The Course and Outcome of Dementia

(Extracted from Dementia India Report 2010)

Dementia affects every person in a different way. Its impact can depend on what the person was like before the disease; his/her personality, lifestyle, significant relationships and physical health. The problems linked to dementia can be best understood in three stages. The duration of each stage is given as a guideline; sometimes people can deteriorate quicker, and at other times more slowly.

Early Stage: first year or two

The early stage is often overlooked. Relatives and friends (and sometimes professionals as well) see it as normal part of 'old age'. As the onset of the disease is gradual, it is difficult to be sure exactly when it began. The person may have problems talking properly (language problems), become lost in familiar places, have difficulty in making decisions, show mood changes, depression or anxiety and show a loss of interest in hobbies and activities.

Middle stage: second to fourth or fifth years

As the disease progresses, limitations become pronounced and more restricting. The person with disease has difficulty with day-to-day living and, may become extremely dependent on their family and carers and need help with personal hygiene like toileting, washing and dressing.

Late Stage: fifth year and after

This stage is one of near total dependence and inactivity. Memory disturbances are very serious and the physical side of the disease becomes more obvious. The person may have difficulty eating or difficulty walking, have bladder and bowel incontinence or be confined to a wheel chair or bed.

The Management of Dementia: The standard treatment goals are -
• Early diagnosis
• Optimization of physical health, cognition, activity and well being
• Detection and treatment of Behavioural and Pyschological symptoms of dementia
• Educating carer and providing long term support to carer

Acknowledgement :  Alzheimer’s & Related Disorders Society of India (2010). The Dementia India Report: prevalence, impact, costs and services for Dementia: Executive Summary. (Eds) Shaji KS, Jotheeswaran AT, Girish N, Srikala Bharath, Amit Dias, Meera Pattabiraman and Mathew Varghese. ARDSI, New Delhi. ISBN: