# What is Dementia / Mate Wareware? ## Alzheimer's New Zealand **Source:** [https://alzheimers.org.nz/about-dementia/what-is-dementia/](https://alzheimers.org.nz/about-dementia/what-is-dementia/) **Capture Date:** 2026-06-07 --- ## Overview Dementia (mate wareware) is not a single disease but an umbrella term for a group of symptoms caused by progressive diseases that damage the brain. It is a chronic, progressive condition that affects memory, thinking, behaviour, personality, and the ability to perform everyday tasks. > "Mate wareware is the te reo Māori term for dementia. Mate means 'disease' or 'illness', and wareware means 'to forget' or 'to be forgotten'." --- ## Key Definition - **Dementia / mate wareware** is a progressive brain condition that causes a decline in cognitive function beyond what is expected from normal ageing. - It affects a person's ability to think, remember, reason, and manage daily life. - It is not a normal part of ageing — while age is the biggest risk factor, dementia is caused by specific diseases that damage the brain. --- ## Most Common Forms of Dementia ### 1. Alzheimer's Disease (50–70% of cases) - The most common form of dementia. - Characterised by the build-up of **amyloid plaques** and **tau tangles** in the brain. - Symptoms typically begin with short-term memory loss and gradually progress to affect all cognitive functions. - On average, people live 7–10 years after diagnosis, though this varies widely. ### 2. Vascular Dementia (15–25% of cases) - Caused by reduced blood flow to the brain, often following a stroke or from chronic small vessel disease. - Symptoms may have a sudden onset (post-stroke) or stepwise progression. - Risk factors include high blood pressure, diabetes, smoking, and high cholesterol. - Memory may be less affected than speed of thinking and problem-solving. ### 3. Lewy Body Dementia (10–15% of cases) - Caused by abnormal protein deposits (Lewy bodies) in brain cells. - Characterised by **fluctuating cognition**, **visual hallucinations**, and **Parkinsonism** (rigidity, slow movement, tremor). - People may have extreme changes in alertness and attention from day to day. ### 4. Frontotemporal Dementia (FTD) (5–10% of cases) - Typically affects people at a younger age (often 45–65). - Caused by progressive damage to the frontal and temporal lobes of the brain. - Early symptoms are often **personality and behaviour changes** (disinhibition, apathy, loss of empathy) or **language difficulties** (problems finding words, speaking fluently). - Memory may be relatively preserved in early stages. ### 5. Mixed Dementia - Very common in older adults — a combination of Alzheimer's disease and vascular dementia (or other types). - Symptoms reflect the combination of underlying pathologies. --- ## Progressive Nature Dementia is **always progressive**, meaning symptoms worsen over time. However, the rate of progression varies greatly between individuals and types of dementia. ### Typical Progression #### Early Stage (Mild) - Forgetfulness, especially recent events and new information - Difficulty finding the right words - Getting lost in familiar places - Mood changes — anxiety, irritability, depression - Loss of interest in hobbies or social activities - Still able to live independently with minimal support #### Middle Stage (Moderate) - Increasing memory loss — may not recognise familiar people - Communication difficulties — trouble understanding or being understood - Need help with daily activities (dressing, bathing, toileting) - Behaviour changes — restlessness, wandering, repetitive questioning, agitation - Sleep disturbances (sundowning — increased confusion in late afternoon/evening) - May need constant supervision for safety #### Late Stage (Advanced / Severe) - Severe memory loss — cannot recognise self or close family - Limited speech — may use only single words or sounds - Complete dependence for all personal care - Difficulty eating and swallowing (risk of aspiration and weight loss) - Incontinence - Bed-bound or chair-bound - Increased vulnerability to infections (especially pneumonia and urinary tract infections) --- ## Common Symptoms ### Cognitive Symptoms - **Memory loss:** Especially short-term / recent memory. May forget conversations, appointments, where items were placed. - **Difficulty with language:** Trouble finding the right word (aphasia), understanding conversation, following instructions. - **Disorientation:** Losing track of time, date, or place; getting lost even in familiar settings. - **Impaired judgement:** Poor decision-making around safety, finances, or personal care. - **Problems with planning and problem-solving:** Difficulty following recipes, managing money, or organising activities. - **Loss of concentration:** Easily distracted, difficulty following a conversation or TV programme. ### Behavioural and Psychological Symptoms (BPSD) - **Agitation and aggression:** Verbal or physical outbursts, often driven by confusion or frustration. - **Anxiety and fear:** Common in early and middle stages; may be triggered by unfamiliar situations. - **Depression:** Very common, especially in early stages when awareness of decline is present. - **Apathy:** Loss of interest, motivation, and initiative. - **Repetitive behaviour:** Repeated questions, actions, or movements. - **Restlessness and wandering:** Especially in middle stages. - **Sleep disturbances:** Difficulty falling asleep, frequent waking, "sundowning". - **Hallucinations and delusions:** More common in Lewy body dementia but can occur in other types. - **Disinhibition:** Inappropriate social behaviour, loss of social filters (common in frontotemporal dementia). ### Changes in Personality and Emotions - **Personality changes:** A once outgoing person may become withdrawn; a calm person may become irritable. - **Loss of empathy:** Difficulty understanding others' feelings or perspectives. - **Emotional lability:** Rapid mood swings, laughing or crying inappropriately. --- ## Prevalence in New Zealand - Over **70,000 people** are estimated to be living with dementia in New Zealand (as of 2024–2026 estimates). - This number is projected to more than triple by **2050** (to over 170,000), driven by the ageing population. - Dementia is the **third leading cause of death** in New Zealand. - Māori and Pasifika peoples are at higher risk due to higher rates of cardiovascular risk factors and are likely to experience onset at younger ages. - Dementia affects people of all ethnicities, income levels, and backgrounds. ### Risk Factors | Risk Factor | Type | | ------------------------------------------------------------------------- | --------------------------- | | Age (the strongest risk factor) | Non-modifiable | | Genetics (e.g., APOE ε4 gene) | Non-modifiable | | Family history | Non-modifiable | | Cardiovascular health (hypertension, diabetes, high cholesterol, smoking) | Modifiable | | Physical inactivity | Modifiable | | Hearing loss | Modifiable (with treatment) | | Social isolation and depression | Modifiable | | Traumatic brain injury | Partially modifiable | | Excessive alcohol consumption | Modifiable | --- ## Key Messages - Dementia is **not a normal part of ageing** — it is caused by brain diseases. - Early diagnosis allows for better planning, access to treatments and support, and participation in decisions about care. - A healthy lifestyle (balanced diet, regular exercise, not smoking, managing health conditions) can reduce the risk of dementia. - People with dementia can and do live well with the right support — especially in early stages. - Support is available through Alzheimer's NZ, Dementia NZ, Health NZ, and local community services. --- ## When to See a Doctor If you or someone you know is experiencing memory problems or other cognitive changes that are affecting daily life, see a GP. Many conditions that mimic dementia are treatable (e.g., thyroid problems, vitamin deficiencies, depression, medication side effects). --- ## Summary of Key Facts | Topic | Detail | | ----------------------- | ------------------------------------------------------------------------------------------ | | **Definition** | Umbrella term for progressive brain diseases causing cognitive decline | | **Most common form** | Alzheimer's disease (50–70% of cases) | | **Other forms** | Vascular dementia, Lewy body dementia, frontotemporal dementia, mixed dementia | | **Key feature** | Progressive — symptoms worsen over time (early → middle → late stages) | | **Common symptoms** | Memory loss, language difficulties, disorientation, behaviour changes, personality changes | | **Prevalence in NZ** | 70,000+ (projected to triple by 2050) | | **Biggest risk factor** | Age (not a normal part of ageing itself) | | **Prognosis** | Variable, average 7–10 years from diagnosis (Alzheimer's) |