The government has announced a pilot programme to screen 40-year olds for dementia. The government wants to make Britain “the best place in the world to live with dementia“.
There are about 850,000 in the UK who suffer from Alzheimer’s disease and other severe neurodegenerative problems (approx 70% have Alzheimer’s and 20% vascular dementia).
Only those over 65 have a mid-life MoT at present. If the pilot is a success it will be extended to all GPs allowing them to suggest ways that people can cope with it better.
Exercising more, controlling weight and blood pressure, and eating better, are a few ways that could help.
Another part of the project is to enlist people in research to allow doctors to better understand and treat the condition.
Dementia can be frightening and the Alzheimer’s Society says more than 9 out of 10 people think hospitals are frightening places. The health secretary has pledged that people in high dependency units will be seen regular by consultants, up to twice a day if appropriate.
Dementia support groups welcomed the shift in attitude from the government which has made dementia one of its top four priorities. “Many people with dementia face stigma and a health and care system that simply does not work for them resulting in emergency hospital admissions, extended stays and desperate loneliness”
Public Health England is looking at lifestyle as a risk factor and asking doctors to look at patients with high blood pressure, irregular heartbeats or early signs of type 2 diabetes (this is part of the mid-life MoT).
A study published by Cardiff University in 2013 had looked at the lifestyles of over 2,000 men aged 45-59 over 35 years.
It found that men who were non-smokers, who took exercise, kept their weight down, drank little and ate well, had a 60% drop in dementia and cognitive decline as well as 70% fewer instances of heart disease, stroke, and diabetes.
The director of research and development at the Alzheimer’s society says “What’s emerging is that what’s good for the heart, in terms of lifestyle, is also good for the head. We don’t yet understand why this is so and we need to do more research on it”
“If we could delay the average age on onset of Alzheimer’s by five years we could cut patient numbers (currently 850,000 and predicted to rise to 2 million by 2050) by a third” Dementia is the leading cause of death for women in England and Wales.
Researchers at Yale University think that helping people to have a more optimistic view of old age could delay the onset. They found that people with pessimistic views of old age, thinking that the elderly are irritable, slow to learn and forgetful, are themselves more likely to acquire the disease.
However it’s hard to untangle the psychological and medical factors given that early changes can take place 15 years before symptoms show. Recent US research suggests that forgetfulness in your 60s can be a sign of a higher dementia risk
However memory loss is not the only symptom.
Walking slowly could be an early sign of dementia, according to researchers in France who measured people’s walking speed and gait. Speed of walking has also been associated with life expectancy along with other simple tasks.
The researchers acknowledge that people could also be influenced by other illnesses such as cardio-vascular disease or depression which could have an impact on the brain.
Some of the symptoms might seem more obvious – like not recognising yourself in the mirror, forgetting how to work the microwave, or not knowing what day or year it is.
Even a warped sense of humour could be an early sign of dementia. So if you are laughing inappropriately at tragic events or enjoy slapstick humour they could be early warning signs which show up 9 years before other symptoms.
The leader of this research at UCL said “Personality and behaviour changes should be prompts for further investigation and clinicians need to be more aware of these symptoms as a potential early sign of dementia”.
There is a lot of research into this tragic condition and there is also some good news. The number of men developing the condition has dropped considerably since the 1990s when there were 42 cases per thousand population now down to 27. In older men over 85 the incidence has almost halved from 72 to 38 cases per thousand.
This has been attributed to men living healthier lifestyles than they did 20 years ago. However with obesity and diabetes on the increase among the middle-aged these gains might not be maintained. So its back to “what’s good for your heart is good for your brain”