Dementia

According to some estimates, around 50 million people worldwide are affected by dementia, and this number is expected to triple by 2050 due to the ageing of the global population. In Italy, at least one million people- one in four older individuals- live with some form of dementia.

The term dementia refers to a condition characterised by a decline in cognitive functions- such as language, memory, and spatial awareness- severe enough to interfere with a person’s autonomy and functional independence.

Dementia can be caused by numerous diseases that directly or indirectly affect the central nervous system. The most common form is Alzheimer’s disease, accounting for about 60% of all cases, but it is not the only one. Other types include vascular dementia and dementia with Lewy bodies, which are the second and third most common forms, respectively. There are also frontotemporal dementia and dementias associated with trauma, infections, or alcohol abuse.

Dementia is often preceded by mild cognitive impairment (MCI), a stage where cognitive decline is noticeable but does not prevent the person from being autonomous. This condition can progress to full-blown dementia, remain stable over time, or even improve. Therefore, it should not be considered a pre-dementia condition but rather a risk factor for its onset.

Dementia is frequently viewed, particularly in certain cultural contexts, as an inevitable part of ageing rather than an actual disease. Conversly, it is a pathology and should be recognised as such: not everyone who ages develops dementia. In recent years, the inevitability of dementia has been questioned, as modifiable risk factors have been identified (e.g., low education level, high blood pressure, diabetes, smoking, hearing impairment, obesity, and depression) that can be targeted with preventive interventions.

Timely diagnosis of dementia is crucial for optimising available pharmacological and non-pharmacological treatments and for organising appropriate patient care. Recognising early signs and symptoms that may serve as warning signals is therefore essential.

Here are the most common symptoms to watch out for:

• Memory problems, particularly in remembering recent events- the person cannot recall recent occurrences, tends to repeat questions or statements about events from the recent past (from a few hours up to a few days prior) and forgets where they left objects such as keys or phone.

• Language difficulties: the person struggles to find the right word, forgets the meaning of common words or shows changes in their usual verbal fluency.

• Trouble recognising and naming common objects.

• Difficulty reading and/or writing.

• Problems using everyday tools or objects.

• Difficulty orienting in space and time- they may get lost and be unable to find their way home, forget how to reach familiar places, even those frequently visited.

• Inappropriate clothing choices for the season.

• Feelings of mental confusion and disorientation.

• Difficulty with grocery shopping, handling money and estimating purchasing power.

• Changes in personality and behaviour, such as apathy, irritability or agitation.

• Altered consumption of alcohol, tobacco or food.

• Depression and/or anxiety.