What is dementia?

The brain can suffer many different diseases and injuries. A disease that slowly breaks down brain cells is called neurodegenerative diseases, but in everyday speech people talk about dementia or cognitive diseases. These have different effects depending on the different areas of the brain. The disability when it is so pronounced that it becomes difficult to cope with one's everyday life is called dementia. Before that, however, many have had lighter gradually increasing symptoms long before it became clear dementia, it is called cognitive impairment.

The most common neurodegenerative diseases are: Alzheimer's disease, vascular dementia, frontotemporal dementia, Lewy body disease, and even Parkinson's disease can lead to dementia but there are many others. There are also a number of very rare neurological diseases, such as Huntington's disease or rare diseases such as progressive supranuclear paralysis (PSP), corticobasal neurodegeneration (CBD), Creutzfeldt-Jakob disease (CJD) or amyloid lateral sclerosis (ALS).

In order to determine which disease the patient has suffered from, make a diagnosis, the doctor needs to obtain a number of facts about the patient and their disease development, but also results from various examinations, including radiographs. In specialist clinics, samples are sometimes also taken from the back fluid. If you want to know more about what a basic investigation should contain, read more here. Regardless of the dementia, it causes the person to have difficulty coping with their everyday life. This is when the disability is so pronounced that the person meets the criteria for dementia. The disability should have lasted at least six months and not be due to any other treatable cause. The concept of dementia includes that the disorder should be permanent and acquired, that is, that it represents a decline in intellectual, emotional and practical capacity, compared to how the person has been in the past.

The word dementia will eventually be replaced by “cognitive disease”

The word dementia derives from the Greek term “de mens,” which means “without a soul” and is an umbrella term for many different conditions with similar symptoms. The symptoms are equivalent to acquired brain damage and are different from those that arise from age. It’s normal to become forgetful as the years pass by, but it’s abnormal not living a normal life because of it.

In practice, therefore, the concept of dementia is moving away to be replaced by cognitive impairment and a specific disease with the collective term cognitive disease instead of dementia. In Sweden, diagnoses are also based on another international diagnostic code system, ICD-10/11 (International Statistical Classification of Diseases and Related Health Problems). The concept of dementia still exists there, and the National Board of Health and Welfare's national guidelines still use the collective name Dementia. In practice, both concepts now exist, dementia and cognitive disease, and the public often talks about dementia, which is the same thing. However, the concept of dementia will eventually disappear. Here we have chosen to write dementia/cognitive disease.

In recent years (2014), the concept of them has even been replaced by the diagnosis of cognitive disease in the diagnostic and statistical manual of mental disorders (DSM-5). The reason is above all that those suffering from dementia have a disease and are not without a soul at all. On the contrary, they are still a person worthy of exactly the same respect and care as a person who can speak for himself. To be diagnosed with cognitive disease, the doctor needs to clarify which disease causes the symptoms (Alzheimer's disease, cerebrovascular disease. Lewy body disease, frontotemporal disease, etc.) and memory impairment and one of the five other cognitive domains (attention, executive functions, language, spatial perception and behavior). The disability should also be so pronounced that those who are ill can no longer cope with their everyday life.

In the future, we will be talking more and more about the respective cognitive disease and the symptoms of the disease in question.

Mild cognitive impairment

For mild cognitive impairment (formerly "Mild cognitive disorder"), impairment in cognitive function (See how the brain works) is enough, but that the impairment is not so pronounced that the person has difficulty coping with their everyday life. This is a condition you can also call cognitive impairment. For example, they may be diagnosed with "Mild cognitive impairment of the Alzheimer's type".

Johan Sundelöf, Senior Physician, Specialist in Geriatrics and Palliative Medicine
Reviewed by: Johan Sundelöf, Senior Physician, Specialist in Geriatrics and Palliative Medicine
Updated: January 22, 2021
Published: 15 December, 2020

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