Rising incidence of dementia

I recently attended a lecture day regarding dementia. We were addressed by a consultant geriatrician, clinical directors and a lecturer and researcher into dementia.

The problem doctors are experiencing is that countries are not ready to cope with the onslaught of this disease- Kathryn Borg

There was much to be learned from this day, especially how to define dementia when we use it so freely and perhaps don’t understand the full range of symptoms associated with this very descriptive word.

In answer to the question ‘What is dementia?’ we learn that it is the “global deterioration of higher intellectual functioning occurring in an alert patient”. It can be static or progressive, reversible or irreversible. This all depends on where the patient fits in the dementia spectrum. It is important to understand that memory problems are normal with ageing.

The dementia spectrum in­cludes three basic areas: the normal ageing group, the group in-between and referred to as those with mild cognitive impairment, and the more serious types which are classified as follows:

The main types of dementia are Alzheimer’s (50 per cent), Vascular (five per cent) (related to strokes and blood vessels), a mixture of the two (25 per cent), Lewy Body (five to15 per cent- those attributed to illnesses such as Parkinson’s), fronto-temporal (five to15 per cent – linked to the front of the brain and common in younger people), and other non-specific types (five per cent).

The percentages after each type represent the percentage of patients affected according to the Health and Social Care NHS Foundation Trust. This clearly shows that Alzheimer’s is the leader within the population of the UK and this probably reflects other European countries too.

However, the 25 per cent mixture of the two reflects how a type of dementia can be apparent after a stroke or cardiac arrest.

The consultant gave the recently topical example of the footballer, Fabrice Muamba, who collapsed in the UK during a football match when he suffered a cardiac arrest. The consultant explained that a short period of the heart ceasing to function could cause dementia referred to as vascular dementia.

He went on to explain that medical tests were necessary to determine the cause of dementia to enable the correct treatment to take place. The following could cause secondary dementia: head injury, brain tumour, brain infection, blood clot on the brain, lack of oxygen to the brain, kidney disease, endocrine disease, anemia, cancer, depression, and blood chemistry disorders.

It is at this point that one realises that dementia is not a general adjective to describe all memory problems but a term used to cover a whole range of possible causes ranging from those affecting the younger age group through to the elderly.

There are, of course, risk factors. Some are genetical, some relate to lifestyle. Family history is at the top of the scale, followed by family history of suffering from Parkinson’s. After that, another risk factor is a family history of Down Syndrome.

The next percentage down is attributed to head injury, hypothyroidism, depression and finally, smoking. This is the list in descending order of risk factors for Alzheimer’s. However, taking all that into consideration, the largest risk factor is age.

To offer clarity on this I will reproduce a table given in the lecture which represents the chances in the next 12 months of the population developing Alzheimer’s relating to the UK:

Based on this table, together with the demographic figures which show that most European countries have an ageing population, it can be assumed that in 10 years’ time some form of dementia will be affecting a large part of the population.

It was estimated that dementia would be similar in statistics to cancer figures today. That is one in three people. In the next 30 years, incidences of dementia will double.

The problem doctors are experiencing is that countries are not ready to cope with the onslaught of this disease. Not enough money has been spent in caring, research, support of carers in the community, diagnosis, medication and lifestyle advice.

This particular lecture was to discuss the dementia strategy for the city, which is where the lecturer and researcher came into the group. He is involved in raising awareness, and providing information for those in the early stages of suffering and for carers. He also stressed that it was important to remove the stigma of dementia, and help people understand the benefits of early diagnosis and care.

The Department of Health in the UK has produced a document entitled ‘The Prime Minister’s Challenge on Dementia’, which intends to deliver major improvements in dementia care and research by 2015.

What was interesting were the facts about carers. There are over half a million carers in England. These are primary carers for people suffering from some kind of dementia. If these carers did not exist, the country could not support the extent of suffering of these dementia patients.

They save the nation nearly €8.5 billion each year. Unfortunately, research shows that carers of people with dementia experience greater strain and distress than carers of older people.

From my own research, I have discovered that many carers who have had little or no support have suffered breakdowns, serious stress and mental illnesses themselves.

For those who are interested in more information, Information Needs of People with Dementia and Carers, published by the Alzheimer’s Society, London, can help.

It is a subject we all need to be aware of; it could affect us and our family in the coming years.

kathryn@maltanet.net