Signs of dementia can cause anxiety and fear in anyone who is aging and experiencing cognitive decline. These concerns are often reflected in the psyche of family members, friends and loved ones.
Part of the challenge is the many unknowns and ambiguities that accompany the dementia that it is is not the only disease diagnosed. Rather, this syndrome—involving a gradual decline in thinking, memory, or other cognitive abilities—usually results from various terminal neurodegenerative diseases.
The most common culprit, Alzheimer’s disease, is now associated with dementia in approximately 1 in 9 Americans age 65 and older, according to a 2022 Report by the Alzheimer’s Association. At least in a broader sense 55 million people worldwide live with some form of dementia, according to World Health Organization statistics.
Many often wonder if there is a cure for dementia, how it causes death, and what are the treatment and prevention options for dementia.
Is there a cure for dementia?
Although there is no cure for dementia, most people live for many years or even several decades, as the syndrome progresses gradually on a case-by-case basis. It usually involves three stages—early, middle, and late—before death, caused either by the underlying neurodegenerative disease or by associated complications.
Today, researchers are still uncovering the underlying causes, which is not only improving care and support, but also helping patients and families know what to expect in the dementia process.
How does dementia cause death?
The common theme in neurodegenerative cases—including Alzheimer’s, frontotemporal dementia or dementia with Lewy bodies – is that these diseases originate in a specific area of the brain. They kill the cells, then slowly spread to neighboring regions.
Alzheimer’s, for example, begins in hippocampus, usually associated with memory. Specifically, it destroys neurons and their connections in the entorhinal cortex subregion of the hippocampus. Over time, this damaging activity spreads to more nearby memories and the frontal cortex, where it begins to affect personality and decision-making.
End stages of dementia
In the final stages of dementia, the neurodegenerative disease penetrates the deepest parts of the brain. This can interfere with basic body functions, such as heart rate and breathing.
Read more: How does Alzheimer’s disease lead to death?
Historical, associated complication such as respiratory or urinary tract infections and falls were the cause of death as dementia progressed. But improvements in patient care are creating more incidents where brain cell death is essentially fatal, according to Scott Small, director of the Alzheimer’s Research Center at Columbia University.
“The most important thing is the cells dying,” says Small.
What are the signs of dementia?
Because the outward symptoms and signs of dementia appear relatively late in the process, much research and treatment today focuses on identifying biomarkers in the blood that can signal problems in the early stages.
“By the time I see a patient with Alzheimer’s dementia, I’m usually pretty sure they’ve had a slow-onset disorder for at least a decade or more,” says Small.
But even with blood tests and dynamic tests, finding the right markers for neurodegenerative diseases like Alzheimer’s is challenging. This is because these are complex diseases, not ones that involve a particular faulty gene.
“It’s not a simple genetic response,” Small says of the nature of Alzheimer’s and similar diseases. “A combination of many – technically hundreds – of genes, each with a small weight, [are] conspiring together with the environment to ultimately tip the balance of health.”
Furthermore, even the early outward signs of dementia, such as forgetfulness, can be mistaken for dementia cognitive aging, which is a normal part of aging. The difference with dementia is the speed of its progression and the severity of its effects.
Read more: Alzheimer’s disease is not the only cause of dementia
Dementia care and prevention
Current research shows that people age 65 and older live an average of four to eight years after being diagnosed with Alzheimer’s dementia, with some people living as long as 20 years, according to Alzheimer’s Association.
The good news for those living with dementia today is the growing range of treatment options. Dementia care and prevention can include both therapeutic and drug options to manage the symptoms, and since the last few years, a number of drugs designed to treat Alzheimer’s disease itself.
Since January of this year, the US Food and Drug Administration (FDA) approved Leqembi as the second drug of its kind to target the underlying Alzheimer’s disease process. The the first drug of its kindAduhelm, was approved in the summer of 2021
Understanding the signs and symptoms to look for and learning about the different types of dementia can help healthcare professionals provide the best options for care and prevention.
Read more: The 4 main types of dementia