Prevalence and impact of dementia in Australia

Question

Choose one of the chronic diseases or determinants outlined below, you can choose a different one from the 4 below if preferred

• Oral Health
• Dementia
• Hearing Disorders (focus on childhood middle ear conditions)
• Hypertension (high blood pressure)

Prepare a detailed project plan for an innovation in chronic disease health education, promotion, prevention or management for an Australian community. Explore how you anticipate it will improve health outcomes for the chosen community?

Dementia is a condition that is connected to a number of disease and is featured by the impairment of brain functions like memory, understanding and reasoning. Early symptoms include difficulty in remembering and later it the symptoms may be worse like difficulty in performing day to day activities. The major cause of dementia is Alzheimer’s disease. The second cause of dementia is Vascular dementia and the other causes are  front temporal lobar degeneration and dementia with Lewy bodies (Ratnavalli E et al, 2002). For the Australians Dementia is a major health crisis. As estimated 222,100 people in Australia suffered from it in 2011 and this is to increase  to 464,000 by 2031. Few people get the support from the family and friends and the others depend on support from the organizations or the paid support. The interventions provide improvement in disabilities and functioning but do not suppress of the disease. In the later paragraphs the frequency, causes, the prevalence, the modifiable and non modifiable risk factors, the services used up by the patients, the mortality rates are given. All these things are explained in detail.

It is increasing with age and its an inevitable part of ageing and affect young people also. It is increasing due to population ageing and the growth in population. It affects few people who are under 65 that is 1 in 4 and who are 85 years of age. The prevalence in female is far more than males, especially in their old age. This id due to the long life of males and the prove that the dementia is a old age disease probably. The studies show that the rate of dementia is higher than given in the data collected. The AIHW is coming up with new methods that gives more accuracy to the prevalence results and the projection. In studies it has been seen the victims of Dementia are higher in the Indigenous Australians. In a study of Kimberley region of the Northern Territory, the rate of Dementia was 12% in the Aboriginal peoples who are 45 years of age or more than that. Here the Dementia is more common in males than females. The reason behind this is the low social and health profiles among these Aboriginal Australians (Seeher et al. 2011).

Many conditions prevails in humans that can cause Dementia. Of them the most common are explained below:

• Alzheimer disease: It is approx for 50 to 80% of the Dementia conditions which cause abnormal plaques and tangles in the human brain.
• Vascular dementia: It is the damage of the brain that is due to cerebrovascular diseases like stroke.
• Lewy bodies: In this abnormal proteins known as lewy bodies develop in brain cells.that affects the functions of brain (Draper 2011).
• Fronto temporal lobe dementia: It is the damage to the front part of the brains in which there are symptoms that are related to the personality and behaviors in the intial stages of Dementia.
• Other type: They are alcohol induced dementia, head injury dementia, Parkinsons disease dementia and Huntington dementia.

The frequency of occurrence of dementia is a major concern. The risk factors are being researched out to stop the frequency of occurrence. Risk factors are the determinants  to tell about the basic causes of the dementia (Sager et al, 2006). The risk factors are of two categories the modifiable and the non modifiable. The non-modifiable risk factors for dementia are explained below:

• Age: The frequency increases with the age. About 1 in 30 Australians who is between 70 to 74 is having dementia, 1 in 8 Australians aging between 80 to 84 have dementia. About 1 in 3 Australians who is between 90 to 94 have dementia (Berr et al, 2005). The female who are aged are more prone towards the disease than the males.
• Genetics: There are inherited genes in the various forms of dementia that includes Alzheimer’s diseases, down syndrome, familial front temporal dementia. The inherited genes sometimes become a cause of the condition.

Causes of dementia

The modifiable risk factors for dementia are explained below:The brain factors that can be controlled are

• Mental activities: Facing mental activities regularly like education, occupation or leisure are associated with lowering the risks of dementia and cognitive declines (Harvey et al, 2003).
• Social activities: Indulging in social activity and being connected to family and friends lowers the risk of getting dementia as it helps the brain to function positively (Weitzel, 2011).

The body factors that can be controlled are:

• Alcohol: Drinking too much alcohol damages the brain and causes a high risk of dementia and other cognitive diseases (Neal, 2003).
• Diet: a healthy diet plan is required to have a healthy brain growth. The meal should be nutritious to build up the growth of the brain.
• Physical work: regularly exercising improves brain functioning and reduces the risk of dementia and other cognitive declines.

The heart factors that can be controlled are:

• Blood pressure: Long term treatment is to be done in case individual is having high blood pressure problems because high blood pressure increases the risk of dementia.
• Body weight: Obesity should be avoided to decrease the risk.
• Cholesterol: Optimum level decreases the risk (Press D, et al, 2014). High cholesterol causes higher risk of dementia.
• Diabetes: Type 2 is associated to increased risk so it should be avoided.
• Smoking: Passive smoking increases the risks so it is to be avoided to have proper functioning of brain.

Prevention of dementia is hard as the cause is still unknown. Till now no cure of dementia is known. But adapting lifestyle and medication changes can decrease the risks of dementia. The prevention is based upon the early detection and the reducing of reoccurrence and the symptoms. The plan here focuses on the community which consists of young adults who can follow the following prevention steps and decrease the disease to a much larger extent. The three types of prevention methods that should be followed at each level by these young adults are as follows:

Primary prevention: The disease can be prevented in the general population by encouraging community spread measures like the good nutritional status, physical fitness, immunization and keeping the environment safe (Goldman L, et al, 2014). The primary prevention methods help maintain good health and reduces the occurrence of the diseases. These method includes the basic lifestyle changes that ensure healthy brain functioning and reducing the risks associated with the occurrence of the disease. It also includes including a diet which is rich in nutrition and helps the brain to function properly. It ca

Secondary prevention: It is when the detection is made at the early stage of the disease and before the symptoms occurs. There is prompt and effective intervention done to prevent disease progression (Thorgrimsen et al, 2003). The onset conditions of the disease are to be prevented.

Tertiary prevention: The prevention or the minimizing the complications or the disabilities developed with the disease. These tertiary preventive measures are known to be the part of the medical treatment and the management of the condition. It includes providing medication and taking up therapies to reduce the effectiveness and symptoms of the dementia.

For this prevention plan the group which is targeted is the young age form 30 to 40 years whose lifestyle, dietary patterns, early onset and then minimizing the complications if already prevailed can decrease the prevalence to a much larger extent.

The Dementia patients requires lot of aged care and the health service that consists of primary health care, community aged care, residential care and the hospital care. According to a in 2008 study the care packages that were taken up by the patient comprises of following:

• 14% Community Aged Care Packages
• 18% Extended Aged Care at Home
• 88% Extended Aged Care at Home Dementia

The other services which was used up includes the  health care service, home and the community care, Community nursing service, Aged care services. The services taken up by the Aboriginal Australians is very less. However if the services are taken up by them the information gathered about it is very less. The services which the Aboriginal used included support from community, diagnostics, management and the residential care of the old people.

On time diagnosis is must in order to have accurate care and medication. In reality there is no cure for it but the interventions that improves the condition are though available. The medication falls in two categories. These are on drugs or non drugs.

• The drug intervention targets cognitive functions, behavioral and psychological symptom and the other disease occurring on side (Seeher et al. 2011). The results improves or declines the cognitive functions but the progression of the disease is not stopped. The other behavioral features like aggression agitation, illness, depression and anxiety are balance. Anti psychotics drugs are used up to handle extreme behaviors and the sedative effects. Evidences show that some people are benefited with these medicines but al though they face some side effects also that consists of occurrence of stroke and death.
• Non drug intervention report to improve the cognitive signs like cognitive training, validation therapy, reminiscence therapy, validation therapy and physical exercises. The evidences about these non interventions are not known yet. Studies show that if an individual is engaged more in cognitive activities than the risk of having dementia is decreased.  The people who are already the patients of dementia there cognitive training evidences are still not gathered but the studies say the improvements can be seen like better mood, better quality of life, better social functioning. The non drug treatment so as to improve behavioral and psychological changes are much more preferred than the drug interventions. So it can be said that behavioral management process will surely give results with efficiency. This consists of finding and treating the cause of bad mood swings or bad behaviors, untreated pain and other medical circumstances.

Modifiable and non-modifiable risk factors

Dementia is the major and the leading cause of mortality among the Australians. From the year 1997 to 2009 the number of people who died from dementia is increasing steadily form 3400 to 8700 that is from 21 to 34 deaths in a population of 100000. In the year 2009 dementia became the third largest cause of death among the Australians. However, it is to keep in mind that the part of increment occurred due to changes in coding instructions in ICD-10 and the Veterans’ Entitlements Act 1986 and Military Rehabilitation and Compensation Act 2004.

It can be seen Dementia is a disease of loneliness and is in relation to many other disease and like Alzheimer’s disease. Dementia prevalence can be stopped if it is prevented in early stages and a suitable treatment along with support, emotional care from the community, friends, family and other significant ones. The prevention plan that is meant for specific communities and specific age groups should be followed by every individual seriously so as to reduce the prevalence of the disease. The services can also be used up by the ones who are already the sufferers of the disease.

Conclusion

Summing up, it can be said that Dementia is a life threatening condition for the human beings that solely occurs due to loneliness and with age. Dementia occurs mostly in aged people as they are the one who are most isolated and free from any regular activities like work. Till now in spite of so many researches occurring everywhere in the world no cure has been found out to stop the progression or to completely abolish the disease. The only cure is to gain support from family and friends. The drug and non drug interventions though have been found out that improves the functions and improves psychological and behavioral features. The prevalence of it is constantly increasing in Australia. The risk factors along with the prevention methods should be taken in to account so as to control the spread and improve the conditions of the patients of Dementia. Many of the researches has been performed in past and many are still performed to find out the evidences and the prevalence rate. But still a lot has to be done the research that could find a cure and should halt the progression is still to be found.

References

Berr C, Wancata J, Ritchie K. Prevalence of dementia in the elderly in Europe. Eur Neuropsychopharmacol2005;15:463–71.

Books.Goldman L, et al. Goldman’s Cecil Medicine. 24th ed. Philadelphia, Pa.: Saunders Elsevier; 2012.

DoHA (Department of Health and Ageing) 2010a. National mental health report, 2010. Canberra: Commonwealth of Australia.

Draper B 2011. Understanding Alzheimer’s and other dementias. Australia: Longueville

Harvey RJ, Skelton-Robinson M, Rossor MN. The prevalence and causes of dementia in people under the age of 65 years. J Neurol Neurosurg Psychiatry2003;74:1206–9. 

Neal, M; Briggs, M (2003). “Validation therapy for dementia.”. The Cochrane database of systematic reviews (3): CD001394.

Preventing Alzheimer’s disease: What do we know? National Institute on Aging.

Press D, et al. Treatment of dementia.

Ratnavalli E et al. (2002). “The prevalence of frontotemporal dementia“.Neurology 58 (11): 1615–21.

Sager MA, Hermann BP, La Rue A, Woodard JL (2006). “Screening for dementia in community-based memory clinics“ (PDF). Wisconsin medical journal 105 (7): 25–9

Seeher K, Whithall A & Brodaty H 2011. The dementia research mapping project: the 2010 update fi nal report.Canberra: Dementia Collaborative Research Centre

Thorgrimsen, L; Spector, A; Wiles, A; Orrell, M; Wiles, Anne; Orrell, Martin (2003). “Aroma therapy for dementia“. The Cochrane database of systematic reviews (3): CD003150

Weitzel T, Robinson S, Barnes MR et al. (2011). “The special needs of the hospitalized patient with dementia“. Medsurg Nurs 20 (1): 13–8; quiz 19.