About dementia

What is dementia?

  • Dementia is a broad term used to describe a group of symptoms that cause progressive damage to the brain.1
  • Dementia is not a specific disease, but rather, refers to the long-term and often gradual decline in a person’s ability to think, remember, and function in regular daily activities.2 Changes to personality, mood and difficulty using and/or understanding language may also occur.3
  • Dementia is not a normal part of ageing, although its incidence does increase with age.4
  • The terms ‘dementia’ and ‘Alzheimer’s disease’ are often used synonymously. However, dementia refers to a group of cognitive symptoms, such as memory loss and confusion, while Alzheimer’s refers to a specific type of dementia.5

Prevalence in Australia

  • Dementia affects almost 1 in 10 people aged 65 years and above in Australia.6
  • Estimates suggest between 400,000 and 459,000 Australians are currently living with dementia, with Alzheimer’s disease accounting for up to 70 per cent of diagnosed cases.3
  • Just over 1per cent of people living with dementia are estimated to be under 60 years of age.6
  • In 2018, dementia, including Alzheimer’s disease, was the leading cause of death for females in Australia, accounting for 9,973.

Risk factors for Alzheimer’s disease

There are five known risk factors for Alzheimer’s disease:

  1. Age -  The older the person is, the greater their risk of developing the disease.7 The likelihood of developing Alzheimer’s doubles about every five years after age 65.7 After age 85, the risk of developing Alzheimer’s disease reaches almost one-third.7
  2. Gender – Alzheimer’s disease appears to affect more women than men.8
  3. Family history - The risk of developing the disease is greater if a primary relative (parent, grandparent or sibling) develop/developed Alzheimer’s disease prior to the age of 65 years.7
  4. Head injury – A severe head injury or repeated blows to the head may increase the risk of developing dementia, but not necessarily Alzheimer’s disease.7
  5. Down syndrome – For unknown reasons, people with Down Syndrome are prone to developing Alzheimer’s disease in their thirties or forties.9

Dementia warning signs

Memory loss: 

  • Early warning signs of dementia vary between individuals, but most commonly, memory loss and impairment are hallmark features of the disease.10
  • Although at times, everyone can become forgetful, memory difficulties in Alzheimer’s disease are more consistent, and include misplacing items, failing to remember appointments, and/or repeating the same topic or question.10

Difficulty performing familiar tasks:

  • Another early symptom of dementia is difficulty performing routine, everyday tasks.10
  • The sequencing of steps to perform a task may be out of order, or in some cases, the person with dementia may skip a step completely.10

Confusion about time and place

  • Often, an early warning sign of Alzheimer’s disease is when a person becomes disorientated in a familiar place. The person may suddenly not know where they are, not know how to drive home, or forget why they visited the shops.10
  • Frequently forgetting the time, date and day of the week can also be indicative of dementia.10

Problems with words

  • A person with dementia may frequently forget the names of objects, referring to certain items as “things” or “that”. They may also have difficulty putting sentences together and understanding complex instructions.10

Poor judgment

  • Poor or impaired judgement may present as difficulty judging distances, not taking usual safety precautions (e.g. turning off the stove), wearing summer clothing on a cold day, and/or driving erratically, or not following road rules.10

Changes in personality and mood

  • Personality changes include heightened irritability, increased agitation, easily angered, more suspicious, and/or more self-centred and disinhibited. Changes may also include a loss of interest in hobbies and activities, as well as social withdrawal.10

Types of dementia

Dementia symptoms can be classified into:

  • Irreversible causes – include a number of diseases and conditions which affect the brain and lead to progressive and permanent damage to brain cells.11
    • Examples of irreversible dementia include Alzheimer’s Disease and Vascular dementia.12
    • Other conditions include Frontotemporal dementia,  Lewy  Body Disease, Huntington’ Disease and Parkinson’s Disease.12
  • Reversible causes – Reversible causes of dementia are conditions that mimic dementia symptoms but do not cause progressive or permanent brain damage13 They are conditions which are usually treatable and or preventable such as delirium, depression, drug side effects, thyroid conditions and B12 deficiency.13

Treatment

  • There is currently no cure for Alzheimer’s disease. There are neither medication or therapies to halt the progression, or reverse damage that has already occurred.14 There are some medications that can be trialled to help slow disease progression and manage the behavioural changes associated with the disease.11
References
  1. Better Health Channel. Dementia - different types. 2014 [cited November 2020]; Available from: https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/dementia-different-types.

  2. Dementia Australia. What is dementia? [cited November 2020]; Available from: https://www.dementia.org.au/about-dementia/what-is-dementia.

  3. Australian Institute of Health and Welfare (AIHW). Dementia. 2020; Available from: https://www.aihw.gov.au/reports/australias-health/dementia.

  4. Evans, S.C., Ageism and Dementia, in Contemporary Perspectives on Ageism, L. Ayalon and C. Tesch-Römer, Editors. 2018, Springer International Publishing: Cham. p. 263-275.

  5. Alzheimer's Association. Dementia vs. Alzheimer’s Disease: What is the Difference? [cited November 2020]; Available from: https://www.alz.org/alzheimers-dementia/difference-between-dementia-and-alzheimer-s.

  6. Australian Institute of Health and Welfare (AIHW), Dementia, in Australia’s health 2016. 2016.

  7. Alzheimer's Association. Causes and Risk Factors for Alzheimer's Disease. [cited November 2020]; Available from: https://www.alz.org/alzheimers-dementia/what-is-alzheimers/causes-and-risk-factors.

  8. Beam, C.R., et al., Differences Between Women and Men in Incidence Rates of Dementia and Alzheimer's Disease. Journal of Alzheimer's disease : JAD, 2018. 64(4): p. 1077-1083.

  9. National Institute on Ageing (NIH). Alzheimer's Disease in People with Down Syndrome. 2017 [cited November 2020]; Available from: https://www.nia.nih.gov/health/alzheimers-disease-people-down-syndrome.

  10. Better Health Channel. Dementia - early signs. [cited November 2020]; Available from: https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/dementia-early-signs.

  11. National Institute on Aging (NIH). Alzheimer's Disease Fact Sheet. 2019; Available from: https://www.nia.nih.gov/health/alzheimers-disease-fact-sheet.

  12. Bello, V.M.E. and R.R. Schultz, Prevalence of treatable and reversible dementias: A study in a dementia outpatient clinic. Dementia & neuropsychologia, 2011. 5(1): p. 44-47.

  13. Chari, D., R. Ali, and R. Gupta, Reversible dementia in elderly: Really uncommon? 2015. 2(1): p. 30-37.

  14. Dementia Australia. Dementia treatments and cure. [cited November 2020]; Available from: https://www.dementia.org.au/about-dementia/dementia-research/dementia-treatments-and-cure.

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