Abstract
Introduction: The term “Dementia” does not refer to a single disease, but to a set of chronic diseases that are the result of the atrophy of the Central Nervous System. Brain neurons are constantly degenerating, resulting in large areas of atrophic cerebral cortex; in the final stage, the brain may often weigh less than 1000g.
Purpose: The purpose of this review study is to investigate the quality of life characteristics of dementia patients, and trace ways how it may be improved.
Material and methods: The study material consisted of articles on the topic found in Greek and international databases such as: Google Scholar, Mednet, PubMed, Medline and the Hellenic Academic Libraries Association (HEAL-Link), using the keywords: quality of life, dementia and dementia patients. The exclusion criterion for the articles was the language, except for Greek and English. Mostly, only articles and studies accessible to authors were used.
Results: Dementia is known to have many organic symptoms and complications that health professionals are called upon to deal with and even prevent, thereby promoting the quality of life of these patients. The healing process should also be addressed to the caregivers. Nurses should be encouraged to educate caregivers and patients about the diagnosis, prognosis, pharmaceutical and non-pharmaceutical strategies that are likely to prove very useful, recognizing that caregivers have an important role to play in managing their problems.
Conclusion: Dementia is a major medical and social problem nowadays, and therefore, the planning of state actions should focus on prevention and management, with the support and expansion of support agencies. Advances in life sciences increase the likelihood of understanding the complex risk factors as regards dementia and suggest appropriate therapeutic interventions.
Introduction
In Greek, the term “dementia” equals to the word “anoia” which includes an alpha privative and the word mind [1]. According to Alzheimer Atlas of Disease: ‘‘Dementia is the term that describes the loss of cognitive abilities in a variety of areas of cognitive functioning, such as memory, reason, executive functions and visual-auditory skills. It is so severe that it interferes with one’s daily, professional and social activities’’ [2]. The term does not refer to a single disease, but to a set of chronic diseases that are the result of the atrophy of the Central Nervous System. Brain neurons are constantly degenerating, resulting in large areas of atrophic cerebral cortex; in the final stage, the brain may often weigh less than 1000g [3].
WHO estimated the global number of dementia patients in 2015 to be 47.5 million people, while projective studies raise that figure to 75.6 million patients by 2030 and 135 million by 2050 (WHO 2015) The global financial cost was estimated at $604 billion in 2010 with the prospect of an increase in life expectancy [4]. The number of patients with dementia was estimated at 9.5 million in 2015 at EU level; this number corresponds to one dementia patient in 50 healthy EU residents. However, the prevalence of the disease is not uniformly distributed across the different European countries. Graph 1 below shows the prevalence of the disease by country of the European Union based on 2015 data. (OECD, 2015) (Graph 1), Source: OECD analysis of data from Prince et al. (2015) and the United Nations (Graph 1).
HELIAD (Hellenic Longitudinal Investigation of Aging and Diet) study showed that the incidence of dementia in Greece is estimated at 4.6% for people over 65. It is a relatively lower rate than other
European populations rising to 6%. Additionally, the incidence of mild mental disorder is 11.8% in persons over 65 years of age [5]. In the last two decades, there has also been a strong interest in the issue of quality of life. Quality of life characterizes various aspects of a person’s life, such as home, work, environment, transportation, entertainment, health or even the products we consume [6]. Studies have shown that better health care (physical and mental) was more associated with higher quality of life. This finding is important in view of the fact that health is a potentially modifiable factor and can be of practical use in the need to label the health monitoring of patients with dementia [7]. The purpose of this review study is to investigate the quality of life characteristics of dementia patients, and trace ways how it may be improved.
Methodology
The study material consisted of articles on the topic found in Greek and international databases such as: Google Scholar, Mednet, Pubmed, Medline and the Hellenic Academic Libraries Association (HEAL-Link), using the keywords: quality of life, dementia and dementia patients. The exclusion criterion for the articles was the language, except for Greek and English. Mostly, only articles and studies accessible to authors were used.
Discussing Dementia
Dementia is a mental disorder that generally comes from organic or metabolic disorders affecting the brain. The dementia syndrome is usually progressive or chronic and there is a disorder of many upper cortical functions. These functions include memory, thinking, orientation, comprehension, performing arithmetic, learning ability, language and judgment [8]. Dementia could be the product of many different illnesses while impairments in mental ability can be reversible or irreversible depending on its reason. The most common forms of dementia are the following:
Alzheimer’s disease
Alzheimer’s disease
Alzheimer’s disease is a neurodegenerative disorder that results in the gradual disruption of one’s cognitive and functional abilities leading to social isolation and loss of social roles [9]). It is the most common form of dementia, as it accounts for over 50-70% of cases after the age of 65 [10].
The American Psychiatric Society based on the DSM-IV-TR Diagnostic Tool uses the following criteria to diagnose the disease [11]:
1) A Documentation of dementia through reliable scales (e.g. Mini Mental Test, Blessed Roth Dementia Scale) with concomitant neuropsychological evaluation.
2) There is at least one disorder of cognitive function, the socalled four A’s of the disease, which is translated into cognitive impairment related to cognition (ignorance), reason (aphasia), mobility (inactivity) and memory (amnesia).
3) Gradual memory decline.
4) Absence of changes in consciousness.
5) The onset of the disease occurs between the ages of 40 and 90 years of human life.
6) Absence of other diseases of the Central Nervous System, such as metabolic diseases (e.g. vitamin B12 deficiency, hypothyroidism), autoimmune diseases (e.g. lupus erythematosus) and diseases due to the use of toxic substances or HIV infection.
Vascular dementia
Vascular dementia accounts for 10-20% of cases of dementia and it is the second most frequent type of dementia. More often than not, it is due to strokes or diseases affecting arteries (e.g. diabetes, hypertension, cardiovascular disease, etc.). According to the ICD-10 classification, vascular dementia is the result of cerebral infarctions, which lead to progressive necrosis of the brain [12]. The onset of vascular dementia is sudden and is characterized by abrupt changes in function. The deterioration of the disease is gradual, while the treatment of hypertension and vascular disease may slow its progression [13].
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