Centres of Excellence -> Neurology -> Dementia


Dementia is one of the main causes of disability and dependence on the help of others in the elderly and the most common form of dementia is Alzheimer's disease. During the neurological examination of patients with suspected dementia, it is necessary to take detailed anamnestic data and information provided by the guardian or other family members. Risk factors for the onset of the disease are age, positive family history (inheritance of both alleles for apolipoprotein E), female gender and head trauma.

Symptoms and course of the disease

The course of the disease can be divided into three stages: early, middle and late. The first symptom is usually forgetfulness of recent events, frequently asking the same questions, forgetting agreements, misplacing things, difficulty in performing daily activities (cooking, driving a car). Decision-making can be difficult already in the early stages of the disease. Over time, patients become disoriented in time and space and are no longer able to find their way home, have difficulties with handling money, maintaining personal hygiene, dressing, controlling urination and become increasingly dependent on other people's help.

In the later stages of the disease, symptoms such as not recognizing close people and significantly more difficult verbal communication appear. In the advanced stages, the patient is completely bedridden and dependent on other people's help. In addition to cognitive symptoms, psychiatric symptoms are also present (lowered mood and loss of interest in activities that the patient used to enjoy, socially inadequate behavior such as agitation, verbal and physical aggression, irritability, blaming close people and changes in the patient's sleep cycle), which is the most common reason for institutionalization .

Causes of dementia

There is a whole range of causes of dementia and for this reason it is necessary to perform imaging tests of the brain (MSCT of the brain/MR of the brain) in order to rule out possible structural damage (stroke, tumor process, hydrocephalus, subdural hematoma). It is also necessary to rule out metabolic and endocrinological disorders, which is why the level of vitamin B12 and thyroid hormone in the blood is evaluated.

Diagnosis and treatment

The diagnosis of Alzheimer's disease is made on the basis of the clinical picture, information from the family and with the help of neurocognitive testing that can help distinguish it from other types of dementia (e.g., fluctuations in cognition, parkinsonism, clear visual hallucinations and relative preservation of short-term memory indicate dementia with Lewy bodies) .

It is important to recognize the symptoms early and start treatment in a timely manner. There are two groups of drugs that differ in their mechanism of action: acetylcholinesterase inhibitors and NMDA receptor blockers. Inhibitors of the enzyme acetylcholinesterase compensate for the lack of the neurotransmitter acetylcholine in certain parts of the brain and are used in the early and middle stages of the disease. Another group of drugs is represented by NMDA antagonists, which are used in the middle and late stages of the disease. In the event of the appearance of depressive, anxiety and psychotic symptoms, psychiatric treatment with antidepressants, antipsychotics or anxiolytics is often necessary. The most important thing is that a person suffering from Alzheimer's has the support and proper care of the family.

If you have noticed memory problems or some of the symptoms above, react promptly and make an appointment for an examination!

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