Between Statistics and Real Life: A Conversation About Dementia

In my everyday clinical practice, I increasingly meet people who complain about memory and concentration problems. This does not always mean dementia. Sometimes the cause is depression - a mental condition that can mimic dementia without being true dementia. In other cases, people live under such intense stress that it is entirely normal for the brain not to function at the level they are used to. I also cannot rule out that I myself have become more sensitive to this topic, as I think more and more about the causes and consequences of this disease. Still, the facts are clear: dementia is being diagnosed more frequently. This is partly due to an aging population, but also because our diagnostic tools have improved significantly.

There are several conversations that have stayed with me in particular.

Recently, I mentioned to a friend of mine results from large scientific studies showing that insufficient sleep is associated with an increased risk of developing dementia. The risk rises especially when people regularly sleep less than six to seven hours per night. Interestingly, very long sleep duration has also been statistically linked to a higher dementia risk. In addition, lack of sleep is associated with increased overall mortality - likely because it affects many processes in the body at the same time. My friend was deeply impressed. She told me that dementia scares her more than anything else and that she would like to avoid it at all costs.

In another conversation - this time with a close friend and former colleague - we discussed how to talk to patients about dementia. He drew my attention to an important publication that highlights something encouraging: a substantial proportion of dementia risk depends on factors that we can influence ourselves. Seeing this summarized in one place often creates a real “aha moment” and can fundamentally change how people view their everyday habits.

I also recall a meeting with patients affected by rare neurological diseases and their families. We talked about symptoms of neurological diseases that are often overlooked, such as memory problems, depression, and severe fatigue. I emphasized that one of the most effective strategies is prevention: regular physical activity, healthy nutrition, sufficient sleep, and maintaining social connections. These are exactly the same factors that generally reduce the risk of developing dementia. At that point, a colleague from the audience asked me directly: “And how many of these things do you follow yourself?” To be honest, I did not like my own answer. There is a saying that doctors are often the most difficult patients - and there is a lot of truth in it.

That is why this question is not purely medical. Regardless of your profession or how busy your daily life is: when was the last time you reflected on the long-term “cost” of the way you live? When was the last time you slept seven hours per night?

It is also important to share some good news. The conversation about dementia does not have to be gloomy. Medicine is advancing at an impressive pace. Today, we can detect early changes related to one of the forms of dementia - Alzheimer’s disease - using advanced imaging and specialized tests. In the near future, this may even be possible through simple blood tests. In recent years, new medications have become available that can slow disease progression in early stages. They are not miracle cures and come with limitations and risks. The treatment is complex, expensive, and not suitable for everyone. The benefits are still being actively debated. Yet one thing is undeniable: for the first time, we can genuinely slow the course of the disease. Just one or two decades ago, this would have seemed unthinkable. And progress continues. More convenient treatment options that could significantly ease the burden for patients and families may soon become available.

Still, despite all scientific advances, one thing remains unchanged: prevention is the best treatment. So the question is simple, but crucial: when was the last time you slept long enough - and truly restfully?