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Introduction

Introduction

With the term dementia, generally, we do not mean a specific disease but a syndrome, that is, a set of disorders (symptoms). Dementias encompass a complex series of permanent (chronic) diseases that lead to progressive and irreversible degeneration of the central nervous system and impair the ability of the mind (cognitive functions) (Video). Alzheimer's disease is the most common form of dementia.

The disorders (symptoms) associated with dementia are represented by a more or less rapid loss of memory, very often accompanied by changes in personality and behavior that can vary from individual to individual. These events are capable of compromising people's autonomy to the point of interfering with the normal performance of daily activities, personal care, work activities and inter-personal relationships.

The World Report on Alzheimer's Disease (World Alzheimer Report) of 2015 defined dementia as one of the main causes of disability in old age, compared to other diseases such as heart attack, cardiovascular disease and cancer. In fact, the number of new cases (incidence) of dementia increases rapidly with advancing age and progressively doubles every 6.3 years, rising from 3.9 cases per year for every 1,000 people aged between 60 and 64 years. , to 104.8 cases per year per 1,000 people aged 90 and over (World Health Organization (WHO), Dementia: a public health priority 2015).

In particular, in Italy the estimates made indicate that there are more than one million people with dementia, of which 600,000 are affected by Alzheimer's (Video). Currently, Italy represents the European state with the highest proportion of elderly people (65 years and over) and, consequently, with a higher risk of increasing dementia.

The different forms of dementia

The different forms of dementia

There are several clinical forms of dementia which are distinguished according to the progression of the disease. Most of them are irreversible but there is also a small number of reversible forms in which the defects of mental abilities (cognitive defects) are secondary to diseases, or disorders, affecting other organs or systems.

Among the forms of the reversible type are present, for example, those caused by an excessive increase in cerebral liquor (normal tense hydrocephalus), the fluid found in the internal cavities of the brain (ventricles); from excessive thyroid activity (hyperthyroidism); from long-term alcohol abuse.

Quickly ascertaining (diagnosing) this type of disease, it allows to intervene in the shortest possible time (early) and to obtain the reduction of dementia until the pre-existing mental abilities are fully recovered.

However, dementias in most cases are irreversible and are the consequence of a process of neurodegeneration, which consists in the progressive loss of function, or death, of the nerve cells, the neurons, with the consequent compromise of the entire system. nervous. Neurodegeneration manifests itself in very different ways, giving rise to very distinct diseases from a clinical, histological and biochemical point of view. Depending on the type of dementia, in fact, the deterioration involves one or more groups of neurons in specific areas of the brain causing extremely various disorders that include different levels of impairment of the capacity of the mind (cognitive deficit), dementia, movement alterations, of behavioral and psychological disorders.

They are divided into primary and secondary forms.

The primary forms are neurodegenerative and include:

  • Alzheimer's dementia (disease) (MA) (Video)
  • frontotemporal dementia (FTD)
  • Lewy body dementia (DLB)

Among the secondary forms, the most frequent is vascular dementia caused by an impaired blood flow in the brain.

In-depth link

In-depth link

World Alzheimer's Report 2015

World Health Organization (WHO). Dementia (English)

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