West Berkshire & North Hampshire

By Dr Richard Rudgley

Most families will be affected at some stage by dementia and with an ageing population doctors are seeing more patients in their surgeries, on home visits or in local residential homes.

A dementia sufferer has seen a progressive decline in their mental abilities, such as memory and problem solving. Alzheimer’s disease is the most common form of dementia accounting for 60% of cases. There are many other causes of dementia including vascular (related to mini-strokes), the uncommon condition Lewybody and the very rare dementia related to BSE (mad cow disease).

Over the age of 65, about 1 in 14 people suffer with Alzheimer’s and that rises to 1 in 6 over the age of 80. At the present time nearly 600,000 people are diagnosed with dementia in the UK.

Symptoms

At first, the symptoms are mild and advance slowly over a seven to ten year period. Gradually the brain loses function and the person may initially develop short-term memory problems, confusion and mood swings. Then the person may show repetitive behaviour, have hallucinations and develop delusions where they believe things that are false. At the later stages they may show a complete loss of memory, become incontinent problems such as swallowing and weight loss. Life expectancy can be reduced; not because of the Alzheimer’s directly but because of the increased frailty which puts the person at increased risk of infection.

Causes

Alzheimer’s is due to increasing damage in the brain and those parts then ‘waste away’ or atrophy. It is not known what causes this to happen but we know of some risk factors including age and hereditary, especially if you have a relative who developed the condition at a young age. It is also more common in people with Down’s syndrome and if there is a history of severe head or neck injury.

In the early stages it can be difficult to diagnose and the symptoms can be similar to those of other conditions such as vitamin deficiencies, thyroid conditions plus stress, depression and anxiety. There is no definitive test but if the condition is suspected, blood tests and a brain scan can help. Specialists may carry out an examination of your memory and thinking skills called the Mini Mental State Examination and a score below 26 out of 30 may indicate the condition.

What next

There is no cure for Alzheimer’s but an early diagnosis is helpful in terms of planning and medication which can slow down the progression of the disease. There are now four drugs available and these can only be prescribed after assessment by a specialist. The government agency NICE presently permits these to be prescribed only for those patients with moderate symptoms but it is likely that later this year these drugs will be available to patients with the early symptoms of Alzheimer’s. 

Just as important as medication is a care assessment plan where present and future health and social care needs are agreed. This is co-ordinated by the patient and family, together with health professionals and social services.

The assessment will include functioning ability in areas such as driving, ability to wash, feed and care for yourself plus financial needs and who is able to support and care for you.

Further information can be found on the website of the Alzheimer’s Society http://alzheimers.org.uk/.