Dementia in Australia - Diagnosis, Causes, Statistics, and the Relationship between Dementia and Nutrition - Coursework Example

Dementia and in Australia Insert name Insert institution Abstract This paper looks at mental issues in Australia with particular emphasis on Dementia, a mental health disorder most common among the elderly. This essay discusses the situation of dementia in Australia in general but draws close attention to the association of dementia with poor nutritional status. Also mentioned is the diagnosis, causes and statistics of dementia and the relationship between dementia and nutrition. The relationship between dementia and nutrition is closely associated with scientific research findings according to literature. The main aspects of nutrition discussed are Vitamin B12 deficiency, dietary fats and antioxidant. For validation of the argument, this essay is therefore closely associated with scientific research findings. In this essay, Alzheimer’s disease, by virtue of its predominant prevalence, represents various other mental health disorders whose contribution to dementia is small. According to research classification adopted in this essay, ‘mid-life’ is the range of 40 to 59 years while ‘late-life’ is 60 years of age or older. The term ‘elderly’ generally refers to adults above 65 years of age and ‘Young adults’ are those who are less than 40 years old. Introduction The impact of mental disorders in Australia has drawn a lot of concern. In the bracket of 16 to 85 years of age, about 3.2 million people (20%) suffer from a mental disorder. The total cost to the economy amounts to $20 billion including cost of carers and lost labour. Some disorders eventually give rise to dementia. Dementia by itself is a source of concern due to its impact on the economy and its increasing prevalence (Australian Bureau of Statistics (ABS), 2008). Dementia has traditionally been associated with natural aging; this is untrue because it is a mental disorder. Other factors such as behavioural tendencies account for the increase of prevalence of dementia. Poor nutritional status among the elderly contributes to this. If this argument is true, then what the society eats is of utmost importance. Poor nutrition here does not refer to lack of good nutrition but has to do with quality of nutrition. It is good to note that the effect of poor nutrition starts before one is elderly (Feng, Li, Yap, Kua, & Ng, 2009). Vitamin B12 is a crucial vitamin in the maintenance of the cognitive functions of the brain. The major highlight is that consumption of foods rich in this vitamin should take place early. Lack of this vitamin in during mid-life increases the chances of developing diseases associated with dementia such as Alzheimer’s disease. Highly saturated fats are unhealthy because they contain large amounts of cholesterol. It is unfortunate that cholesterol, apart from the myriad of problems it causes to people’s health such as heart complications, also causes increases the chances of dementia through diseases such as Alzheimer’s disease. Definition of dementia Dementia is a term that describes a syndrome characterised by decline in mental functions. These maladjustments include impairments in memory, language, perception, personality and cognitive functions. During the early stages of the syndrome, difficulties arise with familiar activities, for example, driving and shopping. With progression of the condition, basic functions such as dressing, bathing and eating become difficult. The behavioural, psychiatric and cognitive symptoms of dementia include a) memory problems especially short term memory b) difficulties in communication through speech and language comprehension, c) varying levels of confusion, getting lost or wandering d) personality and behaviour changes e) depression, delusion and withdrawal. In Australia, the most common types of dementia are dementia in Alzheimer’s disease, vascular dementia and dementia with Lewy bodies. Alzheimer’s disease is a degenerative disease of the brain that makes up about 50- 70 % of all cases. Vascular dementia results from an infection of the small blood vessels of the brain while Lewy bodies are abnormal brain cells that appear all over the brain (Chong & Sahadevan, 2005). Statistics of dementia in Australia In Australia, about 175,000 people had dementia in the year 2003; by 2005, the number had risen to almost 200,000. Out of this figure, females accounted for 64 %, 81% of the total were 75 years old and above. As the population grows, the number of dementia cases will rise dramatically unless there is a medical breakthrough. Since dementia is mainly age-related, the projected figure is about 465,000 people by the year 2030. Dementia is classified as mild in 96,000 people (55% of current estimates), 52,000 people (30%) are classified as moderate and 26,000 (15%) as severe. The majority of people with mild dementia live in households where family members or close relatives care for them. Those with moderate and severe dementia live in care institutions. In 2003, there were approximately 37,000 new cases of dementia reported. Out of this number, 23,000 were female and 14,000 male. About three-quarters of the impact caused by dementia are due to disability and not premature death. The higher figure for women is because women have lower mortality rate than men, dementia therefore has greater chance of setting in with advancing, this reflects in the statistics (Access economics, 2005a). Diagnosis of dementia Dementia manifests itself as a set of signs and symptoms and not as a single disease. Full diagnosis may require up to six months and the importance of early diagnosis is beneficial in many ways. Early diagnosis helps the family and carers of the affected to plan. This includes planning for living arrangements, care options, financial planning and addressing issues concerning the power of attorney. Diagnosis also helps in making decisions concerning rehabilitation programs and provision of aids and services. Also early assessment helps to identify measures to reduce risks, increase independence in daily tasks and enable modifications of the living environment to enhance function. Furthermore, diagnosis can reduce symptoms of dementia by facilitating the access to various medications. These medications may improve the ability to perform daily tasks, improve clarity of thought and reduce hallucinations and delusions (Black, LoGiudice, Ames, Barber & Smith, 2001). Characteristics and classes of dementia A single event may trigger dementia. For example, injury to the brain or repeated brain trauma may cause damage to some parts of the brain associated with normal cognitive functions of an individual, for example, games such as boxing or soccer. Neurosurgery, rapture of blood vessels in the brain during a stroke and infections may affect the brain’s long-term cognitive functions (Chong & Sahadevan, 2005). Dementia usually progresses slowly over a period due to neurodegenerative diseases that causes irreversible loss of brain cells and especially the neurons. As mentioned, Alzheimer’s and vascular disease account for the largest cause of dementia symptoms among the elderly. Changes at the gene level probably trigger mental disorders such as Alzheimer’s but the mechanism by which this takes place remains largely unknown (Chong & Sahadevan, 2005). Dementia is rare in young adults unless there is another predisposing factor such as mental illness, alcohol or drug use that may cause metabolic disturbance and genetic disorders such as Gaucher’s disease. Complaints of memory loss at any age may be because of nutritional deficiencies for example, vitamin B12, niacin and folate or chronic diseases such as HIV or syphilis (Chong & Sahadevan, 2005). Nutritional status and relationship to dementia Vitamin deficiency Research shows that there is a link between vitamin deficiency and dementia. The most crucial vitamin in the series is Vitamin B12. It is one of the eight vitamins of the B-vitamins series. It plays are a crucial role in the functioning and maintenance of the central nervous system and in the formation of red blood cells. Some of the sources of vitamins include dairy products, meat, fish, fortified cereals and a wide variety of animal proteins. Vitamin deficiency was associated with a disease called pernicious anaemia but has since been linked to other diseases. The liver can store Vitamin B12 for a prolonged period; however, people who follow strict vegetarian diets are likely to develop Vitamin deficiency compared to non-vegetarians. According to a survey conducted among older people aged 61 to 87 years, people with higher vitamin B12 levels in their blood are more than five times less likely to experience brain volume loss (brain shrinkage). Brain shrinkage is associated with Alzheimer’s disease, the major cause of dementia among the elderly (Feng, Li, Yap, Kua, & Ng, 2009). Vitamin B12 may prevent loss of brain volume among the elderly people. It is still not clear though, whether lower vitamin B12 values may lead to deterioration of cognitive functions due to its effect on brain size, but the role of vitamins in the production of vital chemicals required for the brain’s normal function remains a fact already established. Elderly people need close monitoring for vitamin deficiency because their digestion of vitamins as efficient as for younger people. During digestion, gastric acid is responsible for the release of Vitamin B12 from proteins to which it is bound. An intrinsic factor released by the gastric parietal cells, enhances absorption of Vitamin B12 into the blood stream. Many elderly people have insufficient amounts of this factor therefore, when tested for vitamins; they might report a low value the same in spite of consuming the required vitamin quantity in the diet. More than 30% of adults aged over 60 years suffer from this problem. Other benefits of Vitamin B12 include, boosting of brainpower and preventing neurological damage due to anaemia (Feng, Li, Yap, Kua, & Ng, 2009). Dietary fat and dementia Dietary fats increase the risk of Alzheimer’s disease and in effect, dementia. Fat composition of food affects blood cholesterol levels in the blood. This is more so with diets that consist of a high ratio of saturated fats to poly- or monounsaturated fats. Hydrogenated vegetable oils contain trans-unsaturated fats mainly from vegetable oils that are widely used in bakeries and restaurants. These fats are particularly harmful and are highly hypercholesterolemic. Cholesterol plays a part in Alzheimer’s because it generates and deposits A-beta that is a significant risk factor for Alzheimer’s disease. High cholesterol level in the blood of persons in mid-life increases the development of dementia through diseases like Alzheimer’s by up to three times in late-life (Morris, Evans & Bienias, 2003). Antioxidants and their effect on dementia There are certain proteins that accumulate in the brains of people with mental health disorders such as Alzheimer’s disease. These protein growths or plaques damage nerve cells. Although the exact mechanism by which these plaques form is unknown, some highly reactive, naturally occurring molecules known as free radicals are partially responsible for plaque formation. Antioxidants have the capability of binding and inactivating these radicals, this is a very promising prospect. Diets high in vitamin C and E are the main source of anti-oxidants. Initial study shows that smoking increases the likelihood of increasing free radicals in the body. This is significant since the habit negates any potential gains gotten from the action of antioxidants (Reddy, Zhu, Perry & Smith, 2009). Measures to improve nutritional status Any planned efforts to reverse the negative trends cut across all spheres society. Individuals need to check the food that they eat. Vegetarians in particular have to take great measures to ensure that they supplement lack of vitamin B12 in their diets, if alternative food sources are scarce then use of vitamin supplement pills is option of consideration. However, it is advisable to consult a medical practitioner for check up and advice. In fact, everyone should get a medical check on vitamin level in the blood to prevent possible vitamin uptake problems that may be unknown. For adults above 55 years this must be a priority due to the point discussed earlier, of increased vitamin uptake difficulty with increasing age. Food choice requires awareness among individuals, for example, some of the fast foods or convenient foods so popular in society today contain harmful substances such as saturated fats. Although these foods are well packed and presented, most are prepared using the cheapest substances possible due to profitability, this area that requires a lot of attention and focus (Clark & Karlawish, 2003). The government should coordinate preventive health reform and put in place structures whereby people can make useful contributions to this issue. The government should also put in place mechanisms to check food manufacturers with regard to food quality in terms of vitamin, fat and cholesterol levels. For example, the packagings of food substances must clearly show the constituents or ingredients in the product. This calls for genuine openness and integrity. This shall enable consumers make relevant decisions when buying food items. Food industry players should themselves take the initiative willingly. They should look for alternative food materials that have higher values of vitamins B12, C and E. Further, they should aim at processing foods using unsaturated fats. These may call for greater investment. The healthcare sector needs to go beyond just treating people but also to guide and advice people on preventive measures. Greater investment is required this sector in order to adopt and implement effective preventive healthcare measures (Access Economics, 2005b). Economic and social costs of dementia to society It costs the economy $6.6 billion to cater for costs associated with dementia. This is equivalent to $40, 000 per year per person with dementia. This includes career costs, lost earnings, patient mortality burden and the cost of aids and home modifications (Access Economics, 2005b). In 2002, about 5,000 people lost their lives due to dementia. Dementia is responsible for an increasing number of deaths in Australia. Dementia and related disorders were the fourth leading cause of death for females, overtaking breast and lung cancer. Deaths due to Alzheimer’s disease have increased form 0.8 out of every 100,000 males in 1980 to 6.6 out of 100,000 in the year 2000. For women, the number rose from an initial of 0.4 deaths per 100,000 to 9.2 deaths per 100,000 over the same period (Access Economics, 2005b). Conclusion In conclusion, from the foregoing discussion in this paper, the fact that poor nutritional status triggers dementia is now without doubt. However, research conducted so far is not conclusive. For example, although research shows that overweight and obesity at mid-life increase the likelihood of developing dementia in late-life. Nevertheless, whatever research has uncovered so far is enough to indicate the need of addressing food and nutrition issues as a matter of urgency. Since the disorders leading to dementia such as Alzheimer’s have no cure, then the only option that remains is enhancing and improving preventive measures to reduce vitamin deficiency, cholesterol uptake and behavioural aspects such as smoking. In developing countries, where food security is low, vitamin deficiency results from actual lack. However, in Australia, a developed nation, the issue is about quality and not quantity. As research continues, new policies designed primarily to improve people’s nutritional status will go a long way in reversing the already alarming rate on prevalence of mental disorders such as dementia. This is a matter of urgency. References Access Economics. (2005a). Dementia estimates and projections: Australian states and territories. Canberra: Alzheimer’s Australia. Access Economics. (2005b). The Dementia Epidemic: Economic Impact and Positive Solutions for Australia. Canberra: Alzheimer’s Australia. Australian Bureau of Statistics. (2008), 2007 National Survey of Mental Health and Wellbeing: Summary of Results (ABS cat. no. 4326.0). Canberra: ABS. Black, K., LoGiudice, D., Ames, D., Barber, B., & Smith, R. (2001). Diagnosing dementia: a reference paper. Canberra: Alzheimer’s Australia. Chong, M.S., & Sahadevan, S. (2005). Preclinical Alzheimer’s disease: diagnosis and prediction of progression. Lancet Neurology 4, 576–9. Feng, L., Li, J., Yap, K-B., Kua, E-H., & Ng, T-P. (2009). Vitamin B-12, apolipoprotein E genotype, and cognitive performance in community-living older adults: evidence of a gene- micronutrient interaction. The Journal of American Clinical Nutrition. 89(4), 1263 - 1268. Morris, M.C., Evans, D.A., & Bienias, J.L (2003).Dietary fats and the risk of incident Alzheimer's disease. Arch Neurol.60, 194-200. Reddy, V.P., Zhu, X., Perry, G., & Smith, M.A. (2009). Oxidative stress in diabetes and Alzheimer's disease. J Alzheimers Dis. 16(4), 763-74. Clark,C. M., & Karlawish, J.H.T.(2003). Alzheimer Disease: Current Concepts and Emerging Diagnostic and Therapeutic Strategies. Ann Intern Med, 138(5), 400 - 410. Read More