What are the main symptoms of dementia and what causes its onset?

Dementia is a clinical term referring to a group of brain diseases that result in progressive deterioration of cognitive functions. Approximately 70 per cent of all dementia cases are of the Alzheimer type (Alzheimer’s disease). Symptoms include memory impairment, difficulties in spatial orientation, changes in mood and personality, communication deficiencies and functional losses in activities of daily living. As the disease progresses, brain function becomes more impaired and individuals will eventually become totally dependent on others.

What causes the onset of the most common forms of dementia is unknown. Brain damage starts approximately 20 years before the first symptoms appear and risk factors include age, female gender, smoking and alcohol abuse, family history, repeated head trauma and cardiovascular and metabolic factors.

Is dementia strictly related to old age?

Dementia can strike at any age. However, the most important non-modifiable risk factor is age – the older an individual gets, the greater the risk. One per cent of individuals at the age of 65 have dementia. This figure increases to about 30 per cent at the age of 80.

Are the family and friends of a person with dementia also affected?

The medico-social consequences of dementia on the affected individual are enormous. With disease advancement, memory is progressively lost. Social contacts cease and the individual becomes isolated, often homebound. The need of community care is therefore imperative in any management plan for individuals with dementia and their caregivers. Family members absorb many of the financial and social costs associated with providing care for dementia. It is therefore not surprising that a lot of research is being conducted on finding ways how to best support carers to continue care at home for long periods to delay or prevent institutionalisation.

Are there any effective cures for dementia?

Dementia affects each individual differently. The most common form of dementia, Alzheimer’s disease, cannot be cured nor the disease process halted. It is thus of vital importance that medical advice is sought as soon as the first symptoms appear. Although there is no cure, medications that slow down the mental decline are available with the aim of enhancing the quality of life.

Individuals with dementia should maintain an active and healthy lifestyle and keep their social contacts intact for as long as possible. Studies have shown that physical exercise, mental exercise, healthy eating and broad social contacts can all act as protective factors in dementia.

Locally, how many people have dementia?

The first study to determine the local prevalence of dementia was published in 2007. The findings estimated that in 2010, there were approximately 4,500 individuals with dementia. Recent data on prevalence rates using new criteria suggest that the number of individuals with dementia is higher than previously reported and should exceed 14,000 cases by 2060.

This progressive increase in affected individuals will have important socio-economic consequences and will invariably put greater demands on government-supported healthcare services.

Moreover, there will be a growing burden on family members who, in the majority of cases, provide informal care at home.

Given that Malta has an increasingly ageing population, will the incidence of dementia increase?

The prevalence rates for dementia will increase as age remains the most important risk factor. The number of individuals over the age of 65 will exceed 28 per cent by 2050. Much of the increase will occur in the oldest-old age bracket. Currently, 3.2 per cent of the population in Malta is at the age of 80 years and over. This will reach almost 12 per cent by 2060. These figures should also be interpreted on the basis of the current negative population growth which will inevitably lead to a dramatic shift in the old-age dependency ratio in the coming years.

Locally, is there enough awareness of dementia?

Unfortunately, not enough even though positive developments in this aspect were reported in these last few years. A lot of work remains to be done in making Malta a dementia-friendly country where individuals with dementia and their caregivers feel valued.

Dementia awareness and support in the community mostly comes from the Malta Dementia Society and its support group. Talks, seminars and other activities are frequently organised for individuals with dementia, caregivers and healthcare professionals. The society also collaborates with the central authorities and various other non-governmental organisations on issues that promote the well-being and quality of life of these individuals and those who care for them.

Dr Charles Scerri is a resident senior academic at the Department of Pathology, Faculty of Medicine and Surgery, University of Malta. He is one of the co-founders and secretary of the Malta Dementia Society, secretary of Alzheimer Europe, national focus point on dementia and member of the Scientific Advisory Board of the European Union Joint Progamme for Neurodegenerative Diseases.

Malta Dementia Society

The Malta Dementia Society was set up in September, 2004 in commemoration of World Alzheimer Day. The main aim of the society is that of increasing awareness on dementia in Malta through the organisation of seminars and talks on various aspects of dementia care and management. The Malta Dementia Society is an active member of Alzheimer Europe and Alzheimer Disease International and is frequently invited to participate in various European and pan-European initiatives.

For more information contact the Malta Dementia Society on info@maltadementiasociety.org.mt.