The Science of Dementia: Insights into Pathophysiology and Patient Care

Dementia is a clinical diagnosis requiring new functional dependence based on progressive cognitive decline. It is estimated that 1.3% of the entire UK population, or 7.1% of those aged 65 or over, have dementia. Applying these to 2013 population estimates gives an estimated number of 19,765 people living with dementia in Northern Ireland. The clinical syndrome of dementia can be due to a variety of underlying pathophysiological processes. The most common of these is Alzheimer's disease (50 75%) followed by vascular dementia (20%), dementia with Lewy bodies (5%), and front temporal lobar dementia (5%). The clinical symptoms and pathophysiological processes of these diseases overlap significantly. Biomarkers to aid diagnosis and prognosis are emerging. Acetylcholinesterase inhibitors and meantime are the only medications currently licensed for the treatment of dementia. The nature of symptoms means people with dementia are more dependent and vulnerable, both socially and in terms of physical and mental health, presenting evolving challenges to society and to our healthcare systems.