The News has launched its Take Care Together campaign to raise awareness of dementia and support those affected by the condition. Health reporter Priya Mistry finds out more about the condition and what causes it, and speaks to a nurse to find out how best to look after someone with dementia.
When you ask someone who hasn’t experienced dementia what the condition is, more often than not it’s dismissed as something that is a natural part of aging.
However that couldn’t be further from the truth as people of all ages can be affected by the condition.
The word dementia describes a large group of symptoms that affect brain nerve cells, causing them to die.
Ian Le Guillou is a research communications officer for the Alzheimer’s Society charity.
He says: ‘Dementia is an umbrella term that describes a range of diseases that all result in a long-term decline in mental ability.
‘Only in very rare cases is it hereditary – in most instances it is simply based on the individual person.
‘Getting dementia is also not a natural part of ageing.
‘As you get older you may experience a bit of memory loss, but that’s completely different to what dementia is, which is a disease.
‘Symptoms can vary quite a lot depending on what form of dementia you have but can include problems remembering birthdays and events, language problems and difficulty thinking and planning.
‘Alzheimer’s is the most-common form of dementia, but sadly no matter which form you have there is no cure.
‘There is also no way to slow down the effects of dementia – with Alzheimer’s you can have medication that can briefly delay symptoms but that’s only useful for early-onset and will only help for about six months.’
There is currently no cure and the condition gets progressively worse.
‘We are researching different drugs that could help, but that does require funding,’ adds Mr Le Guillou.
‘It’s not usually possible to say for sure why a particular person has developed dementia.
‘It’s known that high blood pressure, lack of physical exercise and smoking – all of which lead to a narrowing of the arteries – increase the risk of developing Alzheimer’s disease and vascular dementia.
‘But an important message to stress is that having a healthy lifestyle can help reduce the risk of dementia.
‘Regular physical exercise, maintaining a healthy weight, not smoking, and drinking only in moderation are all linked to a reduced risk.’
The charity also reminds people that it’s important that conditions such as diabetes, heart problems, high blood pressure and high cholesterol are all kept under control.
Portsmouth Hospitals NHS Trust, which runs Queen Alexandra Hospital, says all patients who come into A&E, and are aged 75 and over, have a dementia assessment within three days.
Patients are asked whether they have been more forgetful in the past 12 months to the extent that it has significantly affected their daily life.
If the answer is yes, they will need investigation – either during the admission or afterwards by their GP.
Around 1,300 patients a month take part in this assessment, and around 260 patients – 20 per cent – will require follow-up, some of whom already have a dementia diagnosis.
Bev Vaughan is a matron at Queen Alexandra Hospital, in Cosham, and works on the dementia wards.
She explains the kind of care staff strive to give and what works well to help someone with dementia.
She says: ‘We have been working really hard to support those who have dementia and have had many successes.
‘Many of our staff take part in dementia awareness, dementia simulation and dementia champion workshops.
‘Sometimes people with dementia will display challenging behaviours, and it is very important to understand that may be primarily as a result of feeling frightened and disorientated out of their own familiar environment.
‘A caring attitude can go a long way when looking after people with dementia.
‘A calm manner, and direct contact is key, and sometimes a simple explanation about where the patient is and what is happening, can be invaluable.
‘More than anything though, our work with all patients it is about compassion.’
VASCULAR dementia is the second most common cause of dementia.
This is caused by reduced blood supply to the brain due to diseased blood vessels.
Blood is delivered to the brain through a network of vessels called the vascular system.
If the vascular system within the brain becomes damaged – so that the blood vessels leak or become blocked – then blood cannot reach the brain cells and they will eventually die.
This death of brain cells can cause problems with memory, thinking or reasoning.
Someone with Alzheimer’s would see a steady decline, whereas with vascular it happens in sharp steps.
A person may not experience change for a while, but then suddenly go through a major change.
- Slowness of thought
- Difficulty with planning
- Trouble with language
- Problems with attention and concentration
- Mood or behavioural changes
It’s estimated that around 10 per cent of people with dementia have more than one type at the same time.
This is called mixed dementia, and the most common combination is Alzheimer’s disease with vascular dementia. However it’s often difficult to diagnose this as it’s hard to distinguish which form of dementia in killing which nerve cells and therefore causing the problems.
Autopsies play a key part in determining whether someone had mixed dementia and which forms.
ALZHEIMER’S disease is the most common cause of dementia.
It is named after the doctor – Alois Alzheimer – who first described it as a physical disease that affects the brain in the 1910s.
During the course of the disease, proteins build up in the brain to form structures called ‘plaques’ and ‘tangles’.
This leads to the loss of connections between nerve cells, and eventually their death and loss of brain tissue.
People with Alzheimer’s also have a shortage of some important chemicals in their brain, which are messengers helping to transmit signals around the brain.
When there is a shortage of them, the signals are not transmitted as effectively.
The earliest symptoms are memory lapses, such as difficulty recalling recent events and learning new information.
The person may lose items around the house, struggle to find the right word in a conversation, forget someone’s name, forget recent conversations or events, get lost in a familiar place or on a familiar journey and forget appointments or anniversaries.
Over time this can lead to problems with language, judging distances, concentrating, and losing track of things.
In the later stages of Alzheimer’s disease someone may become much less aware of what is happening around them.
They may have difficulties eating or walking without help, and become increasingly frail.
Eventually the person will need help with all their daily activities.
FOR some people with Alzheimer’s disease, the earliest symptom is not memory loss.
This is called atypical Alzheimer’s disease.
The underlying damage is the same, but the first part of the brain to be affected is not the part that controls memories, which means memory loss is not the first symptom to surface.
Atypical Alzheimer’s is more common in people diagnosed when they are under 65 (early-onset Alzheimer’s disease).
In this age group it represents up to one-third of cases and the typical forms are:
- Posterior cortical atrophy – occurs when there is damage to areas at the back and upper-rear of the brain.
These are areas that process visual information and deal with spatial awareness.
Early symptoms are often problems identifying objects or reading, even if the eyes are healthy.
Someone may also struggle to judge distances when going down stairs, or seem uncoordinated.
- Logopenic aphasia – involves damage to the areas in the left side of the brain that produce language.
The person’s speech becomes laboured with long pauses.
- Frontotemporal dementia – the front and side parts of the brain are damaged over time when clumps of abnormal proteins form inside nerve cells, causing them to die.
At first, changes in personality and behaviour may be the most obvious signs.
Depending on where the damage is, the person may have difficulties with fluent speech or may forget the meaning of words or objects.
The symptoms of these types of dementia are often different in the early stages but become more similar in the later stages.