Dementia

Dementia is a condition that affects memory, thinking and the ability to perform daily activities. It can be caused by many different diseases that damage the brain.

Dementia gets worse over time. Although more common after age 65, it is not an inevitable part of ageing.

Things that increase the risk of developing dementia include:

Dementia can be caused by several diseases which over time damage the brain, typically leading to deterioration in cognitive function beyond what might be expected from the usual consequences of biological ageing. The impairment in cognitive function is commonly accompanied, and occasionally preceded, by changes in mood, emotional control, behaviour or motivation.

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. There is often a lack of awareness and understanding of dementia, resulting in stigmatization and barriers to diagnosis and care.

Dementia can affect memory, thinking, communication, mood, and behaviour. As symptoms worsen, so does the need for daily support.

Changes in mood and behaviour sometimes happen even before memory problems occur. Common changes include:

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.

Symptoms vary from person to person and usually become more severe over time. Some symptoms may appear only in the later stages of dementia.

As the condition progresses, the need for help with personal care increases. People with dementia may not be able to recognize family members or friends, develop difficulties moving around, lose control over their bladder and bowels, have trouble eating and drinking and experience behaviour changes such as aggression that are distressing to the person with dementia as well as those around them.

Dementia is caused by many different diseases or injuries that damage the brain. Alzheimer disease is the most common form and contributes to 60–70% of cases. Other forms include vascular dementia, dementia with Lewy bodies (abnormal deposits of protein 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, in the context of certain infections such as HIV, as a result of harmful use of alcohol, after repeated injuries to the brain, or because of nutritional deficiencies. The boundaries between different forms of dementia are not always clear and mixed forms often co-exist.

There is no cure for dementia, but a lot can be done to support people living with dementia and those who care for them.

Non-pharmacological interventions can improve quality of life and daily functioning. These may include rehabilitation, psychoeducation, physical activity, social engagement, cognitive stimulation and support for carers.

Some medications can help manage dementia symptoms:

If a person living with dementia is at risk of hurting themselves or others, non-pharmacological approaches should be tried first. Only when clearly needed, medicines like haloperidol and risperidone may be considered with caution, under close supervision.

For those diagnosed with dementia, there are things that can help manage symptoms to maintain quality of life and well-being:

Plan ahead of time. Over time, it may be harder to make important decisions for yourself or your finances:

It is important to recognize that providing care and support for a person living with dementia can be challenging, impacting the carer’s own health and well-being. As someone supporting a person living with dementia, reach out to family members, friends, and professionals for help. Take regular breaks and look after yourself. Try stress management techniques such as mindfulness-based exercises and seek professional help and guidance if needed.

To help carers look after themselves and the person they support, WHO created iSupport, a self-help programme that offers practical skills and training for people caring for someone living with dementia.

Although age is the strongest known risk factor for dementia, dementia can also affect younger people, and young-onset dementia – in which symptoms begin before the age of 65 – accounts for up to 9% of cases.

Evidence suggests that people can reduce the risk of cognitive decline and dementia by adopting healthy behaviours and lifestyles, managing health conditions that are known to increase the risk for dementia, and reducing environmental risk factors.

Dementia risk accumulates across the life course, and some risk factors may have a greater impact at particular stages of life.

Social factors such as poverty, limited education and unequal access to employment and health care can also influence the risk of dementia. Reducing risk therefore requires not only individual action, but also supportive systems and policies that shape people’s everyday lives.

The WHO guidelines on risk reduction of cognitive decline and dementia, second edition, provide comprehensive, practical recommendations to support countries, health systems and communities in integrating dementia risk reduction into policies and programmes.

Unfortunately, people living with dementia are frequently denied the basic rights and freedoms available to others.

In many countries, physical and chemical restraints are used extensively in care homes for older people and in acute-care settings, even when regulations are in place to uphold the rights of people to freedom and choice.

An appropriate and supportive legislative environment based on internationally accepted human rights standards is required to ensure the highest quality of care for people with dementia and their carers.

WHO recognizes dementia as a public health priority. In May 2017, the World Health Assembly endorsed the Global action plan on the public health response to dementia 2017-2025, extended to 2031. The Plan provides a comprehensive blueprint for action for policy-makers, international, regional and national partners, and WHO in the following areas: addressing dementia as a public health priority; increasing awareness of dementia and creating a dementia-inclusive society; reducing the risk of dementia; diagnosis, treatment and care; information systems for dementia; support for dementia carers; and research and innovation

To facilitate the monitoring of the global dementia action plan, WHO developed the Global Dementia Observatory (GDO), a data portal that collates country data on 35 key dementia indicators across the global action plan’s seven strategic areas. As a complement to the GDO, WHO launched the GDO Knowledge Exchange Platform, which is a repository of good practices examples in the area of dementia with the goal of fostering mutual learning and multi-directional exchange between regions, countries and individuals to facilitate action globally.

Global action plan on the public health response to dementia 2017–2025View publication