The phenomena of population ageing - having as contributing factors the increased life expectancy at birth and low levels of fertility in a process known as ‘ageing at the bottom’ – is, simultaneously, a major conquest and a considerable challenge for the contemporary society. Concerns have been raised about the sustainable provision of healthcare and assistance to older adults as well as on how to guarantee older adults’ security, civic participation and independent living. Since increasing age is a primary risk factor for dementia, as the demographic ageing takes place, the prevalence of this group of diseases is expected to grow. In 2012, the World Health Organization (WHO) published the report ‘Dementia, a Public Health issue’, where the prevalence for dementia in the population with 60 or more years was estimated as ranging between 5% and 7%, and noticed its exponential increase with age. In particular, for Western Europe, the prevalence of the disease doubles with an increase of 6.3 years of life.
Dementia is a syndrome resulting from a set of conditions affecting the brain with overwhelming consequences for the person living with dementia and informal caregivers. The disease affects the individuals in cognitive, functional and social dimensions. According to the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM–5; 2014), the criteria for dementia diagnosis are the following:
- Decline in one or more cognitive domains, when compared with a previous level of functionality, namely with regards to complex attention, executive function, learning and memory, language, perceptual-motor and social cognition.
- The cognitive deficits interfere with an independent carrying of everyday activities.
- The cognitive deficits do not occur in the context of a delirium.
- The cognitive deficits are not better explained by another mental disorder.
Depending on the disease phase, there are different symptoms and signs.
- Early-stage: forgetfulness, especially for recent events, difficulties in finding the right words to express an idea, orientation problems regarding time (day, month, seasons) and space (fell lost in familiar places), difficulties in taking decisions and manage finances, trouble in managing complex domestic tasks, changes in humor and behavior.
- Middle-stage: severer signs of forgetfulness, especially for recent events and persons’ names, orientation problems and difficulties in understanding time and space notions, trouble in communicating both regarding expression and comprehension of ideas, need for help regarding personal care, need for help regarding daily activities such as cooking and shopping, difficulties in living alone, behavior changes such as sleep disorders, aggression, disinhibition, wandering.
- Late-stage: high level of dependence and inactivity, loss of time and space notion, difficulties in understanding social situations and events, difficulties in recognizing relatives and friends as well as familiar objects, incapability of eating without help and swallowing difficulties, greater need for help in personal care, incontinence, walking and movement problems, behavior alterations which can include aggressiveness towards the caregiver.
Can you reduce your risk of dementia?
In its majority, the diseases originating dementia are incurable and cannot be reversed, causing a progressive and irreversible cognitive decline. Be aware about the risk factors, in particular the ones that can be modified, as well as on the protective factors, is an essential step to define prevention strategies, in order to reduce the risk of developing the disease. As happens with other diseases, lifestyle and health status can reduce the risk of developing dementia. The Alzheimer’s Disease International in its 2014 report - World Alzheimer Report 2014. Dementia and Risk Reduction – suggests that recommendations for the reduction of death by cancer, diabetes, cardiovascular diseases and chronic respiratory diseases also apply to dementia prevention. Recommendations include:
- Smoke cessation
- Maintenance of a healthy and balanced diet, which includes the reduction of salt, sugars and saturated fat Currently, the market offers a lot of technology-based solutions to help you managing your diet, including apps targeted at managing food intake.
- Keep the alcohol consumption within recommended limits which are now of 14 units maximum each week spread over 3 or more days.
- Be physically active: technological solutions in the market can be used to help you stay physically active. This is the case for exergames, i.e. videogames which offer simultaneously a form of doing physical exercise.
- Keep your mind active: you can give your mind daily workouts by doing leisure and playful activities such as work searches, reading, playing cards, among others. Currently, there are a lot of technology-based options to train your brain, such as brain training apps with entertaining exercises.
- Pay attention to medicines intake in order to use medication properly.
In sum, for preventing dementia, the Alzheimer’s Disease International emphasizes the need to control diabetes, stop smoking, and maintain a proper physical and mental activity. Dementia prevention, therefore, requires a change of unhealthy and harmful lifestyles and habits.
The ActiveAdvice project will soon be able to support information and advice gathering about the technology-based solutions which can help improving older adults’ health and quality of life. Stay linked to our blog and subscribe our newsletter for more information!