NOW WHERE HAVE I PUT MY GLASSES? A DISCUSSION AROUND DEMENTIA Dr Marion Overton U3A SCIENCE 19TH JUNE 2015

Possible reasons for misplacing glasses Poor vision “Usual place” not there Preoccupation Disorientation  Including “Toxic confusional state” Any other disturbance of brain function  Eg depression, stroke

What is Dementia? “Loss of recent memory” Brain cells die more quickly than in normal ageing Permanent Cognitive ability no longer adequate to cope with one’s environment

How common is it? >800,000 people with dementia in UK Estimate > 1 million in ,000 aged under 65 In Derbyshire, 11 new diagnoses / day Cost: £26.2 billion per year  Family & friend carers save £11 billion/year

Types of Memory Working memory -short term (7 items) Episodic  past events & emotions Semantic  words & facts  familiar faces & objects Prospective - future events Procedural - learnt activities (see “The Memory Handbook”)

Brain Structure

Causes of Dementia Alzheimer’s disease

Alzheimer’s Disease

Causes of Dementia Alzheimer’s disease Vascular Lewy Body

Lewy Body dementia

Causes of Dementia Alzheimer’s disease Vascular Lewy Body Rarer causes, some treatable, eg  Alcohol  Low vitamin B12  Low thyroid hormone

How do I spot it in others? Recent memory Other brain function involvement eg  Movement and Coordination  Swallowing and speech  Personality Challenging behaviour

How is dementia diagnosed? Not by GPs! Memory testing eg MMSE Psychiatric assessment Review of medication Blood tests Brain scan

How can it be treated? Cholinesterase inhibitors (MMSE 20-10)  Aricept (Donezepil hydrochloride)  Exelon (Rivastigmine)  Reminyl (Galantamine) Occupational therapy, speech and language, community psychiatric nurses (National Dementia Strategy 2009)

How can we help someone with dementia? “24-hour wraparound care for lifelong well- being” Contented Dementia by Oliver James ISBN No questions 2. Learn where your friend’s mind is now 3. Don’t contradict

Practical care Research dementia care homes Lasting Power of Attorney, and a Will Claim benefits Lots of reassurance! But safety issues Get help with Challenging Behaviour Care for the Carers Become a Dementia Friend

How can I avoid getting dementia? Genetic forms Vascular Delaying the onset  “reinforcement of your cognitive reserve”  “better recruitment of your neuronal network”

Current Research areas Genetics –Alzheimer’s disease and Vascular dementia Early Diagnosis –abnormal proteins eg amyloid- beta Clinical tests for different types of dementia New drug treatments Immunotherapy –antibodies against rogue proteins

Thank you Literature Alzheimer’s Society  Help the Aged, Age Concern Friends Carers Elder Abuse response line