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1
Introduction
WHO IS THIS BOOK FOR?
ā¢ I think my memory is going?
ā¢ I have a relative or friend who has started behaving oddly?
ā¢ What is Alzheimerās disease?
ā¢ Is Alzheimerās disease the same as dementia?
ā¢ What can I do to stop getting dementia?
If these are the sorts of questions that you are asking yourself, this book is for you. Dementia is a disease of the brain. First, we define dementia before going on to list the symptoms. This chapter helps you decide whether you, a member of your family or a friend may have dementia.
Next, we discuss treatment and how to get help, and after that we give some tips on how to make the best of life if you or a loved one is found to have dementia. Then we consider how future developments may change the outlook for people with dementia, and describe some common questions and give some answers. Finally, we describe how the brain works. Some of that chapter is a bit technical, so you may decide to skip it.
There is a lot of myth and misinformation about dementia. This book is intended for anyone who has dementia or may be worried that they or their family and friends have dementia.
This book is also invaluable for people who live or work with someone with dementia.
We hope that by reading this book you will have a better understanding of what causes the illness and how it is diagnosed and treated.
WHAT IS DEMENTIA?
āDementiaā is a term used to describe any condition where a variety of different brain functions such as memory, thinking, recognition, language, planning and personality deteriorate over time.
Dementia is not part of normal ageing. Everyone gets more forgetful as they get older; that does not mean that they have dementia. The most common type of dementia is Alzheimerās disease, but there are several other types.
WHO GETS DEMENTIA?
Dementia is common. It is estimated that there are over three-quarters of a million people with dementia in the UK and this number is rising. As people get older the risk of dementia increases rapidly. It is estimated that one in five people aged over 80 years has some type of dementia.
Dementia can affect anyone. Prominent people such as Ronald Reagan, Harold Wilson, Margaret Thatcher, Iris Murdoch, Terry Pratchett and many other well-known names from all walks of life have developed dementia. It is a global problem, occurring in all ethnic groups and all social classes. No one is immune.
It is important to recognise when someone may have dementia. A swift and accurate diagnosis is important while people can still plan their lives and have a say in their treatment. Getting a diagnosis is also helpful to explain why someone isnāt getting on as well as they used to and it ensures that they get the necessary help. It is also reassuring to be told if you donāt have dementia.
FACTS AND FIGURES ABOUT DEMENTIA
Dementia is common; about 1 in every 90 people in the UK has dementia. In 2017, it was estimated that there were over 750,000 people in the UK with dementia and this will rise to over one million by 2030.
Dementia is rare below the age of 65, but can occur in people as young as 30. About 1 in 20 people over the age of 65 has dementia, rising to about one in five people aged over 80. Two-thirds of people with dementia live at home, and over three-quarters of people living in care homes have dementia.
Dementia is becoming more common because the biggest risk factor for dementia is getting older, and people are living longer. However, the number of new cases of dementia per 1000 of the population is reducing, mainly because of better general health. One in three people with dementia never get the condition diagnosed.
People who develop dementia often live for many years with the condition. Nearly everyone who has dementia will get worse over time and many people will eventually need to be cared for because they cannot live safely alone. It is not uncommon for someone to live seven to ten years after a diagnosis and then to die of something else.
DIAGNOSING AND TREATING DEMENTIA
The prospect of receiving a diagnosis of dementia is frightening. Other conditions such as depression and some physical illnesses (for example, Parkinsonās disease) can look like dementia. Dementia can be diagnosed only after careful assessment by a doctor.
In the last 20 years, there has been a great deal of research into treatments of dementia, and drugs are now available to treat memory loss and problems with thinking. There has also been a lot of progress in understanding how someone with dementia, and families and carers, can be supported.
In this book, we describe how dementia is diagnosed and treated. It is important to remember that not all the services and facilities described in this book are available in all areas.
LIVING WITH DEMENTIA
People with dementia can have a good quality of life with help, support and quality care. Dementia is not just about memory loss. Many other problems can occur during the course of the illness, including anxiety, depression, wandering, incontinence and aggression. These can be helped too, and we have included practical advice to help cope with the day-to-day problems that can occur in dementia.
Throughout this book, we have used examples to illustrate some of the problems and difficulties. Although these are based on real patients, we have changed the details to ensure anonymity.
Key points
ā¢ The term ādementiaā is used to describe the symptoms that occur when brain function is affected by a variety of different causes. Alzheimerās disease is by far the most common cause
ā¢ Dementia is not part of normal ageing
ā¢ Dementia is common, affecting over 750,000 people in the UK
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What Is Dementia?
Case study ā Mary
Mary, a retired factory worker, is 79 and lives alone after her husband died three years ago. Mary is becoming increasingly worried about her memory. Recently she went shopping and left her shopping trolley in the library when she popped in to return a book. On another occasion, she forgot her PIN number when collecting her pension from the post office.
She visited her doctor because she thought she was developing Alzheimerās disease. Dr Thomas listened carefully to her problems and ordered some tests. It turned out Mary did not have dementia. āAs we get older our memory does get worse,ā Dr Thomas told her. āBut a problem with memory alone does not mean someone is developing Alzheimerās disease, or any other dementia.ā
This chapter explains what dementia is, and outlines the common types of dementia and conditions that can mimic it.
DEFINING DEMENTIA
Dementia is a term that is applied to several different conditions that affect the brain. Just like the word āarthritisā refers to many different causes of joint pain, there are several different types of dementia, with subtly different symptoms. The most common cause of dementia is Alzheimerās disease, but there are many other causes.
Most kinds of dementia have similar symptoms, including:
ā¢ loss of memory, especially for recent events
ā¢ problems with thinking and planning
ā¢ difficulties with language such as not finding the right words for things
ā¢ failure to recognise people or objects
ā¢ a change in personality, for example becoming more argumentative
ā¢ developing depression, anxiety and other psychological problems.
Our brains (if we think about what our brains do) have many different functions. Making a cup of tea might seem simple but in fact this is quite a complex task and provides examples of several different brain functions:
ā¢ We imagine a cup of tea (abstract thinking) and decide to make one (motivation).
ā¢ We may ask whoever is with us if they want a cup (language).
ā¢ We plan making the tea, ensuring that things are done in the right order, putting the tea in before the boiling water (executive function).
ā¢ We remember where the tea, sugar and milk are stored (memory).
ā¢ We recognise the teapot and kettle (recognition).
ā¢ We...
