WE ARE DEDICATED TO PROVIDING SUPPORT FOR FAMILIES AND INDIVIDUALS WITH ALZHEIMER'S OR DEMENTIA AND THEIR CARERS.
Dementia is an umbrella term for a collection of symptoms that are caused by disorders affecting the brain and impact on memory, thinking, behaviour and emotion
Understanding Dementia
The word ‘dementia’ stems from a Latin word and is not a specific disease. According to the World Health Organisation: “Dementia is a syndrome – usually of a chronic or progressive nature – that leads to deterioration in cognitive function (i.e., the ability to process thought) beyond what might be expected from the usual consequences of biological ageing. It affects memory, thinking, orientation, comprehension, calculation, learning capacity, language, and judgement. Consciousness is not affected. The impairment in cognitive function is commonly accompanied, and occasionally preceded, by changes in mood, emotional control, behaviour, or motivation.”
Dementia is progressive, which means that the symptoms will get worse over time. However, many people living with dementia lead active and fulfilling lives for many years.
Dementia results from a variety of diseases and injuries that primarily or secondarily affect the brain, such as Alzheimer’s disease or a single stroke or series of strokes. Alzheimer’s disease is the most common cause of dementia, but not the only one. The specific symptoms that someone with dementia experiences will depend on the parts of the brain that are damaged and the disease that is causing dementia.
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 worldwide. Dementia has physical, psychological, social, and economic impacts, not only for people living with dementia, but also for their caregivers, 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.
The global impact of dementia
Prevalence of Dementia
Globally
The ADI: World Alzheimer’s Report of 2021 indicated that “there are over 55 million people living with dementia worldwide. The numbers are rising daily with forecasts that it might reach 78 million by 2030 and 139 million by 2050. The greatest increases will be in the low- and middle-income countries. A new case of dementia arises somewhere in the world every 3 seconds.”
Nearly 60% of people with dementia currently live in low- and middle-income countries and most new cases (71%) are expected to occur in those countries. As most countries enforced lockdown measures to contain the spread of COVID-19 during 2020– 2021, movement restrictions cut off much access to healthcare services for people with dementia symptoms; the full impact of this disruption to the diagnosis of dementia is yet to be seen. Up to three-quarters of those with dementia worldwide have not received a diagnosis according to the World Alzheimer’s Report.
The focus of the World Alzheimer’s Report 2021 is The Journey through Diagnosis. The World Health Organisation (WHO) Global action plan on the public health response to dementia targets at least 50% of countries to diagnose 50% of the estimated number of people with dementia by 2025. Worldwide more than half of the health care practitioners still incorrectly see dementia as a part of normal ageing. Caregivers across the world have been confirmed to hide the diagnosis of a family member or relative. Caregivers also reported health problems because of caregiving responsibilities. However, they expressed positive sentiments about their role as caregivers.
The global picture of dementia prevalence is complex and affected by a variety of different factors, from life expectancy to quality of health data reporting. The public is concerned about developing dementia and generally thinks there is nothing a person can do to prevent dementia.
South Africa
According to the World Alzheimer’s Report (2016), it was estimated that there were 4.4 million people over the age of 60 years living in South Africa of whom about 187,000 living with dementia. This number is predicted to rise to 250,000 by 2030, with a concurrent increase in the number of older people (60 years plus) to 7 million. A study: Dementia Prevalence in a Rural Region of South Africa: A Cross-Sectional Community, (2016) in the Amatole District Rural Eastern Cape is the first large dementia prevalence study reported in South Africa.
Prevalence data are lacking for South Africa.
The report reflected as follows:
- The number of people 60-plus estimated to be living with dementia in South Africa could be 352,000, rather than the 187,000 reported by Alzheimer’s Disease International.
- In this low-income, rural Xhosa-speaking population the knowledge and awareness of dementia is poor, resulting in an urgent need to address poor awareness, inadequate services, and care provision for older people in the lower socio-economic and rural communities in South Africa.
- There is a need for more clinicians, allied health professionals, community health workers, and caregivers to be trained in dementia awareness, diagnostic screening, and feasible interventions, especially in rural areas.
- The potentially modifiable risk factors that contribute to cognitive impairment in this population need to be identified and addressed as this may help reduce the prevalence in the future.
- The perceptions of difficulty with activities of daily living may be influenced by cultural expectations of the older person’s functional abilities.
- The biggest risk factor for dementia is older age. However, lower life expectancy in South Africa might be expected to reduce the prevalence. The risk of dementia due to increased age is complex. It is subject to various contributing factors across the life course that may differ between those living in high and low income regions.
- This study needs to be replicated in other regions of the country to obtain a more complete picture of the prevalence of dementia in South Africa and of regional prevalence differences that may exist.
Normal Ageing vs Dementia
As people get older, they get a little more forgetful. With age most people will need a bit longer to remember things, get distracted more easily, or struggle to multi-task as well as they did before. The brain change with age and people might experience these changes from middle age – during the 40s, 50s, and early 60s – onwards.
According to Alzheimer’s UK in the table below, some of the possible changes due to both normal ageing and early dementia are listed. Everyone is different and not everyone with dementia will have all these symptoms.
| ABILITY | Possible changes due to normal ageing | Possible changes due to dementia |
| ‘Short-term’ memory and learning new information |
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| ‘Short-term’ memory and learning new information |
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| Planning, problem-solving and decision-making |
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| Language |
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| Orientation |
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| Visual perceptual skills |
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| Mood and behaviour |
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How is Dementia Diagnosed?
There is no one dementia test, so diagnosis can be challenging and will require several visits to your doctor or specialist.
Step 1: Consult your doctor or local clinic if you are concerned about yourself or a loved one. Do not attempt to self-diagnose. Your doctor will review your medical history and symptoms and conduct a physical examination.
Step 2: Doctors may order several tests for dementia diagnosis to rule out other, sometimes reversible conditions such as depression, hormonal imbalance, thyroid problems, head injuries, or vitamin deficiencies.
Step 3: After an initial diagnosis of dementia, a referral is made to a specialist (Neurologist, Psychiatrist) who will conduct other tests and brain scans to confirm the diagnosis.
Step 4: There is no cure for dementia, but a lot can be done to support people living with the illness and those caring for them. Contact your local ADASA office for assistance post-diagnosis or any other queries.
Types of Dementia
Alzheimer’s Disease:
Currently, the most common cause of dementia is characterised by Amyloid plaques and beta-tangles that form inside and in between brain cells. Symptoms include impairment in memory, ability to think and reason, language, and visuospatial skills.
Vascular Dementia:
Characterised by disease or injury to the blood vessels leading to the brain. (Strokes). Symptoms include impaired motor skills, judgment, and language impairments.
Frontotemporal dementia:
Is characterised by deterioration of the frontal and temporal lobes of the brain resulting in symptoms such as personality changes, inappropriate behaviour, and language difficulties.
Lewy-body dementia:
Characterised by Lewy-body protein deposits on brain cells. Symptoms include hallucinations, disordered sleep, impaired thinking, and motor skills.
HIV-related dementia:
HIV-associated dementia is chronic cognitive deterioration due to brain infection by HIV. It is a serious consequence of HIV infection and is typically seen in the advanced stages of the disease.
Other:
Dementia is related to Parkinson’s disease, Huntington’s disease, Crutzfeldt-Jakob disease, Korsakoff-syndrome, and many more.
What Is Alzheimer's Disease?
Warning Signs of Dementia
In most cases, dementia symptoms progress gradually over several years. The early signs, usually memory
problems may not be immediately obvious. Symptoms vary and forgetting things is a normal part of aging, but
those with dementia often have one or more of the following:
- Memory problems (short-term)
- Diminished ability to plan activities
- Problems with language and communication
- General confusion, disorientation in time and/or place
- Difficulty with abstract thinking, lapses in judgment
- Difficulty performing a familiar activity
- Misplacing objects and problems keeping track of things
- Behaviour and personality changes
- Sudden mood swings
- Challenges in understanding visual and spatial information
- Loss of initiative/ apathy
Risk Factors
Several risk factors can increase one’s chance of developing dementia. These risk factors can be either modifiable (changeable) or not-modifiable (unchangeable):
Non-modifiable Risk Factors for
Developing Dementia
- Age (More common in those 65 and older)
- Genetics
- Sex or Gender
- Ethnicity
Modifiable Risk Factors for
Developing Dementia
- Traumatic brain injuries
- High Blood pressure & cholesterol
- Obesity
- Physical inactivity
- Smoking, illicit drug use & excessive alcohol consumption
- Depression
- Social isolation
Maintain a Healthy Lifestyle
Reduce your risk of developing dementia by maintaining a healthy lifestyle through:
- Regular exercise.
- Eating a healthy balanced diet.
- Not drinking more than the safe recommended limit of alcohol.
- Don’t smoke.
- Manage chronic health problems such as high blood pressure (hypertension), diabetes and high cholesterol.
- Get enough sleep.
- Stay involved socially.
- Engage in intellectually stimulating activities such as reading, doing cross-word puzzles, sudoku or any other mind-stretching games.
Resources
We rely on ActionPrint for all our printing requirements and highly recommend their services. For more details, visit their website: ActionPrint
You are welcome to download PDFs of the following flyers, pamphlets, or booklets for personal use
Flyers (English)
- What is Dementia?
- What is Alzheimer’s disease?
- Stages of Dementia
- Compassionate Communication
- Common types of dementia
- Normal ageing vs Dementia
- Dementia and Stimulating Activities
- Living well with a dementia diagnosis
- Rights of the person with dementia
- Dementia Behaviours
- Dementia and Practical Tips for Caregivers
Pamphlets (English)
Booklets (English)
- Understanding and caring for people living with dementia. (Illustrated version)
Frequently asked questions
The early symptoms of Alzheimer’s disease and other types of dementia can vary; however, there are broad similarities shared between them all. These similarities include the most common sign of memory loss and the loss of practical abilities, both of which can lead to somebody withdrawing from work or social activities. Dementia affects each person differently. No two people will have symptoms that develop in the exact same way. Your personality, general health, and social situation are all unique factors that can determine the impact dementia is likely to have on your day-to-day life.
It is only in a few rare cases where Alzheimer’s disease runs in families. In these types of cases, there is a direct link between an inherited mutation in one gene and the onset of the disease. There are rare familial forms of dementia caused by genetic mutations such as familial Alzheimer’s disease, frontotemporal dementia, and familial vascular dementia, which are more likely to occur in people under the age of 65.
For families where this is the case, family members, such as brothers, sisters, and children, have a one in two chance of developing Alzheimer’s disease.
At the moment, there is no cure for Alzheimer’s disease or dementia.
Researchers are still in the stages of developing drugs that can slow down the progression of the disease. However, they still do not know how to prevent different types of dementia from occurring or how to reverse its effects. With more research invested into the causes of dementia, it is hoped that more effective treatments may become possible over time. One of the best ways you can reduce your risk of developing Alzheimer’s disease or dementia is by engaging in healthy behaviours, both mentally and physically. An important mantra to remember is this: what is good for your heart is good for your brain.
While there are no drugs that can cure Alzheimer’s disease, there are a number of drug treatments which can help treat symptoms and slow progression of the condition. The main class of such compounds is the cholinesterase inhibitors.
Sometimes people may opt to use drugs which control some of the symptoms of Alzheimer’s disease, such as sleeplessness or agitation. However, it is recommended that the use of drugs such as sleeping pills or tranquilisers, be kept to a minimum as they may lead to increased confusion. Non-drug treatments, including practical and emotional support, are equally important and effective. We recommend that all people living with dementia, as well as carers and loved ones, seek out support.
It is important to know that you are not alone. Many people and organisations, both professional and voluntary, can help.
One of the best ways you can find help for yourself or a loved one is by reaching out to the Association for Dementia and Alzheimer’s of South Africa NPC (ADASA). We can put you in touch with regional tailored resources that are relevant to where you live. If you’re a carer, they can also assist in connecting you with other carers who will understand your worries and be able to help you.
ADASA offers a national telephone helpline, as well as branches throughout the country. These local groups will know about services in your area.