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    What is Dementia

    Dementia is an umbrella term for a group of symptoms involving a decline in cognitive functions such as memory, language, reasoning, orientation, comprehension, learning and judgement, with this decline being severe enough to interfere with activities of daily living.

    In addition to cognitive changes, changes in mood, behaviour, motivation and emotional control are common — sometimes these signs appear even before intellectual difficulties become evident.

    Three areas influenced by dementia

    Cognitive

    Dementia can affect various cognitive functions, including memory, attention, language, reasoning and planning. Difficulties may arise in learning and remembering new information, maintaining attention, processing information, finding words, understanding or producing speech, recognising people and objects, planning and carrying out tasks, solving problems and adapting to new situations. Changes may also occur in the ability to recognise emotions and understand other people's intentions and perspectives.

    Psychological

    Dementia may be associated with changes in mood, behaviour and personality. Anxiety, agitation, sadness, apathy and reduced interest or motivation may occur, as well as changes in sleep. In some cases, changes may also occur in how situations are interpreted, leading the person to believe in or perceive events that do not correspond to the observable reality of their surroundings.

    Functional

    Dementia can progressively affect a person's ability to carry out everyday activities and, consequently, their independence and autonomy. In the early stages, difficulties may arise in more complex activities, such as using transport, managing health-related matters, shopping or preparing meals. As dementia progresses, difficulties may arise in basic activities of daily living, such as dressing, eating and personal hygiene.

    Dementia is caused by diseases or injuries that affect the brain. In the vast majority of cases, it is a progressive and irreversible condition, marked by the gradual loss of previously acquired abilities.

    Each person experiences dementia differently, depending on factors such as personality, lifestyle and other associated conditions.

    Although age is the greatest known risk factor for developing dementia, dementia is not part of the normal ageing process.

    There are other medical conditions with symptoms similar to dementia whose treatment may reverse cognitive decline, so assessment by a healthcare professional is essential.

    In general, there is no cure for dementia. However, there are non-pharmacological and pharmacological approaches that can improve cognitive, behavioural and emotional symptoms and influence its progression.

    Alzheimer's disease accounts for more than 60% of dementia cases.

    Bibliographic references

    Mainly referring to the pages I What is Dementia I Signs and Symptoms I Types of Dementia I Diagnosis I Mild Cognitive Impairment I

    American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.).

    Alzheimer’s Association. (2023) Special Report. The patient journey in an era of new treatments. https://www.alz.org/getmedia/12127c15-bc6b-4410-b1ba-a6402cccfe17/alzheimers-facts and-figures-special-report-2023.pdf

    Barreto, J. (2005). Os sinais da Doença e a sua Evolução, in Castro-Caldas, A. & Mendonça, A., (Eds.), A Doença de Alzheimer e outras Demências em Portugal (pp. 27-40). Lidel

    Caldas de Almeida, M., Barrios, H. S., Pereira, C., Santos, A. C., Pinto, V., Costa, S., Conde, A., & Pedrosa, H. (2015). Manual de Boas Práticas. Demência. União das Misericórdias Portuguesas

    Carretero, V. I., Pérez, C., & Sánchez-Valladares, V. (s.d.). Guía práctica para familiares de enfermos de Alzheimer. Fundación Reina Sofía /CEAFA

    Dubois, B., Villain, N., Schneider, L., Fox, N. C., Campbell, N., Galasko, D., Kivipelto, M., Jessen, F., Hanseeuw, B., Boada, M., Barkhof, F., Nordberg, A., Froelich, L., Waldemar, G., Frederiksen, K. S., Padovani, A., Planche, V., Rowe, C., Bejanin, A., ... Frisoni, G. B. (2024). Alzheimer disease as a clinical-biological construct: An International Working Group recommendation. JAMA Neurology, 81(12), 1304–1311. https://doi.org/10.1001/jamaneurol.2024.3770

    Jack, C. R., Andrews, J. S., Beach, T. G., Buracchio, T., Dunn, B., Graf, A., Hansson, O., Ho, C., Jagust, W., McDade, E., Molinuevo, J. L., Okonkwo, O. C., Pani, L. Rafii, M. S., Scheltens, P., Siemers, E., Snyder, H. M., Sperling, R., Teunissen, C. E., & Carrillo, M. C. (2024) Revised criteria for diagnosis and staging of Alzheimer's disease: Alzheimer's Association Workgroup. Alzheimer's Dement. 2024; 20:51435169. https://doi.org/10.1002/alz.13859

    McKhann, G. M., Knopman, D. S, Chertkow, H., Hyman, B.T., Jack., C.R. Jr, Kawas, C.H., Klunk, W.E., Koroshetz, W.J., Manly, J.J., Mayeux, R., Mohs, R.C., Morris, J.C., National Institute for Health and Care Excellence. (2018). Dementia: Assessment, management and support for people living with dementia and their carers (NICE guideline NG97). NICE. https://www.nice.org.uk/guidance/ng97

    Nunes, B. (2014). Alzheimer em 50 questões essenciais. Lidel.

    McKhann, G. M., Knopman, D. S., Chertkow, H., Hyman, B. T., Jack, C. R., Jr., Kawas, C. H., Klunk, W. E., Koroshetz, W. J., Manly, J. J., Mayeux, R., Mohs, R. C., Morris, J. C., Rossor, M. N., Scheltens, P., Carrillo, M. C., Thies, B., Weintraub, S., & Phelps, C. H. (2011). The diagnosis of dementia due to Alzheimer's disease: Recommendations from the National Institute on Aging–Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimer's & Dementia, 7(3), 263–269. https://doi.org/10.1016/j.jalz.2011.03.005

    Sacuiu, S. F. (2016). Dementias. En C. Rosano, M. A. Ikram, & M. Ganguli (Eds.), Handbook of Clinical Neurology (3rd series, Vol. 138, Neuroepidemiology). Elsevier. https://doi.org/10.1016/B978-0-12-802973-2.00008-2

    Waldemar, G., Frederiksen, K. S., Padovani, A., Planche, V., Rowe, C., Bejanin, A., ... Frisoni, G. B. (2024). Alzheimer disease as a clinical-biological construct: An International Working Group recommendation. JAMA Neurology, 81(12), 1304–1311. https://doi.org/10.1001/jamaneurol.2024.3770