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Posted: January 12th, 2024

A Critique of the Literature on Dementia’s Effects and Prognosis

A Critique of the Literature on Dementia’s Effects and Prognosis

Dementia is a term that describes a group of symptoms affecting memory, thinking and social abilities. It is not a specific disease, but rather a result of various causes that damage or destroy brain cells and their connections. Dementia affects people differently depending on the type, cause and stage of the condition. Some of the most common types of dementia are Alzheimer’s disease, vascular dementia, Lewy body dementia, frontotemporal dementia and mixed dementia. Dementia is a life-limiting condition that has no cure, but some treatments and interventions may help to slow down its progression or improve the quality of life of people living with it.

This paper aims to provide a critical review of the literature on the effects and prognosis of dementia, focusing on the following aspects:

– The cognitive, psychological and behavioral changes that occur in people with dementia and how they impact their daily functioning and relationships.
– The factors that influence the life expectancy and survival rate of people with dementia, such as the type and stage of dementia, coexisting medical conditions, age, sex, ethnicity and lifestyle.
– The challenges and opportunities for providing end-of-life care for people with dementia, such as communication, symptom management, decision making, ethical issues and bereavement support.

Cognitive, Psychological and Behavioral Changes

One of the most noticeable effects of dementia is the decline in cognitive abilities, such as memory, language, attention, reasoning, problem-solving and executive functions. These impairments interfere with the person’s ability to perform everyday tasks, such as managing finances, driving, cooking or taking medications. Cognitive decline also affects the person’s orientation to time, place and person, leading to confusion and disorientation. As dementia progresses, the person may lose their ability to recognize familiar faces, objects or words, or to communicate their needs and preferences.

Dementia also causes psychological and behavioral changes that can be challenging for both the person with dementia and their caregivers. Some of these changes include:

– Personality changes: The person may become more apathetic, withdrawn, irritable, aggressive or disinhibited. They may also show mood swings or emotional lability.
– Depression: The person may experience persistent sadness, loss of interest or pleasure in activities, low self-esteem or suicidal thoughts.
– Anxiety: The person may feel nervous, restless or fearful. They may also develop phobias or obsessive-compulsive behaviors.
– Agitation: The person may become restless, agitated or distressed. They may also exhibit repetitive behaviors, such as pacing or wandering.
– Psychosis: The person may have delusions (false beliefs) or hallucinations (false perceptions) that are not based on reality. They may also become paranoid or suspicious of others.
– Sleep problems: The person may have difficulty falling asleep or staying asleep. They may also have changes in their sleep-wake cycle or experience sundowning (increased confusion or agitation in the evening).

These psychological and behavioral changes can have a negative impact on the person’s quality of life and well-being. They can also increase the risk of falls, injuries, infections or malnutrition. Moreover, they can cause stress, burden and emotional distress for the caregivers who have to cope with these challenges on a daily basis.

Factors Influencing Life Expectancy and Survival Rate

Dementia is a progressive condition that worsens over time. However, it is difficult to predict how long someone with dementia will live for. This depends on many factors that vary from person to person. Some of these factors are:

– Type and stage of dementia: Different types of dementia have different rates of progression and survival outcomes. For example, Alzheimer’s disease is usually slower than vascular dementia or frontotemporal dementia. The stage of dementia also affects the prognosis. People with mild cognitive impairment (MCI) have a better prognosis than people with moderate or severe dementia.
– Coexisting medical conditions: People with dementia often have other chronic or acute medical conditions that can affect their health and survival. Some of these conditions include cardiovascular disease, diabetes mellitus, stroke


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