All You Need to Know About Dementia

Dementia is an umbrella term for several diseases affecting memory, other cognitive abilities and behaviour that interfere significantly with a person’s ability to maintain their activities of daily living. Although age is the strongest known risk factor for dementia, it is not a normal part of ageing. WHO is working very closely with the Member States and other relevant stakeholders to improve the lives of people with dementia and their carers, while decreasing the impact of dementia on communities and countries.

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Key facts

• Dementia is a syndrome in which there is deterioration in cognitive function beyond what might be expected from the usual consequences of biological ageing.
• Although dementia mainly affects older people, it is not an inevitable consequence of ageing.
• Currently more than 55 million people live with dementia worldwide, and there are nearly 10 million new cases every year.
• Dementia results from a variety of diseases and injuries that primarily or secondarily affect the brain. Alzheimer’s disease is the most common form of dementia and may contribute to 60-70% of cases.
• Dementia is currently the seventh leading cause of death among all diseases and one of the major causes of disability and dependency among older people globally.
• Dementia has physical, psychological, social and economic impacts, not only for people living with dementia, but also for their carers, families and society at large.

Signs and symptoms

Dementia affects each person in a different way, depending upon the underlying causes, other health conditions and the person’s cognitive functioning before becoming ill. The signs and symptoms linked to dementia can be understood in three stages.

Early-stage: the early stage of dementia is often overlooked because the onset is gradual. Common symptoms may include:

• forgetfulness
• losing track of the time
• becoming lost in familiar places.

Middle stage: as dementia progresses to the middle stage, the signs and symptoms become clearer and may include:

• becoming forgetful of recent events and people’s names
• becoming confused while at home
• having increasing difficulty with communication
• needing help with personal care
• experiencing behaviour changes, including wandering and repeated questioning

Late-stage: the late stage of dementia is one of near-total dependence and inactivity. Memory disturbances are serious and the physical signs and symptoms become more obvious and may include:

• becoming unaware of the time and place
• having difficulty recognizing relatives and friends
• having an increasing need for assisted self-care
• having difficulty walking
• experiencing behaviour changes that may escalate and include aggression.

Common forms of dementia

There are many different forms of dementia. Alzheimer’s disease is the most common form and may contribute to 60-70% of cases. Other major forms include vascular dementia, dementia with Lewy bodies (abnormal aggregates of protein that develop inside nerve cells), and a group of diseases that contribute to frontotemporal dementia (degeneration of the frontal lobe of the brain). Dementia may also develop after a stroke or in the context of certain infections such as HIV, harmful use of alcohol, repetitive physical injuries to the brain (known as chronic traumatic encephalopathy) or nutritional deficiencies. The boundaries between different forms of dementia are indistinct and mixed forms often co-exist.

Rates of dementia

Worldwide, around 55 million people have dementia, with over 60% living in low- and middle-income countries. As the proportion of older people in the population is increasing in nearly every country, this number is expected to rise to 78 million in 2030 and 139 million in 2050.

Treatment and care

There is currently no treatment available to cure dementia. Anti-dementia medicines and disease-modifying therapies developed to date have limited efficacy and are primarily labelled for Alzheimer’s disease, though numerous new treatments are being investigated in various stages of clinical trials.

Additionally, much can be offered to support and improve the lives of people with dementia and their carers and families. The principal goals for dementia care are:

• early diagnosis in order to promote early and optimal management
• optimizing physical health, cognition, activity and well-being
• identifying and treating accompanying physical illness
• understanding and managing behaviour changes
• providing information and long-term support to carers.

Risk factors and prevention

Although age is the strongest known risk factor for dementia, it is not an inevitable consequence of biological ageing. Further, dementia does not exclusively affect older people – young onset dementia (defined as the onset of symptoms before the age of 65 years) accounts for up to 9% of cases. Studies show that people can reduce their risk of cognitive decline and dementia by being physically active, not smoking, avoiding harmful use of alcohol, controlling their weight, eating a healthy diet, and maintaining healthy blood pressure, cholesterol and blood sugar levels. Additional risk factors include depression, social isolation, low educational attainment, cognitive inactivity and air pollution.

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Impact on families and carers

In 2019, informal carers (i.e. most commonly family members and friends) spent on average 5 hours per day providing care for people living with dementia. This can be overwhelming. Physical, emotional and financial pressures can cause great stress to families and carers, and support is required from the health, social, financial and legal systems. Fifty per cent of the global cost of dementia is attributed to informal care.

Disproportionate impact on women

Globally, dementia has a disproportionate impact on women. Sixty-five per cent of total deaths due to dementia are women, and disability-adjusted life years (DALYs) due to dementia are roughly 60% higher in women than in men. Additionally, women provide the majority of informal care for people living with dementia, accounting for 70% of carer hours.

CC: World Health Organization