Why Is Alzheimer’s On The Increase

Who Pays For Care

Anyone with savings or income above £23,250 is expected to pay for their own care fees.

People with savings below that are entitled to help with the cost of care from their local council. Generally, the less savings the person has, the more the authority will pay towards care.

This money goes towards paying for a carer to visit, or for a care or nursing home.

The current standard amount the NHS will pay towards nursing care is £165.56 per week, according to the Alzheimer’s Society.

As funding is linked to an individual’s means, health services which may also help – such as hospitals – do not necessarily receive more public money if more people with the condition live in any one area.

A report from the London School of Economics shows the cost of dementia to the UK economy is £34.7bn per year.

Dr Karen Harrison-Dening, head of research and publications at Dementia UK, said there was no standardised service across the country.

“Care at the moment is very hit or miss. We rely heavily on families to care for their loved ones themselves,” she said.

“If you developed cancer in later life the NHS would step in.

“There would be NHS Continuing Healthcare, Macmillan nurses and bereavement support, but far less likely in dementia.”

Alzheimer’s Disease Or Dementia

Many people wonder what the difference is between Alzheimer’s disease and dementia.

Dementia is an overall term for a particular group of symptoms. The characteristic symptoms of dementia are difficulties with memory, language, problem-solving and other thinking skills that affect a person’s ability to perform everyday activities. Dementia has many causes . Alzheimer’s disease is the most common cause of dementia.

Brain Changes Associated With Alzheimer’s Disease

A healthy adult brain has about 100 billion neurons, each with long, branching extensions. These extensions enable individual neurons to form connections with other neurons. At such connections, called synapses, information flows in tiny bursts of chemicals that are released by one neuron and detected by another neuron. The brain contains about 100 trillion synapses. They allow signals to travel rapidly through the brain’s neuronal circuits, creating the cellular basis of memories, thoughts, sensations, emotions, movements and skills.

The accumulation of the protein fragment beta-amyloid outside neurons and the accumulation of an abnormal form of the protein tau inside neurons are two of several brain changes associated with Alzheimer’s.

Plaques and smaller accumulations of beta-amyloid called oligomers may contribute to the damage and death of neurons by interfering with neuron-to-neuron communication at synapses. Tau tangles block the transport of nutrients and other essential molecules inside neurons. Although the complete sequence of events is unclear, beta-amyloid may begin accumulating before abnormal tau, and increasing beta-amyloid accumulation is associated with subsequent increases in tau.,

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Can Ventriculomegaly Be Treated

How is ventriculomegaly treated? Ventriculomegaly only needs to be treated if the baby has hydrocephalus, a build-up of cerebrospinal fluid in the brain. Treatments for hydrocephalus include: Shunt placement: In this process a small tube is implanted in the brain while the child is under anesthesia.

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Trends In The Prevalence And Incidence Of Alzheimer’s Dementia Over Time

A growing number of studies indicate that the prevalence, – and incidence, , – of Alzheimer’s and other dementias in the United States and other higher-income Western countries may have declined in the past 25 years,, , – though results are mixed., , , These declines have been attributed to increasing levels of education and improved control of cardiovascular risk factors., , , , , Such findings are promising and suggest that identifying and reducing risk factors for Alzheimer’s and other dementias may be effective. Although these findings indicate that a person’s risk of dementia at any given age may be decreasing slightly, the total number of people with Alzheimer’s or other dementias in the United States and other high-income Western countries is expected to continue to increase dramatically because of the increase in the number of people at the oldest ages.

3.7.1 Looking to the future: Aging of the baby boom generation

• By 2025, the number of people age 65 and older with Alzheimer’s dementia is projected to reach 7.1 million â almost a 22% increase from the 5.8 million age 65 and older affected in 2020.,
• By 2050, the number of people age 65 and older with Alzheimer’s dementia is projected to reach 13.8 million, barring the development of medical breakthroughs to prevent, slow or cure Alzheimer’s disease.,

FIGURE 5

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Health Environmental And Lifestyle Factors

Research suggests that a host of factors beyond genetics may play a role in the development and course of Alzheimers. There is a great deal of interest, for example, in the relationship between cognitive decline and vascular conditions such as heart disease, stroke, and high blood pressure, as well as conditions such as diabetes and obesity. Ongoing research will help us understand whether and how reducing risk factors for these conditions may also reduce the risk of Alzheimers.

A nutritious diet, physical activity, social engagement, and mentally stimulating pursuits have all been associated with helping people stay healthy as they age. These factors might also help reduce the risk of cognitive decline and Alzheimers. Researchers are testing some of these possibilities in clinical trials.

Treatment Of Alzheimer’s Dementia

2.5.1 Pharmacologic treatment

None of the pharmacologic treatments available today for Alzheimer’s dementia slow or stop the damage and destruction of neurons that cause Alzheimer’s symptoms and make the disease fatal. The U.S. Food and Drug Administration has approved five drugs for the treatment of Alzheimer’s â rivastigmine, galantamine, donepezil, memantine, and memantine combined with donepezil. With the exception of memantine, these drugs temporarily improve cognitive symptoms by increasing the amount of chemicals called neurotransmitters in the brain. Memantine blocks certain receptors in the brain from excess stimulation that can damage nerve cells. The effectiveness of these drugs varies from person to person and is limited in duration.

Many factors contribute to the difficulty of developing effective treatments for Alzheimer’s. These factors include the slow pace of recruiting sufficient numbers of participants and sufficiently diverse participants to clinical studies, gaps in knowledge about the precise molecular changes and biological processes in the brain that cause Alzheimer’s disease, and the relatively long time needed to observe whether an investigational treatment affects disease progression.

2.5.2 Non-pharmacologic therapy

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Comorbidities Of Deaths Due To Dementia And Alzheimers Disease

This section looks at comorbidities where dementia and Alzheimer’s disease was the underlying cause of death. There are several ways to look at this, the following have been used here:

• pre-existing conditions any condition mentioned after dementia and Alzheimer’s disease on the death certificate
• immediate cause of death Part I of the death certificate
• contributory factors of death Part II of the death certificate

The death certificate ) used in England and Wales is compatible with that recommended by the World Health Organisation . It is set out in two parts: Part I gives the condition or sequence of conditions leading directly to death, while Part II gives details of any associated conditions that contributed to the death but are not part of the causal sequence.

The leading causes of death groupings have been used in this comorbidities section.

As Populations Age Rates Soar

by Cheryl Bond-Nelms, AARP, November 17, 2017

The Alzheimers Association says, Someone in the United States develops Alzheimer’s dementia every 66 seconds.

Degenerative brain disease and dementia are on the rise across all 50 U.S. states, according to the Alzheimers Association. As the rate of Alzheimers continues to escalate, more financial stress will be placed on health care programs. The trend will also increase the need for caregivers nationwide.

An estimated 5.5 million Americans are living with Alzheimers disease, according to the Alzheimers Association. The statistics are broken down by age and ethnicity and are listed as follows on their site.

• One in 10 people age 65 and older has Alzheimer’s dementia.
• Almost two-thirds of Americans with Alzheimer’s are women.
• African Americans are about twice as likely to have Alzheimer’s or other dementia as whites.
• Hispanics are about one and one-half times as likely to have Alzheimer’s or other dementia as whites.

Another startling figure exposed by the Alzheimers Association is that Someone in the United States develops Alzheimer’s dementia every 66 seconds.

The state with the highest rate of Alzheimers is Alaska. Cases of the disease are projected to increase from 7,100 in 2017 to 11,000 in 2025 an increase of 54.9 percent, reports AA.

Below is a list of the 10 states that are predicted to have the highest rate increases of Alzheimers by 2025.

1. Alaska

Alzheimers Increase, 2017-2025: 54.9 percent

2. Arizona

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How Is Alzheimer’s Disease Diagnosed

There is currently no single test to identify Alzheimer’s disease. The diagnosis is made only after careful clinical consultation.

The clinical diagnosis might include:

• A detailed medical history
• Lumbar puncture for cerebral spinal fluid tests
• Medical imaging

These tests will help to eliminate other conditions with similar symptoms such as nutritional deficiencies or depression. After eliminating other causes, a clinical diagnosis of Alzheimer’s disease can be made with about 80% to 90% accuracy if the symptoms and signs are appropriate. The diagnosis can only be confirmed after death by examination of the brain tissue.

It is important to have an early and accurate diagnosis to determine whether a treatable condition other than Alzheimer’s disease, is causing the symptoms. If Alzheimer’s disease is diagnosed, medical treatment and other assistance can be discussed.

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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Support For Families And Alzheimer’s Disease Caregivers

Caring for a person with Alzheimers can have significant physical, emotional, and financial costs. The demands of day-to-day care, changes in family roles, and decisions about placement in a care facility can be difficult. NIA supports efforts to evaluate programs, strategies, approaches, and other research to improve the quality of care and life for those living with dementia and their caregivers.

Becoming well-informed about the disease is one important long-term strategy. Programs that teach families about the various stages of Alzheimers and about ways to deal with difficult behaviors and other caregiving challenges can help.

Good coping skills, a strong support network, and respite care are other things that may help caregivers handle the stress of caring for a loved one with Alzheimers. For example, staying physically active provides physical and emotional benefits.

Some caregivers have found that joining a support group is a critical lifeline. These support groups enable caregivers to find respite, express concerns, share experiences, get tips, and receive emotional comfort. Many organizations sponsor in-person and online support groups, including groups for people with early-stage Alzheimers and their families.

Read about this topic in Spanish. Lea sobre este tema en español.

Managing Alzheimer’s Disease Behavior

Common behavioral symptoms of Alzheimers include sleeplessness, wandering, agitation, anxiety, and aggression. Scientists are learning why these symptoms occur and are studying new treatments drug and nondrug to manage them. Research has shown that treating behavioral symptoms can make people with Alzheimers more comfortable and makes things easier for caregivers.

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Alzheimers Incidence Is Rising Not Falling A Researcher Says

11 Apr 2018

In the last few years, numerous studies have reported that dementia incidence is falling in the developed world. The drop in new cases has been attributed to better public health, in particular improved blood pressure control, but this conclusion may not tell the whole story. At the first Advances in Alzheimers and Parkinsons Therapies Focus Meeting , held March 1518 in Turin, Italy, Walter Rocca of the Mayo Clinic in Rochester, Minnesota, summarized recent research from his group and others that suggests the incidence of neurodegenerative diseases such as Parkinsons, amyotrophic lateral sclerosis, and early onset Alzheimers is going up, not down. The reasons are unclear but could be environmental factors. Rocca argued this trend may extend to late-onset AD as well. He attributed the drop in all-cause dementia in recent decades to fewer cases of vascular dementia and stroke, which he thinks could be masking an increase in pure AD pathology.

• The incidence of PD, ALS, and early onset AD appears to be rising.
• The incidence of late-onset AD may be rising too.
• The drop in all-cause dementia is due to vascular health improvements.

The dementia developing de novo in this group is very different in causes and manifestations from dementias with earlier onset, Rocca noted. This important work supports the hypothesis that improvements in cardiovascular health may be a major hope for the prevention of dementia.

Trends In Dementia Caregiving

There is some indication that families are now better at managing the care they provide to relatives with dementia than in the past. From 1999 to 2015, dementia caregivers were significantly less likely to report physical difficulties and financial difficulties related to care provision. In addition, use of respite care by dementia caregivers increased substantially . However, as noted earlier, more work is needed to ensure that interventions for dementia caregivers are available and accessible to those who need them. A 2016 study of the Older Americans Act’s National Family Caregiver Support Program found that over half of Area Agencies on Aging did not offer evidence-based family caregiver interventions.

FIGURE 11

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Avoidable Use Of Health Care And Long

6.5.1 Preventable hospitalizations

Preventable hospitalizations are one common measure of health care quality. Preventable hospitalizations are hospitalizations for conditions that could have been avoided with better access to, or quality of, preventive and primary care. Unplanned hospital readmissions within 30 days are another type of hospitalization that potentially could have been avoided with appropriate post-discharge care. In 2013, 21% of hospitalizations for fee-for-service Medicare enrollees with Alzheimer’s or other dementias were either for unplanned readmissions within 30 days or for an ambulatory care sensitive condition . The total cost to Medicare of these potentially preventable hospitalizations was $4.7 billion . Of people with dementia who had at least one hospitalization, 18% were readmitted within 30 days. Of those who were readmitted within 30 days, 27% were readmitted two or more times. Ten percent of Medicare enrollees had at least one hospitalization for an ambulatory care-sensitive condition, and 14% of total hospitalizations for Medicare enrollees with Alzheimer’s or other dementias were for ambulatory care sensitive conditions.

FIGURE 16

What Are The Symptoms

The symptoms of hydrocephalus can vary significantly from person to person and mostly depend on age. Conditions other than hydrocephalus can cause similar symptoms so it is important to see a doctor to receive proper diagnosis and treatment.InfantsSigns and symptoms of hydrocephalus in infants include:

• a rapid increase in head size
• an unusually large head

Brain imaging and other testsTests to accurately diagnose hydrocephalus and rule out other conditions may include:

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Numbers Of People With Dementia

Someone in the world develops dementia every 3 seconds. There are over 55 million people worldwide living with dementia in 2020. This number will almost double every 20 years, reaching 78 million in 2030 and 139 million in 2050. Much of the increase will be in developing countries. Already 60% of people with dementia live in low and middle income countries, but by 2050 this will rise to 71%. The fastest growth in the elderly population is taking place in China, India, and their south Asian and western Pacific neighbours.

Demographic ageing is a worldwide process that shows the successes of improved health care over the last century. Many are now living longer and healthier lives and so the world population has a greater proportion of older people. Dementia mainly affects older people, although there is a growing awareness of cases that start before the age of 65.

There are over 10 million new cases of dementia each year worldwide, implying one new case every 3.2 seconds.

Symptoms Of Alzheimer’s Disease

In the early stages the symptoms of Alzheimer’s disease can be very subtle. However, it often begins with lapses in memory and difficulty in finding the right words for everyday objects.

Other symptoms may include:

• Persistent and frequent memory difficulties, especially of recent events
• Vagueness in everyday conversation
• Apparent loss of enthusiasm for previously enjoyed activities
• Taking longer to do routine tasks
• Forgetting well-known people or places
• Inability to process questions and instructions
• Deterioration of social skills
• Emotional unpredictability

Symptoms vary and the disease progresses at a different pace according to the individual and the areas of the brain affected. A person’s abilities may fluctuate from day to day, or even within the one day, becoming worse in times of stress, fatigue or ill-health.

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Diagnosis Of Dementia Due To Alzheimer’s Disease

• Obtaining a medical and family history from the individual, including psychiatric history and history of cognitive and behavioral changes.
• Asking a family member to provide input about changes in thinking skills and behavior.
• Conducting problem-solving, memory and other cognitive tests, as well as physical and neurologic examinations.
• Having the individual undergo blood tests and brain imaging to rule out other potential causes of dementia symptoms, such as a tumor or certain vitamin deficiencies.
• In some circumstances, using PET imaging of the brain to find out if the individual has high levels of beta-amyloid, a hallmark of Alzheimer’s normal levels would suggest Alzheimer’s is not the cause of dementia.
• In some circumstances, using lumbar puncture to determine the levels of beta-amyloid and certain types of tau in CSF normal levels would suggest Alzheimer’s is not the cause of dementia.