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Understanding How Dementia Causes Death

February 27, 2023
Scott A. Small, MD

Scott A. Small, MD

Signs of dementia can spark anxiety and fear in anyone who is aging and experiencing cognitive decline. These concerns often ripple into the psyche of family members, friends and loved ones, too.

Part of the challenge is the many unknowns and uncertainties that accompany dementia, which is not a sole diagnosable disease. Rather, this syndrome — involving a gradual decline in thinking, memory or other cognitive abilities — typically stems from various terminal neurodegenerative diseases.

The most common culprit, Alzheimer’s disease, is now linked to dementia in roughly 1 in 9 Americans age 65 and older, according to a 2022 report from the Alzheimer’s Association. More broadly, at least 55 million people worldwide are living with some form of dementia, per World Health Organization stats.

Many often wonder if there is a cure for dementia, how it causes death and what the options are for dementia care and prevention.

Is There a Cure for Dementia?

Though there is no cure for dementia, most people live for many years or even multiple decades as the syndrome progresses gradually on a case-by-case basis. It typically involves three stages — early, middle and late — before death, either caused by the root neurodegenerative disease or related complications.

Today, researchers are still unraveling the core causes, which is not only advancing care and support but also helping patients and families know what to expect in the process of dementia.

How Does Dementia Cause Death?

The common theme in neurodegenerative cases — including Alzheimer’s, frontotemporal dementia or Lewy body dementia — is that these diseases originate in a particular region of the brain. They kill cells, then slowly spread to neighboring regions.

Alzheimer’s, for example, starts in the hippocampus, commonly associated with memory. More specifically, it destroys neurons and their connections in the entorhinal cortex subregion of the hippocampus. With time, that damaging activity expands to more memory stores nearby and the frontal cortex, where it starts affecting personality and decision-making. 

Final Stages of Dementia

In the final stages of dementia, the neurodegenerative disease dives into the deepest parts of the brain. This can inhibit basic bodily functions, such as heart rate and breathing.

Historically, associated complication like respiratory or urinary tract infections and falls have been the cause of death as dementia progresses. But improvements in care for patients are creating more incidents where the death of brain cells is essentially fatal, according to Scott Small, director of the Alzheimer’s Disease Research Center at Columbia University.

“What matters most is the dying of cells,” Small says. [read more]

Source: Discover Magazine