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.
Mental Health Vs Physical Illness
We were surprised to find that mental health conditions were a much stronger predictor of dementia than chronic physical diseases, said Dr. Richmond-Rakerd.
This reinforces the need, said Dr. Richmond-Rakerd, to think about dementia prevention earlier in the life course because mental health conditions tend to peak in young adulthood, while chronic physical diseases do not typically emerge until later in life. Supporting young peoples mental health could be a window of opportunity to help reduce the burden of dementia in older adults.
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Down Syndrome And Alzheimers Disease
People with Down syndrome have a third copy of chromosome 21, instead of the usual two copies. This genetic change causes a collection of characteristics, including intellectual disability and some common physical traits.The APP gene that leads to the production of the beta-amyloid protein present in Alzheimers plaques is located on chromosome 21. This means that people with Down syndrome make one and a half times the amount of APP and, as a consequence, more beta-amyloid. This appears to be the cause of the earlier appearance of the brain changes typical of Alzheimers disease in people with Down syndrome.
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Isnt Dementia Part Of Normal Aging
No, many older adults live their entire lives without developing dementia. Normal aging may include weakening muscles and bones, stiffening of arteries and vessels, and some age-related memory changes that may show as:
- Occasionally misplacing car keys
- Struggling to find a word but remembering it later
- Forgetting the name of an acquaintance
- Forgetting the most recent events
Normally, knowledge and experiences built over years, old memories, and language would stay intact.
What Are The Most Common Types Of Dementia
- Alzheimers disease. This is the most common cause of dementia, accounting for 60 to 80 percent of cases. It is caused by specific changes in the brain. The trademark symptom is trouble remembering recent events, such as a conversation that occurred minutes or hours ago, while difficulty remembering more distant memories occurs later in the disease. Other concerns like difficulty with walking or talking or personality changes also come later. Family history is the most important risk factor. Having a first-degree relative with Alzheimers disease increases the risk of developing it by 10 to 30 percent.
- Vascular dementia. About 10 percent of dementia cases are linked to strokes or other issues with blood flow to the brain. Diabetes, high blood pressure and high cholesterol are also risk factors. Symptoms vary depending on the area and size of the brain impacted. The disease progresses in a step-wise fashion, meaning symptoms will suddenly get worse as the individual gets more strokes or mini-strokes.
- Lewy body dementia. In addition to more typical symptoms like memory loss, people with this form of dementia may have movement or balance problems like stiffness or trembling. Many people also experience changes in alertness including daytime sleepiness, confusion or staring spells. They may also have trouble sleeping at night or may experience visual hallucinations .
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What Are The Symptoms Of Vascular Dementia
People with vascular dementia may experience:
- Difficulty performing tasks that used to be easy, such as paying bills
- Trouble following instructions or learning new information and routines
- Forgetting current or past events
- Misplacing items
- Loss of interest in things or people
- Changes in personality, behavior, and mood, such as depression, agitation, and anger
- Hallucinations or delusions
- Poor judgment and loss of ability to perceive danger
How Is Ftd Diagnosed
FTD can be hard to diagnose because the symptoms are similar to those of other conditions. For example, bvFTD is sometimes misdiagnosed as a mood disorder, such as depression. To make matters more confusing, a person can have both FTD and another type of dementia, such as Alzheimer’s disease. Also, because these disorders are rare, physicians may be unfamiliar with the signs and symptoms.
To help diagnose frontotemporal dementia, a doctor may:
- Perform an exam and ask about symptoms
- Look at personal and family medical history
- Use laboratory tests to help rule out other conditions
- Order genetic testing
- Conduct tests to assess memory, thinking, language skills, and physical functioning
- Order imaging of the brain
A psychiatric evaluation can help determine if depression or another mental health condition is causing or contributing to the condition. Only genetic tests in familial cases or a brain autopsy after a person dies can confirm a diagnosis of FTD.
Researchers are studying ways to diagnose FTD earlier and more accurately and to distinguish them from other types of dementia. One area of research involves biomarkers, such as proteins or other substances in the blood or cerebrospinal fluid which can be used to measure disease progression or the effects of treatment. Researchers are also exploring ways to improve brain imaging and neuropsychological testing.
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What To Do If A Loved One Is Suspicious Of Having Dementia
- Discuss with loved one. Talk about seeing a medical provider about the observed changes soon. Talk about the issue of driving and always carrying an ID.
- Medical assessment. Be with a provider that you are comfortable with. Ask about the Medicare Annual Wellness exam.
- Family Meeting. Start planning, and gather documents like the Health Care Directive, Durable Power of Attorney for Health Care, Estate Plan.
Chronic Traumatic Encephalopathy/brain Injury
Initial symptoms: Symptoms of brain injury include loss of consciousness, memory loss, personality and behavior changes, and slow, slurred speech.
Progression: While symptoms from a single concussion are often temporary and resolve with appropriate treatment, chronic traumatic encephalopathy typically develops over time from repeated head injuries and is generally not reversible. Later symptoms include poor decision-making ability, aggression, impaired motor function and inability to communicate effectively.
Prognosis: Life expectancy varies according to the severity of injuries.
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Dementia Is A Terminal Illness Study
In the first study to rigorously describe the clinical course of advanced dementia, a leading cause of death among Americans, researchers in the US concluded that dementia is a terminal illness and is insufficiently recognized as such, resulting in many patients not receiving the palliative care that aims to improve the comfort of the terminally ill.
The study was the work of lead author Dr Susan L Mitchell and colleagues and is published online in the 15 October issue of the New England Journal of Medicine, NEJM. Mitchell a senior scientist at the Institute for Aging Research of Hebrew SeniorLife, an affiliate of Harvard Medical School in Boston, Massachusetts, where she is also Associate Professor of Medicine.
Today there are more than 5 million Americans living with dementia, and this number is expected to treble over the next 40 years, with worldwide numbers rising to more than 35 million by 2050, according to a recent study by Alzheimers Disease International.
People with dementia, of which the most common form is Alzheimers disease, have trouble with daily living: they suffer from memory loss, find it difficult to communicate, their personality changes, and they cant reason or make decisions.
Mitchell told the press that:
They hope their findings stress the need to improve the quality of end of life care in nursing homes to relieve the suffering of patients with advanced dementia and improve communication with their family members.
The Impact Of New Breakthroughs And What The Future Holds
Alzheimers disease is age-associated, which means the longer we live, the more risk we have of developing Alzheimers disease dementia. As the populations of many countries around the world keep getting older, Alzheimers is affecting more people. Its an important disease to study due to its impact on so many populations, and its interconnections with other brain diseases.
Dr. Morris spoke to the overlap between people with Alzheimers and those with Parkinsons. Some people with one disease may develop symptoms of the other, making an accurate diagnosis even more complex. But this also means that as research brings us new ways to prevent, diagnose, and treat Alzheimers, these breakthroughs will also have an impact on other brain diseases and types of dementia.
We dont yet know whether or how certain lifestyle practices might reduce the risk for Alzheimers disease, especially in light of potential genetic or environmental factors. In the meantime, Dr. Morris advocates a heart-healthy diet and staying mentally, physically, and socially engaged, as these lifestyle behaviors are beneficial for a persons overall health.
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Whats The Difference Between Dementia And Mental Illness
Common symptoms of dementia include memory loss, forgetfulness, difficulty in understanding language, and impaired judgment.
On the other hand, mental illnesses such as schizophrenia or bipolar disorder can cause hallucinations and delusions, which are not present with Alzheimer’s disease or another form of dementia. Dementia is also characterized by a gradual decline, while mental illness usually presents itself in episodic phases that eventually end.
The key to understanding the difference between mental illness and dementia is recognizing two different illnesses with some similar and some unique symptoms. Dementia usually progresses slowly over time it also causes memory, language skills, judgment, or dispositions. Mental illnesses like anxiety disorders , bipolar disorder, and schizophrenia can sometimes mimic the early stages of dementia because they cause difficulties in thinking for other reasons besides Alzheimer’s disease.
Professionals categorize cognition symptoms as mild or major, according to how severe they are. The most recognizable symptoms are challenges with planning, making decisions, staying focused, remembering things, and maintaining appropriate behavior around others.
As you might imagine, anyone wondering “Is Dementia A Mental Illness?” has more important questions that need to be answered and quickly.
Dementia With Lewy Bodies
Initial symptoms: Dementia with Lewy bodies is a type of Lewy body dementia. Dementia with Lewy bodies involves both body symptoms such as motor and muscle weakness and rigidity, as well as brain symptoms like making decisions, memory impairment, and attention span.
In dementia with Lewy bodies, the brain symptoms develop before the body symptoms, at the same time or less than a year after the body symptoms present.
Progression: Dementia with Lewy bodies can vary quite a bit, even from day to day. However, in general the disease starts slowly and worsens gradually.
Prognosis: Average life expectancy depends on many factors but is estimated to be approximately 5 to 8 years after diagnosis.
What Are The Signs And Symptoms Of Dementia
Signs and symptoms of dementia result when once-healthy neurons, or nerve cells, in the brain stop working, lose connections with other brain cells, and die. While everyone loses some neurons as they age, people with dementia experience far greater loss.
The symptoms of dementia can vary and may include:
- Experiencing memory loss, poor judgment, and confusion
- Difficulty speaking, understanding and expressing thoughts, or reading and writing
- Wandering and getting lost in a familiar neighborhood
- Trouble handling money responsibly and paying bills
- Repeating questions
- Not caring about other peoples feelings
- Losing balance and problems with movement
People with intellectual and developmental disabilities can also develop dementia as they age, and recognizing their symptoms can be particularly difficult. Its important to consider a persons current abilities and to monitor for changes over time that could signal dementia.
Symptoms Of Alzheimers Disease
Alzheimers disease typically starts slowly and the symptoms can be very subtle in the early stages. As the disease progresses, symptoms become more noticeable and interfere with daily life. The disease affects each person differently and the symptoms vary.Common symptoms include:
- persistent and frequent memory loss, especially of recent events
- vagueness in everyday conversation
- being less able to plan, problem-solve, organise and think logically
- language difficulties such as finding the right word and understanding conversations
- apparent loss of enthusiasm for previously enjoyed activities
- taking longer to do routine tasks
- becoming disoriented, even in well-known places
- inability to process questions and instructions
- deterioration of social skills
- emotional unpredictability
- changes in behaviour, personality and mood.
Symptoms vary as the disease progresses and different areas of the brain are affected. A persons abilities may fluctuate from day to day, or even within the one day, and can become worse in times of stress, fatigue or ill health.The stages of Alzheimers disease progress from mild Alzheimers disease to moderate Alzheimers disease and then severe Alzheimers disease. During severe Alzheimers disease, people need continuous care. The rate of progression between these stages differs between people.
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Use And Costs Of Health Care And Long
Among Medicare beneficiaries with Alzheimer’s or other dementias, black/African Americans had the highest Medicare payments per person per year, while whites had the lowest payments . The largest difference in payments was for hospital care, with black/African Americans incurring 1.7 times as much in hospital care costs as whites .
- Created from unpublished data from the National 5% Sample Medicare Fee-for-Service Beneficiaries for 2014.
In a study of Medicaid beneficiaries with a diagnosis of Alzheimer’s dementia that included both Medicaid and Medicare claims data, researchers found significant differences in the costs of care by race/ethnicity. These results demonstrated that black/African Americans had significantly higher costs of care than whites or Hispanics/Latinos, primarily due to more inpatient care and more comorbidities. These differences may be attributable to later-stage diagnosis, which may lead to higher levels of disability while receiving care delays in accessing timely primary care lack of care coordination duplication of services across providers or inequities in access to care. However, more research is needed to understand the reasons for this health care disparity.
Economic Impact Of Dementia
The total estimated worldwide cost of dementia was US$ 818 billion in 2015, which represented 1.09% of global GDP at that time. The annual global cost of dementia is now above US$ 1.3 trillion and is expected to rise to US$2.8 trillion by 2050
This figure includes costs attributed to informal care , direct costs of social care and the direct costs of medical care .
Direct medical care costs account for roughly 20% of global dementia costs, while direct social sector costs and informal care costs each account for roughly 40%. The relative contribution of informal care is greatest in the African regions and lowest in North America, Western Europe and some South American regions, while the reverse is true for social sector costs.
This means that if global dementia care were a country, it would be the 14th largest economy in the world. More information is available in our World Alzheimer Report 2015.
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Treating Language Problems In Ftd
Treatment of PPA has two goals maintaining language skills and using new tools and other ways to communicate. Treatment tailored to a persons specific language problem and stage of PPA generally works best. Since language ability declines over time, different strategies may be needed as the illness progresses. The following strategies may help:
- Use a communication notebook , gestures, and drawings to communicate without talking.
- Store lists of words or phrases in a computer or phone to point to.
- Speak slowly and clearly, use simple sentences, wait for responses, and ask for clarification if needed.
- Work with a speech-language pathologist familiar with PPA to determine the best tools and strategies to use. Note that many speech-language pathologists are trained to treat aphasia caused by stroke, which requires different strategies from those used with PPA.
The Effects Of Alzheimers On The Brain
Damage to the brain begins years before symptoms appear. Abnormal protein deposits form plaques and tangles in the brain of someone with Alzheimers disease. Connections between cells are lost, and they begin to die. In advanced cases, the brain shows significant shrinkage.
Its impossible to diagnose Alzheimers with complete accuracy while a person is alive. The diagnosis can only be confirmed when the brain is examined under a microscope during an autopsy. However, specialists are able to make the correct diagnosis up to
- behavioral changes
- difficulty speaking, swallowing, or walking in advanced stages of the disease
Some types of dementia will share some of these symptoms, but they include or exclude other symptoms that can help make a differential diagnosis. Lewy body dementia , for example, has many of the same later symptoms as Alzheimers. However, people with LBD but are more likely to experience initial symptoms such as visual hallucinations, difficulties with balance, and sleep disturbances.
People with dementia due to Parkinsons or Huntingtons disease are more likely to experience involuntary movement in the early stages of the disease.
Treatment for dementia will depend on the exact cause and type of dementia, but many treatments for dementia and Alzheimers will overlap.
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