Dementia By Chelsea Carr

Key features of dementia Dementia is not a single specific disease. It is an term describing a syndrome associated with more than 100 different diseases that are characterised by the impairment of brain functions, including language, memory, perception, personality and cognitive skills. Although the type and severity of symptoms and their pattern of development varies with the type of dementia, it is usually of gradual onset, progressive in nature and irreversible. The four most common forms of dementia include Alzheimer disease Vascular dementia Lewy body disease Frontotemporal dementia

Why has it been selected as a NHPA? Dementia is one of the most recent additions to the NHPA, only being included in 2012. In 2010, dementia was the third most common cause of death, accounting for 6% of all deaths nationally. And contributing significantly to morbidity rates. Dementia was recorded as the underlying cause of 9,003 deaths across Australia—on average, 25 people died from dementia every day.

Burden of disease Dementia accounts for around 4% of the total burden of disease (BOD) in Australia, and it has the 4th largest contribution to burden of disease overall. To those aged over 65, dementia is the second largest contributor to BOD behind cardiovascular disease There are approximately 321,600 people living with dementia in Australia at this present time. This number is only expected to increase

Alzheimer disease The most common form of dementia Accounts for around 2/3 of all cases Most common in those aged over 65, but can also occur in younger ages This disease is characterised by the build-up of proteins both in and around the brain cells. This build-up limits the ability of messages to be transmitted between the cells, causing the brain to become impaired. The first signs of Alzheimer’s include memory loss and vagueness in conversation.

Vascular dementia A form of dementia that occurs as a result of reduced blood flow to the brain This can be caused by a series of small strokes or any similar damage to blood vessels and circulation. The brain becomes impaired due to lack of function from reduced nutrients and oxygen being delivered to the brain. Symptoms include problems with attention, spatial awareness, reasoning & judgment.

Dementia with Lewy bodies Lewy body disease is another common form of dementia This is caused by spherical proteins known as Lewy bodies inside the nerve cells of the brain. Lewy bodies are responsible for the degeneration of nerve cells. A diagnosis is often difficult for this form of dementia as it is often mistaken for Alzheimer’s. Symptoms include problems with concentration and attention, confusion, hallucinations, tremors and stiffness & variations in mental state.

Frontotemporal dementia Frontotemporal dementia is a disease characterised by progressive damage to 2 specific parts of the brain; the frontal lobe and the temporal lobe. Majority of the time both lobes are affected The frontal lobe is responsible for judgment and social behavior, so people affected have issues maintaining appropriate social behavior. The temporal lobe is responsible for language. This affects the way words are comprehended and the inability to speak fluently.

Determinants that act as a risk factor - BIOLOGICAL AGE: 65+ years have a higher risk of developing dementia. GENDER: more common in females most of the time, except with lewy body disease, which is more common in males. GENETICS: those with a family history of dementia have a higher risk of also developing it BLOOD PRESSURE: people with higher blood pressure are more likely to develop dementia BODY WEIGHT: obesity puts people at a higher risk of developing dementia.

Determinants that act as a risk factor - BEHAVIOURAL Tobacco use: puts people at a higher risk of vascular dementia. Inactivity: causes blood vessels to deteriorate, causing a higher risk of developing VD. Alcohol consumption: alcohol abuse can lead to ‘alcohol dementia’ Food intake: higher intakes of fats increase risk of developing dementia.

Determinants that act as a risk factor – PHYSICAL ENVIRONMENT Environmental tobacco smoke: increases risk of developing CVD and therefore vascular dementia. Recreational facilities: lack of access to recreational facilities decreases the amount of physical activity being done, therefore leading to obesity and vascular dementia. Quality of air: smoke, chemicals & hazardous substances in the air increase risk of dementia.

Determinants that act as a risk factor - SOCIAL The link between social determinants and dementia have not been proven, although it is believed that the following factors have impacted the risk of dementia: Level of education: lower levels of education may lead to higher risk of dementia. Social exclusion: those who are less socially active may experience and increased risk of dementia.

Direct, indirect & intangible costs Direct: direct costs of dementia are associated the diagnosis and management of the condition. In 2011, the direct costs of dementia were around $1million in 2009-10, the government contibution for medication used specifically to treat dementia was around $60million. As these medications were funded though the Pharmaceutical Benefits Scheme, sufferers or their families are also responsible for making a co-payment. The cost of implementing health programs such as the Your brain matters program is a community cost of dementia.

Direct, indirect & intangible costs Indirect: dementia leads to the complete dependence on other people. Formal assistance relates to carers who are paid for by the individual, family or government funded financial assistance. Non-formal sources include the care provided free of charge by family, friends, and neighbours. In 2009-10 the cost of formal care was over $3billion If carers are family or friends, they may be required to give up their employment . This reduces productivity and can impact the community.

Direct, indirect & intangible costs Intangible: when first diagnosed, the individual may feel emotions such as sadness, anger, frustration, fear and despair. Family and friends will also experience a sense of loss and sadness if the individual no longer remembers who they are or the relationship they share.

Health promotion strategies YOUR BRAIN MATTERS A program initiated by Alzheimer’s Australia. It is a non-government organization that raises awareness and works to reduce the risk of dementia. Focuses on improving modifiable risk factors in order to reduce the risk of developing dementia Your brain matters works by providing a number of resources including the brain health program, and dementia-related health sheets. http://www.youtube.com/watch?v=e7cuaZa8LUM http://www.youtube.com/watch?v=GgmGBNJpUjw&list=PLAwhBH-4GO5hhph5bUaZJVEv7a6DQXbhB

bibliography http://www.aihw.gov.au/dementia/ https://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=10737423074 Health and human development text book- 3rd edition