Treatment of dementia

What is dementia: in simple terms about the complex

Dementia is not one disease but a syndrome in which cognitive functions deteriorate: memory, thinking, speech, and the ability to orient oneself in time and space. This happens due to the death of neurons in specific areas of the brain.

Imagine a library. The books on the shelves are memories and skills. In dementia, books begin to disappear, not randomly, but from specific shelves. First, recent events are lost (what was for breakfast), while old memories (wedding, birth of children) last longer. Gradually, the librarian — the very ability to think — ceases to navigate even the remaining books.

The main thing to understand: dementia is not normal aging. Forgetting where you put your glasses is normal. Forgetting what glasses are for is a reason for concern.

Early signs: when forgetfulness becomes a disease

The line between age-related absent-mindedness and the onset of dementia is thin. Here are the signals that require a neurologist's consultation:

• Short-term memory impairment. A person repeatedly asks the same question, forgets important meetings and events, but remembers in detail what happened 20 years ago.
• Difficulty with planning. Simple tasks like cooking soup or paying bills become an insurmountable problem.
• Disorientation. A person gets lost in familiar places, confuses the time of day, does not remember what day it is.
• Speech problems. Names of everyday objects are forgotten, pauses appear in conversation, words are replaced with "that thing" and "you know what I mean."
• Mood swings. Irritability, suspiciousness, apathy, or aggression appear without an obvious reason.
• Loss of interest. Hobbies, socializing, news — everything that used to engage them no longer interests them.

🩺 Important: If you notice at least 2–3 signs from this list in a loved one — do not dismiss it as age. Make an appointment with a neurologist. Early diagnosis is a chance to slow the progression of the disease for years.

Types of dementia: why this matters

The type of dementia determines treatment strategy and prognosis.

• Alzheimer's disease — 60–70% of all cases. Begins with impaired memory for recent events. Gradually, problems with speech, orientation, and face recognition develop. Progresses slowly but steadily.
• Vascular dementia — the result of micro-strokes and chronic cerebrovascular insufficiency. Begins not with memory loss but with slowed thinking, difficulty concentrating, and unsteady gait. Progresses in "steps": decline — stabilization — new decline.
• Frontotemporal dementia (Pick's disease) — affects the frontal lobes responsible for behavior. The first signs are not memory problems but personality changes: disinhibition, apathy, violation of social norms, overeating. Often begins before age 60.
• Dementia with Lewy bodies — combines cognitive impairment with motor symptoms (like Parkinson's disease) and visual hallucinations at early stages.

Why early diagnosis makes all the difference

Dementia cannot be completely cured, but its progression can be slowed. And the earlier treatment begins, the longer a person maintains independence.

Diagnosis at the Neuro Clinic includes:

• Neurological examination. Assessment of reflexes, coordination, speech.
• Neuropsychological testing. Special scales (MMSE, MoCA) assess memory, attention, and thinking.
• Brain MRI. Shows atrophy of specific areas, vascular changes.
• Blood tests. Rule out vitamin B12 deficiency, thyroid dysfunction — reversible causes of cognitive impairment that can masquerade as dementia.

🩺 Advice: Do not delay diagnosis out of fear of hearing the diagnosis. Ignorance does not protect — it steals time that could be used for treatment.

Treatment: what actually works

Modern medicine cannot completely stop the death of neurons. But it can slow the process, correct behavioral disorders, and improve the quality of life for the patient and their family.

Medication therapy:

• Acetylcholinesterase inhibitors (donepezil, rivastigmine) — slow the breakdown of the neurotransmitter acetylcholine, improving signal transmission between neurons. Effective in early-stage Alzheimer's.
• Memantine — protects neurons from excess glutamate, which destroys cells in dementia. Used in moderate and severe stages.
• Behavioral medications — antidepressants, antipsychotics (strictly as prescribed by a doctor!) reduce anxiety, aggression, and delusions.

Non-drug methods:

• Apparatus procedures: micropolarization, bioacoustic correction (BAC), translingual neurostimulation (TLNS).
• Cognitive training — exercises to maintain memory and thinking.
• Physical activity — improves cerebral blood flow and reduces the risk of progression.
• Social engagement — communication, music, art therapy slow cognitive decline.

Rehabilitation and care: your route at the Neuro Clinic

Dementia is a diagnosis that affects the entire family. At the Neuro Clinic, we work according to a multidisciplinary support model: we care for both the patient and their loved ones.

Your route at the Neuro Clinic:

• Diagnostic stage: a neurologist and clinical psychologist conduct an examination, testing, and order MRI and blood tests. An accurate diagnosis is made and the stage is determined.
• Medication stage: therapy selection: basic drugs to slow dementia, correction of behavioral disorders. The treatment room allows for a course of infusions and injections on site.
• Apparatus treatment: highly effective methods: bioacoustic brain correction, micropolarization, translingual neurostimulation. Aimed at activating neuroplasticity and improving cognitive functions.
• Cognitive rehabilitation: individual sessions with a clinical psychologist: training memory, attention, and thinking using special protocols.
• Motor rehabilitation: physical therapy to maintain coordination and balance, fall prevention.
• Family support: teaching relatives communication rules, daily organization, and burnout prevention. Psychological consultations for caregivers.
• Supportive stage: day hospital, regular check-ups, therapy adjustment. Complication prevention.

How to communicate with a person with dementia: rules for relatives

Caring for a loved one with dementia is a marathon that requires strength and knowledge. Here are key rules that preserve relationships and the mental health of both sides.

• Don't argue. If a person insists they need to go to work (and they have been retired for 20 years), don't prove otherwise. Redirect attention: "Tell me about your work, I'm interested."
• Don't correct. If your grandmother calls you by the name of her deceased sister — accept it. She hasn't "forgotten you," she is living in a different time layer. Corrections cause resentment and aggression.
• Separate the person from the disease. Aggression, suspiciousness, illogical actions are not "a spoiled character" — they are symptoms. Be angry at the disease, not at your loved one.
• Simplify. Instead of "What would you like for dinner: fish with vegetables or chicken with buckwheat?" ask: "Would you like chicken?" Offer a choice between two options, not an open-ended question.
• Take care of yourself. Caregiver burnout is a real threat. If you are exhausted, you cannot help your loved one. Seek support from a psychologist, share responsibilities with relatives, use day hospital for respite.

A practicing physician's opinion

Elena Konstantinovna Ivanova, psychiatrist at the Neuro Clinic Medical Center:

"Dementia is a diagnosis that scares more than oncology. But fear subsides when understanding and a plan of action emerge. Over years of practice, I have formulated a formula: early diagnosis + properly selected therapy + educated family = years of dignified life.

The biggest mistake is hiding from the problem. Patients who started treatment at an early stage remain independent for 2–4 years longer. These are years they spend with loved ones, not in isolation. At the Neuro Clinic, we care for the patient and their family together. Because dementia is a disease that cannot be treated alone."

Questions for the doctor: honest answers to what scares you most

• Is dementia hereditary? Most cases are not. Only rare familial forms (less than 5%) have a clear genetic nature. But there is a hereditary predisposition: if a parent had dementia, the risk is somewhat higher, but it is not a death sentence.
• Can dementia be prevented? The risk cannot be completely eliminated, but it can be reduced. Blood pressure and blood sugar control, physical activity, mental exercise, social engagement, and depression treatment are proven preventive factors.
• Is a person with dementia dangerous to others? Aggression in dementia is a reaction to fear and confusion, not malicious intent. It is corrected by proper communication and, if necessary, medication. A person with dementia is more often vulnerable than dangerous.
• Should I place my loved one in a nursing home? This is a personal decision for each family, and there is no "right" answer. The main thing is that caregivers do not destroy their own health. Day hospital, a caregiver, support groups — there are intermediate options between full-time care and institutionalization.

Dementia care at the Neuro Clinic

If you have noticed alarming signs in a loved one: forgetfulness that interferes with daily life, personality changes, loss of interest in life — do not delay a visit to the doctor. At our multidisciplinary rehabilitation center, you will receive a full cycle: from a neurologist's examination and neuropsychological testing to therapy selection, apparatus treatment, cognitive rehabilitation, and family support.

We have our own treatment room and day hospital — the patient comes on an individual schedule and returns home the same day. You can make an appointment by phone, through the website, or by leaving a request.

"Dear readers! Dementia changes not only the person but the entire family. But that is no reason to give up. With the right support, you can walk this path while preserving love, respect, and dignity. At the Neuro Clinic, we help families cope. Do not stay alone with this problem. Come — we know how to help." — Marina Sergeevna Krol, neurologist and rehabilitation specialist, chief physician of the Neuro Clinic Medical Center.

CONTRAINDICATIONS EXIST. SPECIALIST CONSULTATION REQUIRED.