dementia: Causes of the disease

Neurodegenerative dementia leads to an accumulation of protein in the brain, which gradually leads to the death of brain cells. Depending on the location of this process, different symptoms occur at different times of the disease. It has been learned that all factors that can lead to a stroke (such as smoking) also increase the risk of developing dementia. 
Although dementia research has made great progress in recent years, many questions still remain unanswered.

Dementia symptoms: These signs indicate a disease

Forgetfulness alone does not yet indicate dementia. This occurs only when the following symptoms have been present for at least six months, with no indication of a temporary state of confusion: 
  • Impaired memory
  • Disruption in another area of cognitive functioning (for example, language, attention, thinking and ability to make judgements, spatial perception)
  • Emotional instability, irritability, sedatedness or more abrasive social manners 
All symptoms must be so pronounced that they lead to significant impairments in everyday life.

Dementia stages

In the early stage of dementia, those affected experience the start of forgetfulness, difficulties concentrating and misjudgements of situations very consciously. However, they often cannot adequately assess the severity of the impairment and its impact on everyday life. They try to hide their deficits from their environment and develop compensatory mechanisms. This often results in depressive symptoms and anxiety. 

Over the course of dementia, patients are less aware of or deny their dysfunctions. In the middle stage of dementia, they increasingly feel the inability to cope with everyday life. 

In the last stage of the disease, verbal communication in particular declines sharply. Nevertheless, even seriously ill patients still have capabilities, especially in the emotional field.

Symptoms – Dementia

  • Forgetting recent events
  • Difficulties carrying out habitual activities, speech disorders
  • Dwindling interest in work, hobbies and friends
  • Difficulties finding one's way around in unfamiliar environments
  • Loss of control over financial affairs
  • Misjudging dangers
  • Mood fluctuations that have not occurred previously, persistent anxiety, irritability and mistrust
  • Persistent denial of errors, confusion or mistakes

Diagnostics

Diagnosis: This is how dementia is detected

At Schoen Clinic, we clarify whether dementia actually exists and what exactly its cause is. To do this, our neurologist first identifies the symptoms of deficiency by checking reflexes, coordination, memory capability, language and orientation. Cognitive testing is often done using short standardised questionnaires or is done by our neuropsychologists. In addition, we perform an electrocardiogram (ECG) and blood tests. Imaging techniques, such as computed tomography, as well as spinal fluid sampling are used for an exact diagnosis.

Computed Tomography (CT) and Magnetic Resonance Imaging (MRI)

CTs and MRIs of the head provide tomograms of the brain, bones and blood vessels. Our radiologist can detect if any circulatory disturbances have occurred and therefore whether a stroke or a atrophy of the brain have occurred.

Positron emission tomography (PET) for early detection

In the case of PET, radioactively-marked substances are used to represent certain functional processes of the brain, such as the metabolism of oxygen and sugar. This makes it possible to detect a reduction in brain activity at an early stage.

Ultrasound examinations

With ultrasound examinations of the blood vessels on the neck and head, we determine whether and how much the vessels are closed or whether the blood flow to the brain is normal. An ultrasound scan of the heart reveals heart changes that can lead to the formation of blood clots.

Spinal fluid sampling

Using a thin needle, we take a sample of the spinal fluid between the vertebral spinous processes in the lumbar region. We then examine whether the sample contains inflammatory cells. To differentiate different forms of dementia, we also determine other parameters, such as glucose and protein content.
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Authors, 16.10.2019