Dementia

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Dementia is a condition associated with an on-going decline in the brain and its abilities; it can lead to having problems with memory loss, thinking speed, understanding, judgement and language. It is an umbrella term for different conditions that involve a decline in cognitive abilities that interfere with daily life[1]. There are currently around 800,000 people in the UK with dementia and one in three people over 65 will develop dementia; with current estimations that by 2025, dementia sufferers in the UK will reach one million[2].

Alzheimer’s disease, Lewy Bodies, Vascular Dementia and Frontotemporal are the most common types of dementia. Less common variants can include: Parkinson's disease, Creutzfeldt-Jakob disease, Huntington's disease and various others. With Alzheimer’s disease being the most common variant, with about sixty-two percent of UK dementia sufferers having this form of condition[3]. Early onset dementia is another key variant, where dementia-like symptoms can be diagnosed at a generally accepted early age. With most early-onset cases showing symptoms of Dementia between the ages of forty to fifty years old[4].

Contents

Symptoms

The key symptoms of dementia can include[5]:

Causes

Dementia is caused by gradual changes and damage in the brain. The most common causes of Dementia involve the brain cells degeneration and hence die more quickly than they would as part of the normal ageing process. The changes usually happen because of a build-up of abnormal proteins in the brain. This damage leads to a decline in a person's mental and sometimes, physical abilities. The abnormal proteins are different and have differing effects in each type of Dementia[6]. Causes of conditions involved with Dementia may be genetically linked, as polymorphisms in the APP gene is a significant factor in causing Alzheimer's disease and Huntington's disease is caused by a autosomonal dominant inherited mutation[7].

Treatment

At the present moment, there are no drug treatments that can cure the common types of Dementia. However, medicines have been developed which can temporarily alleviate symptoms, or slow down their progression[8]. There are two types of medication used to treat Alzheimer’s disease: Acetylcholinesterase inhibitors and NMDA receptor antagonists. The generic names for the Cholinesterase inhibitors are Doneprezil, Rivastigmine and Galantamine; these can temporarily improve or stabilize memory and thinking skills. A specific type of NMDA receptor agonists called Memantine prevents a decline in learning and memory[9]. There are currently no medications to treat other types including Dementia with Lewy Bodies, Parkinson’s disease, Frontotemporal disorders or Vascular Dementia, yet treatment currently focuses on reducing symptoms by making more people comfortable living with the condition. There are research projects being undertaken that involve treatment using: BACE (B Amyloid Cleaving Enzyme) inhibitor, which stops amyloid being produced. There are trials involving anti-amyloid treatment, which are immunizins against amyloid[10].

There are also many alternative psychological treatments being used such as there are increasing numbers of Dementia villages (as found in Hogewey, Netherlands[11]), dementia cafés and increased awareness of Dementia related conditions. The latter involves promoting the education of the public, through celebrity endorsed advertisements[12] and fundraising events for various Dementia related charities[13].

References.

  1. http://www.nhs.uk/conditions/dementia-guide/pages/ about-dementia.aspx
  2. Alzheimer's Society. Dementia 2014 report statistics. cited [4/12/16] Available from: https://www.alzheimers.org.uk/statistics
  3. http://www.nhs.uk/conditions/dementia-guide/pages/ about-dementia.aspx
  4. https://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=164
  5. http://www.nhs.uk/Conditions/dementia-guide/Pages/symptoms-of-dementia.aspx
  6. NHS Choices. Causes of Dementia. Cited [4/12/16], Available from: http://www.nhs.uk/Conditions/dementia-guide/Pages/causes-of-dementia.aspx
  7. https://ghr.nlm.nih.gov/gene/APP#conditions
  8. http://www.nhs.uk/Conditions/dementia-guide/Pages/dementia-cure.aspx
  9. Dementia and Healthcare. NHS Booklet.
  10. NIHR DENDRON Research Questionnaire. DJ. cited [January 2016]
  11. http://hogeweyk.dementiavillage.com
  12. https://www.youtube.com/watch?v=x9MvEZskR6o
  13. https://www.alzheimers.org.uk/site/scripts/documents.php?categoryID=200388
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