Senile dementia: symptoms, treatments and what to do

By Cristiano Antonino On Apr 13, 2023

Senile dementia is a neurodegenerative disease of the brain. It predominantly affects the elderly and causes a gradual and irreversible decrease in cognitive faculties

There are different types of senile dementia, all identifiable with a neurological visit

Among which the best known are:

Alzheimer’s disease
vascular dementia
dementia with Lewy bodies

It should be noted that senile dementia and the so-called age-related cognitive impairment are two different clinical conditions.

In fact, cognitive decline as age progresses is a normal involutionary process that the brain undergoes as a result of aging.

Not all older people develop a form of dementia; some, in fact, remain extremely lucid until death.

Although senile dementia occurs mainly in the elderly, there are forms of juvenile dementia (eg: juvenile Alzheimer’s) that appear between 30 and 40 years of age.

Additionally, there are some forms of dementia that are reversible, due to thyroid problems or vitamin deficiencies.

Symptoms of senile dementia

Senile dementia causes a wide range of symptoms that can be classified into three stages:

characterized by occasional personality problems, mild deficits in memory, language and reasoning
intermediate, in which the problems encountered in the first phase are exacerbated and there is a partial deterioration of the cognitive faculties
advanced, in which total loss of cognitive abilities, difficulty swallowing, inability to recognize loved ones are observed.

It is estimated that between 4 and 6% of people over the age of sixty-five have dementia.

Age is the most important risk factor for the disease.

In people over eighty years of age, about one in five people get sick.

It is estimated that in the future, with the increase in the elderly population, the number of patients is destined to grow.

Senile dementia, the causes of which are not yet known with certainty, is unfortunately still an incurable disease today.

At present, it can only benefit from therapies aimed at alleviating the symptoms.

How the disease manifests itself

Senile dementia disorders are subject to a gradual worsening, which is closely related to the progressive death of brain nerve cells.

As seen, the evolution of symptoms of senile dementia is a three-stage process: initial, intermediate and advanced.

Early stage symptoms

Short-term memory difficulties: for example, patients may forget where they put objects, appointments made the day before, important deadlines
Sporadic lack of judgement: for example donating large amounts of money to associations that ask for door-to-door donations and then failing to justify the absence of this money
Occasional personality changes
Slight problems of logic and calculation
Difficulty concentrating
Mild speech difficulties: such as not being able to find the word you would like to use in a speech or forgetting its meaning
Lack of initiative and passivity: it is a defense mechanism that is implemented as we try to mask these shortcomings
Little mood swings
Slight insomnia
Principle of depression

Being able to recognize these first symptoms right away and promptly contact a specialist is essential for an early diagnosis of senile dementia in order to slow down its course.

Intermediate stage symptoms

The initial symptoms worsen becoming very evident even to family members, as well as registering a greater frequency and intensity.

Emotional lability: crying and sudden mood swings are frequent
Long-term memory, which progressively joins the short-term one
Spatiotemporal disorientation: the patient does not know where he is, what day, month or year it is, how he arrived at a certain place; he is no longer able to return home
Aggravation of language difficulties: often these people do not speak at all because they are no longer able to pronounce a speech
Visual impairment: unable to read and/or identify colors
Difficulty in carrying out the normal activities of daily life, carelessness.

End stage symptoms

Total loss of cognitive functions
Inability to take care of oneself, drink, eat, wash
Bladder and bowel incontinence
Difficulty swallowing
Inability to recognize loved ones
Care

Senile dementia has an inexorably negative prognosis, since it is an incurable disease that causes progressive neurodegeneration of the brain.

Currently, existing therapies are only able to act on the symptoms of the disease, with a view to alleviating them.

Unfortunately, a cure has not yet been discovered capable of blocking the neurodegenerative process peculiar to the condition, so as to reverse its effects on cognitive faculties.

Symptomatic treatment of senile dementia in use today may include:

drugs; the best known and prescribed are the acetylcholinesterase inhibitors (e.g. donepezil, galantamine and rivastigmine) and memantine, a pharmacological preparation which acts on the glutaminergic system. Prescribing other medicines depends on the type of senile dementia you have
physiotherapy exercises, to alleviate movement and balance disorders
occupational therapy, to make the patient as independent as possible from others and reintegrate him into a social context
behavioral therapy which aims to reduce the problematic behaviors induced by the disease (such as aggression, impulsivity, etc.)
speech therapy, to at least partially restore spoken language and ease communication problems
cognitive stimulation through exercises aimed at improving memory, language and so-called problem solving skills.

Furthermore, several studies have shown that by acting on certain risk factors – such as cigarette smoke and diabetes – and observing some good behaviors it is possible, if not to prevent, at least to postpone the onset of neurodegenerative disease.

More specifically, virtuous behaviors include:

learn a second language or play a musical instrument
keep your brain trained by reading books or newspapers or trying your hand at crossword puzzles and rebuses
learn to control stress
make movement. In addition to having a positive effect on health, physical activity promotes the production of a nerve growth factor (the so-called cerebral neurotrophic factor), which protects the neurons of the brain from the deterioration typically observed in the case of senile dementia.

What to do in case of senile dementia

Sometimes people with dementia are able to perceive the symptoms that signal the onset of the disease.

However, when a family member becomes aware of the disease, it is appropriate that they offer the patient all possible support.

Furthermore, those who take care of the patient must always remember that senile dementia does not allow for a truly and exhaustive understanding of what is said and done.

Similarly, it is wrong to assume that the patient can or will do things that were normal for him before the illness.

In this sense, insisting or highlighting the differences with the past will be useless and counterproductive.

Reprimanding the sick person for strange behavior is also a mistake.

Probably the person affected by senile dementia would not understand or in any case would feel threatened.

Instead, be patient and humor her when possible.

Finally, it is necessary to reconsider the environment according to the new needs of the patient:

hiding for example medicines, knives, alcohol or other potentially dangerous objects
equipping the tub or shower with handles to lean on and non-slip rugs
eliminating low tables or other elements that could cause a fall.

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