Life expectancy with dementia - treatment, what to do

Author of the article

Smirnova Olga Leonidovna

Neurologist, education: First Moscow State Medical University named after I.M. Sechenov. Work experience 20 years.

Articles written

94

How many years people live with dementia depends on different features. Every person dreams of remaining sane in old age, but statistics show that for many these desires are not fulfilled. Today, about twenty million people suffer from the disease, and their number is steadily growing every year. Dementia refers to disorders of the nervous system in which cognitive functions deteriorate and a person becomes unable to perform basic actions.

Types of dementia

Dementia before death usually refers to senile dementia. Its manifestations begin at the age of over 65 years, and all disorders occur due to the rapid death of neurons in the cerebral cortex. The patient's mental reactions slow down significantly and short-term memory suffers. In some cases, dementia, the signs of death from which are obvious, can lead to it indirectly, since pronounced disorders in the brain are already irreversible. Other types of dementia include the following.

1. Cortical. Develops in Alzheimer's disease, Pick's disease, as well as in alcoholism. The cerebral cortex is significantly affected.
2. Subcortical. The main manifestations are neurological disorders. There may be severe trembling of the limbs, muscle stiffness, and unsteadiness of gait. Develops in some somatic pathologies or after a hemorrhagic stroke. Death from this type of dementia is quite common.
3. Cortical-subcortical. Diagnosed against the background of vascular disorders. This is often the last stage of dementia before death.
4. Multifocal. It is characterized by a large number of lesions, which often leads to human death.

Important! At the first signs of pathology, the help of a psychologist or psychiatrist becomes relevant - one should not neglect this opportunity to slow down the development of dementia.

Reduced need for food

Deterioration of appetite and sensitivity are signs of imminent death

When a cancer patient is at home, all her loved ones note the signs of death. She gradually refuses food. First, the dose decreases from a plate to a quarter of a saucer, and then the swallowing reflex gradually disappears. There is a need for nutrition through a syringe or tube. In half of the cases, a system with glucose and vitamin therapy is connected.

But the effectiveness of such support is very low. The body tries to use up its own fat reserves and minimize waste. This worsens the patient’s general condition, causing drowsiness and difficulty breathing. Impaired urination and problems with natural needs. It is believed that problems with going to the toilet are also signs of approaching death.

No matter how funny it may seem, in reality there is a completely logical chain in this. If defecation is not carried out once every two days or with the regularity to which a person is accustomed, then feces accumulate in the intestines. Even stones can form. As a result, toxins are absorbed from them, which seriously poison the body and reduce its performance.

It's about the same story with urination. It's harder for the kidneys to work. They allow less and less fluid to pass through and eventually the urine comes out saturated. It contains a high concentration of acids and even blood is noted. For relief, a catheter can be installed, but this is not a panacea against the general background of unpleasant consequences for a bedridden patient.

Symptoms of the disease

The initial signs of pathology are practically not expressed. Signs of approaching death in older people with dementia will, of course, be obvious, but timely diagnosis of the onset of dementia is difficult. Relatives of older people should be alert to such signs as mood swings, indifference to what is happening, and absent-mindedness. As the disease progresses, signs such as:

• speech disorders of varying intensity;
• abstract thinking disorder;
• memory impairment – ​​short-term memory suffers more;
• lack of initiative;
• Disorientation may occur.

The main clinical symptoms depend entirely on the stage of the pathology, the degree of brain damage and the presence of concomitant diseases.

Signs of approaching death

Vascular dementia, the causes of death from which can be different, has fairly clear warning signs. Their identification should necessarily alert the patient’s relatives. All patients with dementia almost completely lose their appetite before death, which leads to severe exhaustion and a pronounced deterioration of their already serious condition. Other warning signs include:

• inability to hold your head up on your own;
• complete loss of independent ability to make swallowing movements;
• complete absence of facial movements;
• severe disturbances of consciousness - stupor or coma.

Important! These cannot be considered accurate harbingers of death, but these signs require urgent medical attention to quickly stabilize the patient’s condition.

As a rule, subcortical vascular dementia, the cause of death in which complete brain failure occurs, can last quite a long time. Patients can remain in this state for several years, provided proper care is provided. Death from dementia in older people is caused by various complications that arise due to disruption of the central nervous system.

Life expectancy of patients diagnosed with dementia, at what age to expect it

Researchers from the University of Cambridge have determined the life expectancy of patients diagnosed with senile dementia. How many years such patients live, according to scientists, largely depends on external factors, but on average it is 4.5-5 years.

By the way, statistical data confirm that dementia between the ages of 60 and 69 occurs in approximately 2% of cases, and after 80 years, up to 20% of older people are susceptible to it. By age 90, the risk of developing the disease increases to 45%.

Although it should be noted that the figures given are very approximate, since a fairly large percentage of older people do not fall under the supervision of psychiatrists, because they do not have psychotic conditions, and it all comes down to problems with memory, intelligence and minor mood swings. Such patients are found in families, it is quite convenient to care for them, and they do not create big problems for their loved ones.

Speaking about how long people with dementia live, it should be emphasized once again that very few people die from this diagnosis. These include only those who died from accidents associated with the characteristics of this disease. Mostly, death occurs from a stroke or heart attack, most often accompanying the vascular form of the disease.

Complications of dementia leading to death

It is difficult to say exactly how long the last stage of dementia lasts before death. A lot depends on how high-quality care is provided for the person. Even if the patient is completely immobilized, death can be “delayed” with proper care. When the disease occurs, all parts of the brain responsible for the normal processes of the body are severely affected. As a result, a person may develop other diseases, which ultimately lead to death. There are several main complications.

1. Thrombosis. It is associated with severely impaired blood circulation and slower blood flow. It is almost impossible to influence this process in any way. Blood clots that form in blood vessels can break off at any time.
2. Bedsores. It is very difficult to prevent their development in a bedridden patient. They are often complicated by additional pathologies - from secondary infection to sepsis. They are often the cause of death.
3. Severe pneumonia. This is a very common complication for anyone who becomes immobilized. In most cases, its development serves as an unfavorable prognostic sign. It is necessary to highlight two main causes of pneumonia - stagnation of blood in the pulmonary circulation and the entry of food particles into the respiratory tract due to impaired swallowing.

How to recognize a patient's terminal condition

Signs of death in older people with dementia can develop very quickly. The first thing that catches the eye of relatives is the absolute lack of interest in life. He does not care about his own condition, he does not complain even with severe pain. Dementia, in which the signs of imminent death are quite clear, speaks of imminent death in the following cases:

• the patient sleeps too long (anabiosis);
• lack of physiological departments;
• general hypothermia;
• dark spots on the skin;
• constriction of the pupils and their weak reaction to light.

The next stage of a person’s “fading away” is pre-agony. It is characterized by a sharp decrease in blood pressure and an increase in heart rate. The blood supply to the brain is greatly reduced, which further aggravates the situation.

The final stage is agony. It has one very interesting feature. There is a short-term activation of all parts of the brain. The person fully comes to his senses, gains the ability to make logical conclusions, and begins to speak.

The situation does not last long. Along with clarity of consciousness, blood pressure normalizes, the heart rhythm becomes correct, but muscle cramps begin. Their development clearly indicates that death will occur after some time. The last stage of dementia before death can sometimes last no more than one or two hours.

Therapy

There is currently no effective treatment; it is only possible to make a person’s life easier and slow down this process. If young people can be brought back to life with the help of doctors, then senile dementia is an irreversible process that gets worse every year.

In many cases, they begin to treat diseases that develop along with the main one. Doctors recommend building your day so that it involves a lot of physical and mental activity. In the initial and moderate stages, doctors may prescribe tranquilizers and nootropic drugs.

Does a person always die with dementia?

Dementia is not essentially a fatal disease. But it causes numerous associated disorders, which become the main cause of death. After an accurate diagnosis of dementia, how long a person will live depends almost entirely on relatives. To reduce the likelihood of death from dementia, relatives should know the basic measures to prevent the development of complications.

1. Provide intensive hygiene care. Such patients, as a rule, lose interest in caring for themselves, and relatives have to force them to shower, change clothes, and comb their hair. If a person is immobilized, he will have to be washed in bed - this must be done at least once every two to three days. This will prevent the development of various skin diseases.
2. Maintain a comfortable temperature in the room where the patient is constantly located. It is undesirable for the temperature to rise above 23 degrees. It is imperative to ventilate the room, even in winter, but drafts should be avoided. Death in dementia often occurs from secondary infections.
3. Exactly follow all instructions of the attending physician in terms of prescribed medications. Such patients are often prescribed antipsychotic drugs and medications for insomnia. Under no circumstances should you change the dosage yourself.
4. If the patient retains the ability to move independently, it is necessary to walk with him for at least 15-20 minutes every day.

In this way, a person with dementia's chances of living a long life can be greatly improved. The important point is to maintain normal brain activity. The easiest way is to solve crossword puzzles. People with dementia may find it difficult to solve difficult ones, so you need to choose easier ones. If necessary, you can suggest. It must be remembered that communication is very important for this category of patients. You cannot ignore their requests, talk as often as possible, and put them in a positive mood.

Drugs

After a comprehensive examination in a hospital, further treatment at home is possible. Patients are prescribed drugs to treat the underlying disease. The basic treatments for most forms of dementia are:

• cholinesterase inhibitors: (Galantamine, Donepizil), their action is based on the accumulation of acetylcholine in the neurons of the brain, a substance that slows down degenerative processes;
• NMDA receptor modulators: (Akatinol, Memantine), these drugs effectively reduce the production of glutamate, a substance that negatively affects brain cells and destroys them;
• antipsychotic, sedatives and antidepressants, their use is justified in case of pronounced changes in the emotional background, the appearance of aggression, anxiety, fears, mania.
• neuroprotectors (Somazin, Cerebrolysin, Cortexin), which improve the trophism of brain tissue, their nutrition and oxygen supply, are effective in vascular pathologies.

With dementia, it is important to begin adequate therapy in a timely manner; this will allow patients to maintain independent skills in everyday life and mental functions longer, and in some forms, restore many lost abilities.

How many years patients receiving treatment live with this diagnosis depends on the form and severity of the disease.

In mild forms, with normal functioning of the cardiovascular system, for many years.

In severe cases, with loss of motor activity, patients die from concomitant complications (sepsis, cardiac, pulmonary or renal failure).