Memory Loss & Other Symptoms Of Alzheimers
Trouble with memoryâspecifically difficulty recalling information that has recently been learnedâis often the first symptom of Alzheimerâs disease.
As we grow older, our brains change, and we may have occasional problems remembering certain details. However, Alzheimerâs disease and other dementias cause memory loss and other symptoms serious enough to interfere with life on day-to-day basis. These symptoms are not a natural part of getting older.
Alzheimer’s is not the only cause of memory loss. Many people have trouble with memory â this does NOT mean they have Alzheimer’s. There are many different causes of memory loss. If you or a loved one is experiencing symptoms of dementia, it is best to visit a doctor so the cause can be determined.
In addition to memory loss, symptoms of Alzheimerâs include:
- Trouble completing tasks that were once easy.
- Difficulty solving problems.
- Changes in mood or personality withdrawing from friends and family.
- Problems with communication, either written or spoken.
- Confusion about places, people and events.
- Visual changes, such trouble understanding images.
Family and friends may notice the symptoms of Alzheimerâs and other progressive dementias before the person experiencing these changes. If you or someone you know is experiencing possible symptoms of dementia, it is important to seek a medical evaluation to find the cause.
Rising Care Needs Of People With Dementia
It is estimated that there are more than 570,000 people with dementia in England, and over the next 30 years that is expected to more than double to 1.4 million .
Dementia is becoming a critically important issue, in terms of both the high personal and social costs related to the disease, and the wider impact on other parts of the health and care system.
Demographic change will drive significant growth in the number of people with dementia, even though the percentage of older people developing some types of dementia may decline as a result of reductions in hypertension and other risk factors .
Research suggests that approximately one in four patients in acute hospitals have dementia and that these needs are not currently well responded to .
Staff in acute settings and care homes may need extra training in caring for people with dementia and delirium.
The cost of dementia will rise by 61 per cent to £24 billion by 2026 , with most of this cost being met by social care and by individuals and families rather than the NHS . Development of effective preventive interventions could save significant sums of money.
Diagnosis Of Young Onset Dementia
- On average, a person may see between two and five different consultants before a diagnosis is made
- The average time to diagnosis is 4.4 years in younger people compared to 2.2 years for people aged over 65
- In England in August 2018, the estimated dementia diagnosis rate for under 65s was 41%, compared to 68% for people aged over 65
- Awareness amongst GPs is still relatively low and when people are younger, symptoms are often attributed to stress, anxiety, depression or menopause
- People who are under 65 are more likely to be diagnosed with a genetically inherited form of dementia or a rarer dementia that can be difficult to recognise
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Common Types Of Dementia In Younger People
There are differences in the types of dementia commonly diagnosed in younger people with dementia compared to those of an older age.
- Alzheimers disease is the most common form of dementia in younger people, accounting for around a third of younger people with dementia, in comparison to about 60% in the older age group
- Vascular dementia is the second most common form of dementia in young people. Around 20% of younger people with dementia have vascular dementia
- Around 12% of younger people with dementia have frontotemporal dementia, compared with just 2% in older people. It most commonly occurs between the ages of 45-65. In about 40% of cases there is a family history of the condition
- Korsakoffs syndrome around 10% of dementias in younger people are caused by a lack of vitamin B1 , most commonly associated with alcohol abuse
Deaths Where Dementia And Alzheimers Disease Was A Contributory Factor
The following analysis will focus on deaths where dementia and Alzheimer’s disease was not the underlying cause of death but was mentioned on the death certificate as a contributory factor.
This has been carried out in line with the leading causes of death groupings, based on a list developed by the World Health Organization . This categorises causes of death using the International Classification of Diseases, 10th edition into groups that are epidemiologically more meaningful than single ICD-10 codes, for the purpose of comparing the most common causes of death in the population.
As mentioned previously, the number of deaths registered due to dementia and Alzheimer’s disease in England and Wales in 2019 was 66,424. However, when we consider the number of deaths involving dementia and Alzheimer’s disease , this number increases to 93,568 deaths registered .
Of the deaths where dementia and Alzheimer’s disease was mentioned on the death certificate but not as the underlying cause, the most common underlying cause for males was cerebrovascular diseases and Parkinson’s disease , and the most common underlying cause for females was cerebrovascular disease . Table 2a and 2b show what other causes were most common as underlying causes of death where dementia and Alzheimer’s disease was mentioned on the death certificate.
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Disproportionate Impact On Women
Globally, dementia has a disproportionate impact on women. Sixty-five percent of total deaths due to dementia are women, and disability-adjusted life years due to dementia are roughly 60% higher in women than in men. Additionally, women provide the majority of informal care for people living with dementia, accounting for 70% of carer hours.
Statistics About Older People In The Uk
Health does decline as people age, but many older people remain healthy and active long into their older age.
- At age 65, men in England can expect to live on average another 8.9 years in good health, and women another 9.8 years in good health just under half of their expected remaining life span. These figures have decreased over the past few years.
- Around 4 million older people have a limiting long-term illness or disability, and it is estimated that this will rise to over 6 million older people by 2030.
- Around 850,000 people are living with dementia in the UK, and Alzheimer’s UK predicts that this figure will rise to 1 million people by 2025. Of these, around a third are currently living in residential care settings.
- Loneliness and low mental wellbeing is a problem for many older people:
- 24% of people aged over 60 stated they felt lonely sometimes or often this equates to just over 3 million people in the UK population .
- A survey carried out for Age UK in 2017 revealed that nearly half of adults aged 55+ said they had experienced depression and around the same number have suffered with anxiety.
- Nearly three-quarters of older people think that having more opportunities to connect with other people would be the best way to help people who are experiencing mental health problems . MHA Communities services offer opportunities such as this.
Age UK regularly updates a factsheet with considerable detail about later life in the UK.
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Things You Need To Know About The Diseases That Cause Dementia
1. Dementia is not a disease in itself Dementia is a word used to describe a group of symptoms that occur when brain cells stop working properly. It is caused by diseases. 2. Alzheimers is the most common disease that causes dementia It alone accounts for around two thirds of all dementia cases. Symptoms of
Frontline Health And Care Professionals
Health and care professionals should provide support and advice on dementia risk reduction as part of their daily contact with individuals. Every contact counts as a chance to educate and empower people to make positive choices about their own health.
Health and care professionals can support the implementation of NHS Englands Well Pathway for Dementia and have an impact on an individual level by:
Advising people that their risk of developing dementia can be reduced by looking after their health, communicating that whats good for the heart is good for the brain.
Knowing where to direct people for timely diagnosis, health and care services, and to personalised support and adaptations that will help them remain independent. If appropriate, checking if a person is suffering from delirium or dementia.
- promoting health messages to support the physical, mental and oral health of people living with dementia and their carers
- supporting people living with dementia to choose from a range of activities tailored to their preferences to promote wellbeing
- considering the language you are using when talking about dementia
Offer the opportunity to complete advance care plans for people with dementia while they have the capacity for these discussions, so that people living with dementia are able to die with dignity in their place of choosing.
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Reducing The Risk Of Getting Dementia
Only 34% of UK adults think its possible to reduce their risk of dementia. Health and care professionals can promote evidence-based messages to middle-aged adults to help reduce their risk of getting dementia.
Working alongside other professionals and public health teams, health and care professionals can influence population-level impact by carrying out whole-system approaches to encourage people of all ages and stages of life to:
- be more physically active
- eat healthily and maintain a healthy weight
- drink less alcohol
- be socially active
- control diabetes and high blood pressure
Smoking is one of the biggest risk factors for dementia and can double an individuals risk, because it causes narrowing of blood vessels in the heart and brain, and oxidative stress, which damages the brain.
The Lancet Commission on the Prevention and management of dementia: a priority for public health published in July 2017, identifies risk factors that, if eliminated, might prevent more than a third of cases of dementia. This report notes a link between hearing loss and the risk of developing dementia. Work is underway to understand more about this relationship and whether wearing hearing aids can reduce risk in people with hearing loss.
A report by the World Health Organization has also highlighted that engaging in the arts may help reduce the risk of cognitive decline.
Who Does Dementia Affect
More than 920,000 people in the UK are living with dementia a number expected to rise to over a million by 2024 .
The vast majority of people with dementia are aged 65 and over, accounting for over 880,000 people. However, an estimated 40,000 people under 65 are living with dementia in the UK .
- there are over 25,000 people with dementia from black and minority ethnic groups in England and Wales, and this is estimated to rise to nearly 50,000 by 2026
- there are 209,600 new cases of dementia in the UK each year
- worldwide, around 50 million people are currently estimated to have dementia and there are 10 million new cases each year
- two thirds of people with dementia are women and over 600,000 women in the UK are now living with dementia. The condition is the leading cause of death in women in the UK.
According to Alzheimers Disease International, the total estimated worldwide cost of dementia was US $1 trillion in 2018. If dementia care were a country, it would be the worlds 18th largest economy . If dementia care were a company, it would be the worlds largest by annual revenue exceeding Apple, Google and Exxon.
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More People Are Living Longer In The Uk
Due to medical advances, more people than ever are surviving heart disease, strokes and many cancers.
Age is the biggest risk factor for dementia, so as more people live longer, the number of people developing dementia is increasing.
Dementia is a life-limiting condition and more research is needed to find treatments that can slow or stop the diseases that cause dementia from worsening.
Changes In The Way Uk Deaths Are Recorded
Reliable death records are important to follow changes in the impact of diseases and to decide priorities for medical research. In 2011, the ONS made changes to the way deaths due to dementia are recorded to better reflect guidance from the World Health Organisation .
Now if a person dies with dementia, doctors can report it as the main cause of death on their death certificate. Previously, the immediate cause of death would be listed, such as a fall or an infection like pneumonia.
But in many cases, these illnesses are a result of underlying dementia causing increased frailty, a weakened immune system, or problems with swallowing.
The ONS also updated their coding system so that vascular dementia would be reflected in the dementia category instead of the stroke category.
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How Alzheimer’s Disease Is Treated
There’s currently no cure for Alzheimer’s disease, but medicines are available that can help relieve some of the symptoms.
Various other types of support are also available to help people with Alzheimer’s live as independently as possible, such as making changes to your home environment so it’s easier to move around and remember daily tasks.
Psychological treatments such as cognitive stimulation therapy may also be offered to help support your memory, problem solving skills and language ability.
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Why Is It Important To Know How Many People Have Dementia
Understanding the number of people with dementia is vital to make sure the right support is available to help people with dementia to live well. It is important when planning the provision of support services, local and national health and care strategies, and dementia research
Not everyone with dementia has a diagnosis. This is why it is important to have an estimate of the total number of people with dementia, both with or without a diagnosis. In 2020 diagnosis rates for dementia fell below two thirds.
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Dementia And Alzheimers Disease Estimated Diagnosis Rates
The aspiration of the challenge on dementia 2020 is that two-thirds of people with dementia and Alzheimers disease have a formal diagnosis for their condition. In December 2020 in England, the estimated dementia and Alzheimers diagnosis rate was 62.4% 56.3 to 67.6). This was a decrease of 5.4 percentage points compared to December 2019, but the decrease was not statistically significant.
Figure 1 shows that since April 2020, there has been a consistent pattern of lower diagnosis rates when comparing the same months for each reporting year, but none of these changes are statistically different. April 2020 corresponds with the peak of the first wave of the coronavirus pandemic.
Figure 1: Dementia and Alzheimers disease estimated diagnosis rates by month, England 2019 and 2020
CCG level data
Figure 2 shows the distribution of the estimated dementia diagnosis rates at CCG level for December 2019 and December 2020. The median value decreased between these time periods from 68.6% to 63.1%. There was substantial variation in diagnosis rates across CCGs in both years, with values ranging from 56.4% to 88.5% in 2019 and from 50.8% to 79.3% in 2020. However, there was no change in variation across CCGs in England between these time periods .
Figure 2: Distribution of dementia and Alzheimers disease estimated diagnosis rates , for CCGs in England 2019 and 2020
Impact On Families And Carers
In 2019, informal carers spent on average 5 hours per day providing care for people living with dementia. This can be overwhelming . Physical, emotional and financial pressures can cause great stress to families and carers, and support is required from the health, social, financial and legal systems. Fifty percent of the global cost of dementia is attributed to informal care.
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Alzheimers Treatment And Support
While there are currently no treatments available to slow or stop the brain damage caused by Alzheimerâs disease, several medications can temporarily help improve the symptoms of dementia for some people. These medications work by increasing neurotransmitters in the brain. To learn about the availability of anti-dementia medications through the National Health System, visit Alzheimer Europe.
Help Is AvailableFind local support groups and services through the Alzheimer’s Society website.
Researchers continue to search for ways to better treat Alzheimer’s and other progressive dementias. Currently, dozens of therapies and pharmacologic treatments that focus on stopping the brain cell death associated with Alzheimer’s are underway.
In addition, having support systems in place and the use of non-pharmacologic behavioral interventions can improve quality of life for both people with dementia and their caregivers and families. This includes:
- Treatment of co-existing medical conditions
- Coordination of care among health care professionals
- Participation in activities, which can improve mood
- Behavioral interventions
- Education about the disease
- Building a care team for support
Dementia costs the UK economy Â£23 billion per year. That is twice that of cancer, three times the impact of heart disease and four times that of stroke.
Comparison With Previous Studies And How Findings Are An Advance On Current Literature
Previous studies have shown cross-country variation in dementia prevalence. However, substantial heterogeneity in case-ascertainment methods across countries and studies makes interpreting any observed differences difficult. We believe this is the first study to compare dementia prevalence in England and the USA using the exact same measure of dementia, thus overcoming previous difficulties in making comparisons across the two countries due differences in diagnostic practices and case definitions. We also compared the SES gradient of dementia in both countries. While some studies have shown in both England and the USA those with lower education and less wealth have been found to have higher rates of dementia, there are no systematic comparative studies. We compared prevalence along the SES gradient using almost identical measures of income, wealth and education. Further, we standardised the cross-country comparison for age and gender, using the English over 70 population as the standard population. We found that dementia prevalence is higher and more concentrated among the poorest in the USA than England. Detailed disaggregation according to SES measures shows the true extent of the excess burden of dementia in the very poorest group in the USA.
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