Healthy minds ... or dementia ?

[Doc Alan]

At last the G8 nations’ politicians are “ declaring war “ on dementia, two months after President Aquino at the Dementia Society of the Philippines

(http://www.bbc.co.uk/news/health-25318194
;

http://www.dementia.org.ph/?fid=history
).

Let’s hope they remember their promises.


The Forum has had two related threads this year

(http://filipinaroses.com/showthread....eing++elderly+
;

http://filipinaroses.com/showthread....g-With-Dignity
).


Dementia should concern us all - directly, or indirectly through affected relatives. It probably affects 800,000 in the UK, at least 200,000 in the Philippines, 44 million people in the world, and is increasing in frequency, because people are living longer.

(http://www.nhs.uk/Conditions/dementi...-dementia.aspx
).


The UK spends several times more on cancer research than dementia, and the Dementia Society of the Philippines was only established a decade ago.


There are many conditions where brain function declines, inevitable with increasing age, but prematurely in the commonest type ( Alzheimer’s … about 3/5 ), vascular dementia ( a fifth ) , or “ mixed “ and others ( a fifth ).


Dementia is incurable ; ultimately sufferers need full time care ; and the social / economic impact is devastating. It costs the UK more than cancer and heart disease combined.


Drugs to stop or even slow the disease progress remain elusive, although there are some new clinical trials. Part of the problem is early diagnosis – by the time memory problems become noticeable, too many brain cells have died over the previous decade or more.


We do know more about the pathology, and changes to be seen on brain imaging.


We are left at present with trying to reduce the risk.

Five measures / healthy habits are thought to help :
• Exercise ( the most important )

• Staying slim

• Eating fruit and vegetables

• Not smoking

• Moderate alcohol intake.


Sounds familiar ? Responsibilty for these lies with individuals and their lifestyle choices. I never make judgements on the Forum. This is the best evidence for reducing risk for the various types of dementia until research comes up with something better.

[Dedworth]

Thanks for highlighting Doc

My wife was talking about this and she was wondering why it is much, much more prevalent in the UK than the Philippines. I suppose a fair bit comes down to lazy lifestyles and diet

[Doc Alan]

It’s been suggested that very few of the UK population have all five “ healthy habits “ ( as in my first post ), with little change in the past three decades.


The only number I have for dementia in the Philippines is 200,000, from the Dementia Society of the Philippines in 2010. This is probably an underestimate, as the term dementia is still unfamiliar to many Filipinos. They use terms like ulyanin and limutin ( forgetfulness ), seen as an inevitable part of ageing – which is only true in part.


The risk of dementia does increase with age - one in three may develop it over the age of 65, and it’s commoner in women. 8% of the world’s population ; almost a fifth of the UK population ; and 4% of the Philippines population are 65 and over. This may well also explain why dementia is thought to be four times as common in the UK as the Philippines.

[andy222]

Thanks for highlighting Doc

My wife was talking about this and she was wondering why it is much, much more prevalent in the UK than the Philippines. I suppose a fair bit comes down to lazy lifestyles and diet

Maybe its not detected in the phils.

[cheekee]

As a senior nurse I deal with dementia more and more in my practice. It takes a great deal of care and patience to work with these patients as they can become very confused and agitated. At the hospital I work at, We have introduced these "pods" that contain items from the past that have been recreated using modern tech. Things like old looking radios and TVs. The idea being that it stimulates them and helps them with familiar memories. A new dementia ward has opened that has been designed to be safer (swipe card access). These kind of patients often require specialing with one to one nursing. Sadly sometimes we need to use sedatives to help them if they are unable to sleep. Sometimes I see dementia patients who haven't been able to sleep for some time and it makes them worse.

Dementia scares me. Its a cruel disease. I wouldn't wish it on my worst enemy. Not being able to remember treasured memories or who your loved ones are.

Very informative post Doc Alan. Thank you.

[lordna]

I don't remember reading this!

Seriously though, another really good post from the Doc. Must be a terrible thing having dementia.

[gWaPito]

At last the G8 nations’ politicians are “ declaring war “ on dementia, two months after President Aquino at the Dementia Society of the Philippines

(http://www.bbc.co.uk/news/health-25318194
;

http://www.dementia.org.ph/?fid=history
).

Let’s hope they remember their promises.


The Forum has had two related threads this year

(http://filipinaroses.com/showthread....eing++elderly+
;

http://filipinaroses.com/showthread....g-With-Dignity
).


Dementia should concern us all - directly, or indirectly through affected relatives. It probably affects 800,000 in the UK, at least 200,000 in the Philippines, 44 million people in the world, and is increasing in frequency, because people are living longer.

(http://www.nhs.uk/Conditions/dementi...-dementia.aspx
).


The UK spends several times more on cancer research than dementia, and the Dementia Society of the Philippines was only established a decade ago.


There are many conditions where brain function declines, inevitable with increasing age, but prematurely in the commonest type ( Alzheimer’s … about 3/5 ), vascular dementia ( a fifth ) , or “ mixed “ and others ( a fifth ).


Dementia is incurable ; ultimately sufferers need full time care ; and the social / economic impact is devastating. It costs the UK more than cancer and heart disease combined.


Drugs to stop or even slow the disease progress remain elusive, although there are some new clinical trials. Part of the problem is early diagnosis – by the time memory problems become noticeable, too many brain cells have died over the previous decade or more.


We do know more about the pathology, and changes to be seen on brain imaging.


We are left at present with trying to reduce the risk.

Five measures / healthy habits are thought to help :
• Exercise ( the most important )

• Staying slim

• Eating fruit and vegetables

• Not smoking

• Moderate alcohol intake.


Sounds familiar ? Responsibilty for these lies with individuals and their lifestyle choices. I never make judgements on the Forum. This is the best evidence for reducing risk for the various types of dementia until research comes up with something better.

It's as easy as that yet most can't be bothered. ..They can't be bothered for their loved ones who will be left behind out of dammed right selfishness.

We don't know the answers as to why and how to cure it. ..what we do know is. .diet and life style choices play a major part in our health.

Many say they don't play the lottery 'it's a waste of money' yet they are quite happy to gamble away with their own lives

Excellent timing Alan. ..just in time for the season of over indulgence. ..namely, gluttony.

[Doc Alan]

Thanks for reading this thread and your responses Ded, Andy, Cheekee, Lordna and GwaPito !


Cheekee’s post, with his practical experience, highlights the cost of dementia to hospitals - in addition to care homes and families. It’s not particularly reassuring that “ a cure could be found within 12 years “ ( David Cameron ). Anyone with a relative or friend suffering from dementia will know it’s not exaggerating to call it a “ living death “.


I lost a 71 years old aunt, peacefully, to cancer last week. It was a rare type with no known cause, and she survived 8 months from diagnosis to death – a blessing in disguise, preferable to years with dementia.


Of course it’s commoner with increasing age, but to dismiss it as an inevitable corollary of ageing is mistaken, in my opinion.


No one, least of all me, is suggesting or trying to dictate, a lifestyle which removes all pleasurable activities in order to live longer - especially in the weeks before Christmas.


But for the increasing number who do survive to 65, it’s never too late to consider how they might increase their personal odds to survive the next two decades and beyond in reasonable health. What’s good for the heart is also good for the brain . Until we understand more about dementia – prevention, early diagnosis and treatment – that’s about all we can do.


In the meantime, let’s hope our Government, and others, don’t forget to invest more in all aspects of dementia .

[Arthur Little]

Alzheimers & Dementia

In the meantime, let’s hope our Government, and others, don’t forget to invest more in all aspects of dementia .

Excellent thread, Alan! Also, ... it's almost as though the politicians themselves suffer from one or other of the aforementioned afflictions, since it seems they've a habit of "forgetting" to actually do anything about either.

Btw ... sorry to read of your aunt's recent death (albeit from an unrelated illness).

[cheekee]

I have to say that the number of patients being admitted to hospital is on the increase. Not that dementia is the cause of the admission, more so for another health issue. These patients often have multiple co morbities. This raises the issue around adequate safe staffing of hospital wards. With winter pressures setting in things can get challenging.

[Rosie1958]

Sadly I can relate to this thread only too well. My lovely mum was diagnosed with Alzheimer's disease at the age of 59. She was always slim, had a healthy balanced diet with fruit and vegetables throughout her life, didn't smoke or drink alcohol but it wasn't enough to stop her having this terribly cruel and debilitating disease. She didn't really understand what was happening to her, it was those around her (my dad and I) that suffered the most. She lasted for nine years and passed away aged 68 in a nursing home weighing about 4 stone

There has been a lack of funding to undertake the research required to help others so I am really pleased that more will be done in that area. In the meantime, my partner's mother who is in her 70s has recently also been diagnosed with Alzheimer's too .............

[Doc Alan]

Research workers in Australia have recently claimed an " Alzheimer’s breakthrough " , which involved improving mice memories by ultrasound. If only the situation in humans was simply a matter of " removing amyloid plaques " - unfortunately it isn’t !

The search for cure(s) goes on, albeit with a smaller amount of resources compared to those directed towards cancers.


In summary :-


• Alzheimer’s disease is the commonest type of dementia. There are changes in the brain beyond those associated with simple ageing ( including build-up of two proteins, amyloid and tau ). However, it’s not that simple, or fully understood, but there’s increasing evidence of an immune response which contributes to disease progression and severity. Alzheimer’s also often occurs with other types of dementia – so-called mixed dementia.


• The second commonest cause of dementia is Vascular dementia – when the blood flow to the brain is reduced. It may occur after a stroke.


• The third commonest type is Dementia with Lewy bodies ( protein clumps within nerve cells in the brain ).


• A relatively rare type is Frontotemporal dementia ( but it usually affects people between 30 and 60 ).


• It’s important to get these diagnoses right, even if the symptoms overlap, as treatments ( if not cure ) may be different.



• The biggest risk factor for most cases of dementia is increasing age, and the lifestyle choices - already recommended in this thread - are the best ways of reducing the chances of developing this distressing and increasingly common group of conditions – which require treatment and support in the absence – so far – of cure.


• Apart from the links already given, this explains in detail the various types of dementia :-


http://www.alzheimersresearchuk.org/...s-of-dementia/

[Doc Alan]

Another " Alzheimer’s breakthrough " has been widely reported in the UK this week :-

" Landmark drug to stop Alzheimer’s disease has been unveiled … Solanezumab has been shown to slow or even halt the illness " ( Daily Mail ) ; " something of a breakthrough " ( Channel 4 ) ; English Health Secretary Hunt ( not known for his grasp of evidence-based medicine ) congratulated US manufacturer Eli Lilly on a " massive step forward " ; " Alzheimer’s breakthrough hopes add to promise of pharma revival " ( Financial Times ).


As members will know from reading this thread, Alzheimer’s disease is the commonest type of dementia - affecting about 0.5 million people in the UK; probably well over 0.2 million in the Philippines ; approaching 50 million in the world ; and expected to increase as people get older – possibly tripling in numbers by the middle of this century. Mental health disorders are already thought to account for more " disability-adjusted life years " ( years of healthy life lost to disability and premature death ) than cancer – about a fifth of the total in " high income countries ". While Alzheimer’s may not be the actual cause of death, it often contributes ( through pneumonia for example ).



We know much about the pathology of dementia, including the commonest type ( Alzheimer’s ) but sadly there’s still no cure, and no guaranteed way of prevention; risk reduction includes the usual factors favouring a healthy lifestyle - not smoking, limiting alcohol intake, staying physically fit and avoiding obesity. It’s not just " amyloid plaques " affecting nerve cells but also inflammation with immune responses – all of which could in theory be prevented or treated.


Many research trials over the past 30 years have produced only a few drugs that manage symptoms, without stopping progression of the disease.


It’s understandable, therefore, that a " breakthrough " has been widely reported in the past week. A true breakthrough would indeed be good news for patients ( and the pharmaceuticals industry ) ! However, this news has to be received with caution. Patients with Alzheimer’s today are not going to benefit - at best the effect is seen only in those with the earliest and mildest signs of the disease. It could still take years before the drug is licensed and approved ; results from a further clinical trial won’t be reported until late next year ; then there’s the cost ( a worry in the UK and far greater worry in the Philippines ).


It would have been good to report this as more positive news, following on from the malaria vaccine reported in another thread. However, unfortunately the " Alzheimer’s drug " is no breakthrough ! Only tiny differences were found in " cognitive scores " ( tests of thinking, memory, problem-solving and language ability ) - which may mean little or nothing for the quality of life and may even have occurred by chance.


Let’s hope the results from the further trial next year are more convincing, and / or some other treatment(s) prove as effective for Alzheimer’s as recent advances in treatment for other common serious diseases like cancer, heart conditions and hepatitis C.


http://www.bmj.com/content/351/bmj.h4064