Dr Matthew Knight

Dementia and the G8

We usually associate G8 conferences with rallies against globalization and rescue packages for the world economy. Yet today world leaders have committed to furthering international efforts to fight dementia- one of the greatest ticking time bombs threatening our society. The UK government alone will double expenditure from its current 60 million pounds to over 130 million pounds by 2025.

The G8 have stated that it would “develop a coordinated international research action plan to target the gaps in research and ways to address them” (1) The Alzheimer’s Society state that there are 800,000 people in the UK with dementia (2), the vast majority of whom are over the age of 65. There are an estimated 44 million people world wide that currently suffer from dementia and how society will meet the challenge of their ongoing medical and home care needs is not yet clear.

The term dementia describes a wide range of conditions- characterized by the progressive decline in the brain’s function. It often presents with difficulties with memory in the first instance, but may also present with general cognitive functions, language skills, mood and judgment (3).

There are many causes of dementia- but the most common ones include Alzheimer’s Disease (where protein structures called plaques and tangles deposit within the cells of the brain causing cellular dysfunction), Vascular Dementia (where brain cells are damaged due to blockage of the blood supply resulting in small strokes), Dementia with Lewy Bodies (a disease with some similarities to Parkinson’s Disease, which results from abnormal protein collections called Lewy bodies depositing in the frontal lobe of the brain- mainly affecting judgment and causing hallucinations) and Fronto-temporal dementia (where damage to brain cells in the front of the brain results in personality and character changes in the early stages). There are up to 100 different causes of dementia.

The accurate diagnosis of dementia is vital- to ensure that appropriate treatments and services are made available (both now and as new treatments become available in the future) and to ensure that reversible causes of confusion are addressed (for example recurrent urinary tract or chest infections, poor eye site, high blood pressure and cholesterol increasing the risk of progression of vascular dementia). The diagnosis of dementia often involves being seen by a specialist following consultation with a GP, and may involve referral to a memory clinic and will usually involve a number of blood tests and a scan of the brain.

The diagnosis of dementia can come as quite a shock and accessing appropriate support is vital. Your GP and specialist can advise on this. A large amount of support material can be found via the Alzheimer’s Society website http://www.alzheimers.org.uk which provides a wide variety of information booklets and links to local support agencies and services.

We are please to see that in patients where the diagnosis of Alzheimer’s versus another form of dementia is unclear, a new dementia brain scan that detects Amyloid protein in the brain (which is a characteristic sign of Alzheimer’s disease) is now available here in the UK.

Once dementia is diagnosed a specialist will decide on whether drug treatments which slow down the process of loss of brain cell function and neurotransmitter depletion are likely to be beneficial (at present these medicines do not slow the rate of cell death down) (4)

As the process of dementia advances, it is likely that more support services will be needed. Home care services can provide a vital support facilitating activities of daily living such as helping with washing and dressing, medication reminders, shopping through to providing companionship and company.

Increased funding into research in dementia will help us identify treatments to slow the process down or even reverse some of the damage already done and investigate further the risk factors associated with dementia. A recent 35 year longitudinal study from Cardiff University found that exercise was the single biggest influence of dementia levels (5)- hopefully future research will delineate the mechanisms underlying these associations and help us find a better cure for dementia. We believe that this combined and coordinated approach from the worlds leading countries will help us fight the battle against dementia, which has scarred the lives of so many families.

At Penrose Care we provide support to our clients with various forms of dementia, and are happy to liaise with family and the patients doctors and hospital nurses to ensure that each client is adequately cared for. We provide a range of services in our clients homes ranging from short term respite care (from regular respite 1 day per month through to a few weeks to cover a holiday for a spouse), through to intensive home care packages in the home. We aim to maximize quality of life and independence for our clients.

Dr. Knight trained as a doctor at the Royal Free Hospital School of Medicine, Hampstead and University College London (UCL). He then undertook his postgraduate training in Internal Medicine, based in north west London, and is currently working full time as a Registrar in Respiratory Medicine, at the Barnet General Hospital. His main interests are Asthma and allergy and he is currently studying part time for a Masters degree in Allergy, at Imperial College London. Dr. Matthew Knight is the co-founder and non-executive director of Hampstead-based Penrose Care, a provider of home care services in London to the elderly – including to persons with dementia – and to non-elderly adults with physical and/or learning disabilities.

Penrose Care is proud to be only one of four Accredited Living Wage Employers in the London home care sector out of over 1,000 agencies and the first independent sector home care organisation in England out of over 7,000 agencies to be compliant with Citizens UK’s landmark Social Care Charter, an ethical pathway for social care providers. Penrose Care provides short care at home visits, day sitting, night services including sleepovers, and live-in care services.

References

1) “G8 ‘will develop dementia cure or treatment by 2025′”: 10 Dec 2013 (BBC News, 2013), http://www.bbc.co.uk/news/health-25318194

2) What is dementia? Fact Sheet: March 2012 (Alzheimer’s Society, 2012) http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=106

3) About Dementia – Dementia Guide (NHS, accessed 11 Dec 2013) http://www.nhs.uk/Conditions/dementia-guide/Pages/about-dementia.aspx

4) “Dementia: Five Priorities”: 10 Dec 2013 (BBC News, 2013), http://www.bbc.co.uk/news/health-25263341

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