The Rise in Dementia - Term Paper Example

The Rise in Dementia Introduction Dementia, in its various forms, stands as a significant cause of functional problems or functional limitation among many people across the world. The disease, which mainly affects elderly people, has been ascending steadily in terms of prevalence over the recent past, and health projections show that the trend will continue to rise (APA 2012, p.1). While this is happening, the causes and cures of this devastating illness remain unclear to healthcare givers and scientists alike. Dealing with the disease and its progression is a fearful experience for many. Relatives are often bundled with distress on learning that the lonesome disease affects a member of their family. Moreover, it is saddening to view a member of the family becoming distant owing to the disease while battling with the disease. It is vital to understand dementia, its incidence, prevalence, as well as risk factors for its rising trend. This need to understand dementia has led to divergent views and several studies provides slightly differing views on the etiology, symptoms, and cures, especially for vascular and Alzheimer’s dementia. Background Information As people age, memory loss is inevitable and normally involves decreased capacity to retrieve information that is in the brain. Memory loss because of old age rarely affects the daily activities of a person. Individuals suffering from memory loss usually apply adaptive strategies like using sticky notes or preparing lists to preserve safety and independence. Over time, individuals develop mild cognitive impairment, which is a combination of symptoms defined as cognitive decline that exceed the expectations known for certain ages and levels of education. Just as memory loss, mild cognitive failure does not interfere with operations of a person from day to day. It does not stand as a diagnosis on its own, although it predisposes one to dementia (Harding et al. 2013, p.3). Dementia, on the other hand, refers to a disorder that involves loss of memory as well as the loss of one or more cognitive functions such as language, reasoning, learning, orientation, handling complex tasks, and spatial ability. At this stage, an individual experiences problems in articulating actvities of daily living (Bryden 2005). Dementia takes many forms that can fall into either Alzheimer’s disease or Non-Alzheimer’s dementias . Alzheimer’s forms of dementia are common ad byznd affect 60 to 80% of all who are affect by this disease. This form is characterized by pathological changes in one’s brain that lead to the loss of thinking, memory, behavior, as well as language. Ultimately, this form of dementia develops into other functional abilities. On the other hand, Non-Alzheimer’s dementias include disorders that are marked by loss of cognitive functions, memory, and other special clinical features (Harding et al. 2013, p.4). Other classifications of dementia such as vascular dementia and mixed dementia also exist. Vascular dementia occurs to around 30% of patients suffering from strokes. In such cases, patients experience stroke in large vessels leading to problems in speech, vision, and motor coordination, which is sometimes coupled by weakness and pain in the limbs. Vascular dementia also leads to slowness, poor judgment, and organizing or planning problems. Mixed dementia, on the other hand, involves cases in which patients suffer from more than one form of dementia, usually vascular and Alzheimer’s disease (Medifocus 2012, p.17). Rising Trend of Dementia Demographic data all over the world signify that the world is approaching another milestone. Over the years, children have increased in number as compared to old people. However, projections show that elderly people will exceed the number of children in the next five years. These demographic shifts are fuelled by rising life expectancy rates and falling fertility rates that are making the aging population to rise in number. Projections expect the population of the elderly to grow beyond 1.5 billion, with most of the elderly people increasing in developing countries. As this happens, a shift in the causes of disease and disability are also changing. In the previous years, communicable and parasitic diseases have been prevalent and have been the major causes of death, especially in developing nations. However, today, chronic and non-communicable diseases present an even bigger threat and diseases such as cancer and age related diseases are continually on the rise (WHO 2010, p.12). This demographic trend is present all over the world as cases of dementia, particularly Alzheimer’s continue to rise. Today, the number of old people facing the risk of developing dementia is on the rise and the disease presents as one of the most significant threats to the health of the elderly. Most people suffering from dementia eventually present the need to a member of the family of a friend who takes care of their needs constantly. Needs range from basic life activities to economic activities implying that the aging population presents both social a heavy social as well as economic burden. Prevalence increases exponentially with age. Worldwide data estimate the current prevalence rate at 25-30% of all people over the 85 years old. This demographic trend calls for urgent measures that will prevent the progression of Alzheimer and Non-Alzheimer related dementia all over the world (WHO 2010, p.13). Divergent Views on the Rise in Dementia Differing views exist on the causes behind the rising trend in dementia cases. These views aim at addressing the all too familiar concern of why dementia occurs to some people and not others. Over the recent past, several longitudinal have done as a lot in documenting major risk factors associated with the disease (Patterson et al. 2007). Among the most important risk factors are alcohol, diet, tobacco use, as well as vascular risk factors. Numerous genetic factors also appear to have causal links according to studies (Hsiung & Sadovnick 2007). Emergent findings that are contributing to the literature on dementia suggest that the disease may be on the rise due to inflammation, insulin resistance, oxidative stress, and mitochondrial dysfunction (de la Monte & Wands 2008). Additionally, growing research suggests that the reduction of cognitive capabilities is not a standardized process and that dementia or Alzheimer’s is not a single disease but a combination of several neurological failures that stem from environmental, genetic, and lifestyle factors that are unique to everyone (Hyman 2008, p.10). Genetic Risk Factors Over the recent past, dementia that is passed from parents to children appears to be on the increase. This has increased the attention given to genetic causes of the disorder by scientists. The assessment of genetic risk factors involves a thorough and accurate assessment of the family history of individuals with the disorder. Obtaining reliable information is not a hard task and family members can give important data such as age of onset and number of members previously diagnosed with the disorder. However, in situations where obtaining this subjective data fails, patients can undergo through tests that aid in confirmation diagnosis. Moreover, neuropathologic findings and clinical reports can assist in presenting the actual clinical picture. Scientific studies associate dementia that has an early age onset predominantly with genetic factors. Early onset dementia usually occurs before an individual attains sixty years of age. It accouts for a small percentage of all dementia cases, 6 to 7 percent. A small number of patients with a genetic form, 13%, have autosomal dominant familial genes that can pass across more than two generations. This implies that most people who have the genetic form of dementia do not transmit it to their grandchildren but only to their immediate children (Chertkow, 2008). According to Patterson et al., 2008, there are three known gene mutations that are directly associated with early onset dementia. The amyloid precursor gene, one of these gene mutations, situated on chromosome 21, causes increased cleavages to occur by the gamma and beta secretase enzyme rather than by the alpha secretase enzyme. The other genes associated with the dementia include presenilin 1 and 2. Patterson further denotes that these genes do not have known association with late onset dementia (Patterson et al. 2006). While most studies link gene mutations with early onset of Alzheimer’s dementia, there exist some that document gene linkages with late onset of the disease. Xiong, Gaspar, Rouleau, 2005, conflicts with Patterson’s views and posits that gene mutations do exist for late onset of dementia as much as they do for early onset of dementia. The study denotes that the most established genetic link for the progression of dementia is the allele 4 of the apolipoprotein E (APOE). This gene is also associated with the development cardiovascular diseases. Although its action is well known, its mode of action in dementia is unknown. The allele seems to shift the age of onset of dementia to a late onset, but the actions are few. Further studies show that individuals who possess this allele have a 30 percent higher chance of developing later onset dementia. In addition to that, first generation relatives with dementia have a double chance of developing late onset dementia than those who are first hand relatives (Xiong et al. 2005). Environmental Factors of Dementia It is argued that the rising trends of dementia are due to the increased toxicity levels of iron and aluminum (RobertYokel & Golub 1997). Research implicates heavy metals as well as solvents as possible risk or causal factors that lead to dementia. Theoretically, high amounts of iron could lead to the formation of oxidant stress and radicals in a humans body leading to the development of different illnesses including dementia. Current research on dementia’s genetic in genes and iron handling present useful outcomes. In addition to that, research has also documented proven results that link dementia disorders to aluminum toxicities. Over the years, epidemiological research has yielded results that link aluminum, tangles, and plaques. Additionally, scientists link aluminum and tau’s abnormal phosphorylation, a major element behind the neurofibrillary tangle. Aluminum is universal and caution over its exposure is required for populations at risk of developing dementia such as those that have dementia running in the family (Mccullagh et al. 2001). Another important risk factor of concern in the development of dementia is smoking. Studies conflict over the actual role of cigarettes in the development of dementia. Early studies posited that nicotine, a component in cigarettes, contributes to cognitive enhancement and thereby reduces the risk of developing dementia. However, current studies state otherwise and relate smoking to increased prevalence of vascular dementia. In particular, a current studies show that cognitive decline and dementia range anywhere between 40 and 80% for those who smoke all the time. Current smokers have shown to have an increased risk of developing Alzheimer’s dementia as well as an annual decline in cognition levels (Anstey et al., 2007). Although these results are promising, this area still needs further research to clarify the few grey areas and clear explanation of the factors behind the development of dementia. Developments in Medications Over the years, dementia has proved as a mysterious disease in its causes, progression, and treatment. This area remains controversial with many divergent views. In fact, some studies suggest that no medications can offer recovery effectively for dementia patients (Perry, 2007). Memantimine, donepezil, and dietary supplements such as resveratrol and ginkgo biloba feature as the main medications in use for patients with dementia. However, these medications and nutrient supplements have proven to be successful in stalling the rate of cognitive decline. Group Health’s diagnosis and treatment guideline does not discourage commencement of pharmacological regimens, but it advices doing so with behavioral or functional goals in mind, discontinuation of anticholinergic before commencement of acetylchonisterase, and creation of a medication plan to monitor the effectiveness of medications (GroupHealth, 2008). Conclusion It is evident that dementia, in all its forms, has been on the rise over the recent past. This article shows that the trends are set to rise in the coming years because of demographic shifts and increase in risk factors. Although various authors and researchers present divergent views concerning the causes behind the rising trend of dementia, it is agreeable that high prevalence and incidence rates are due to the rise in risk factors. In summation, GroupHealth advices proper administration of medication for dementia patients, that is in line with treatment guidelines, to ensure a reduction of complications and aggravation of the condition. References Anstey, K.J. et al., 2007. Smoking as a risk factor for dementia and cognitive decline: a meta-analysis of prospective studies. American journal of epidemiology, 166(4), pp.367–78. Available at: http://www.ncbi.nlm.nih.gov/pubmed/17573335 [Accessed March 19, 2014]. APA, 2012. Guidelines for the evaluation of dementia and age-related cognitive change. The American psychologist, 67(1), pp.1–9. Available at: http://www.ncbi.nlm.nih.gov/pubmed/21842971 [Accessed February 23, 2014]. Bryden, C., 2005. Dancing with Dementia: My Story of Living Positively with Dementia, Jessica Kingsley Publishers. Chertkow, H., 2008. Diagnosis and treatment of dementia: Introduction. Introducing a series based on the Third Canadian Consensus Conference on the Diagnosis and Treatment of Dementia. Canadian Medical Association Journal, 178(31), pp.16–21. GroupHealth, 2008. Current Pharmacologic Treatment of Dementia, Harding, E. et al., 2013. Dementia in my Family: Taking an Intergenerational Approach to Dementia, London. Hsiung, G. & Sadovnick, A., 2007. Genetics and dementia: risk factors, diagnosis and management. Alzheimers Dementia, 3, pp.418–27. Hyman, M., 2008. Dispelling the Myth. Alternative Therapies, 14(2), pp.10–12. De la Monte, S.M. & Wands, J.R., 2008. Alzheimer’s Disease Is Type 3 Diabetes-Evidence Reviewed. Journal of diabetes science and technology (Online), 2(6), pp.1101–1113. Mccullagh, C.D. et al., 2001. Risk factors for dementia. Advances in Psychiatric Treatment, 7, pp.24–31. 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