What is Dementia?

Dementia is a term describing a number of conditions characterised by progressive deterioration in mental functions including memory, judgement, communication skills and behavioural changes serious enough to interfere with daily life. Although dementia becomes increasingly more prevalent in the senior adult population, early onset dementia may occur and is frequently misdiagnosed

Dementia is a syndrome due to illness of the brain, usually of a chronic or progressive nature, in which there is disturbance of multiple higher cortical functions, including memory, thinking, orientation, comprehension, calculation, learning capacity, language and judgement. These symptoms of cognitive function are mostly the result of structural and chemical changes that occur in the brain leading to considerable cell death. It is a progressive illness with patients becoming more in need of help and support in performing everyday activities. Individuals with dementia may also develop behavioural and psychological symptoms including disinhibited behaviour, delusions and hallucinations, verbal and physical aggression, agitation, anxiety and depression. Although different individuals experience dementia differently, understanding how the disease progresses is crucial in planning and providing the right amount of care as well as helping caregivers and patients to foresee the changes that will occur with time.

There are various types of dementia with Alzheimer’s disease (AD) accounting to approximately 70 per cent of all dementia cases. Other common forms of dementia include vascular dementia, Lewy-body dementia, frontotemporal dementia and dementia secondary to disease including other neurodegenerative conditions such as Parkinson’s disease, Huntington’s disease and amyotrophic lateral sclerosis. It is not uncommon that various types of dementia co-exist (mixed dementia), especially in the late stages of the condition. According to the World Health Organisation’s (WHO) Global Burden of Disease Report, dementia contributes to 11.2 per cent of years lived with disability in people aged 60 years and over. This is due to the fact that dementia has a disproportionate impact on independent living in the older adult population.

National Dementia Strategy

It is estimated that in the Maltese Islands, 6,071 individuals had dementia in 2015, a figure equivalent to approximately 1.5 per cent of the general population. As the population ages, the number of individuals with dementia will increase significantly such that by the year 2030, it is projected that 9,883 individuals will be affected. It is well recognised that dementia presents a psychological and financial challenge both to those with the condition as well as their caregivers and family members.

This strategy aims to implement a number of measures in the various areas of dementia management and care with the overarching aim of enhancing the quality of life for individuals with dementia, their caregivers and family members.

One fundamental aspect of this strategy is that of increasing awareness and understanding of dementia among the general public and healthcare professionals in order to reduce stigma and misconceptions about the condition.

A holistic approach in service provision for individuals with dementia, their caregivers and family members will be adopted. Apart from providing all pharmacotherapeutic options to Alzheimer’s disease patients, individuals receiving a diagnosis of dementia will have care plans developed by a multidisciplinary team specialised in dementia management and care.