Actions to be taken for improving functional prognosis in dementia

Abstract

The growing incidence of dementia has led to an increased need for specialized care and higher health and social costs. Functional decline is the main cause of dementia complications. Per definition, dementia diagnosis and severity stratification require a certain degree of functional impairment [1]. Therefore, it is important to determine strategies to prevent functional deterioration in both, general population and especially people with dementia.

The number of older adults with some degree of disability will triple by 2050 due to the increase in the aging population and the prevalence of age-related diseases that lead to functional impairment [2]. Therefore, functional impairment and disability in old people are increasingly becoming a major public health concern. Furthermore, functional impairment severely impairs quality of life and consumes a large proportion of the public health resources, creating an important burden for health care systems.

It is well known that functional loss and disability in dementia are the main consequences of cognitive decline. Therefore, most of the efforts in dementia management have been directed to stop or reverse cognitive decline. However, functional loss and disability are also the consequence of other conditions that are common in old age and comorbid with dementia, such as frailty, sarcopenia, malnutrition, falls, pulmonary or cardiovascular diseases, polypharmacy, depression, and neuropsychiatric symptoms (NPS) [3].