Dementia Awareness Week: Your questions answered

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To mark Dementia Awareness week, we invited our research participants to send in any questions they had about dementia, to be answered by our scientists, clinicians and researchers.

We received a fantastic response, and would like to thank everyone who took the time to contact us. Here are the most popular questions, with answers from our CDP panel.

 

What is the difference between dementia and Alzheimer’s disease?

Dr Tara Spires-Jones, neuroscientist: 

This is a great question. “Dementia” is the term we use for symptoms including problems with memory and thinking. Alzheimer’s is the brain disease that is the most common cause of these symptoms.

People with Alzheimer’s disease have an abnormal build-up of proteins called amyloid and tau in their brains, which are toxic to brain cells and contribute to the symptoms of dementia.

Other examples of brain diseases that cause dementia are: frontotemporal dementia, vascular dementia and dementia with Lewy bodies.

How can dementia be diagnosed in its earliest stages?

Prof Craig Ritchie, psychiatrist and co-director of CDP:

We think that the diseases which lead to dementia may well start decades before the memory problems associated with dementia occur.

To detect these diseases early we increasingly rely on brain scans and other biological tests like spinal fluid analysis. We are also trying to map these changes onto very subtle changes in thinking, for instance orientation.

Once memory problems arise, a doctor will rely on tests of memory, brain scans and a clinical history to understand how changes have progressed over time.

 Are there parts of the world – or certain districts of the UK – where dementia is more pronounced?

Dr Tom Russ, psychiatrist:

Where you live could influence your risk of developing dementia.

In Scotland, Sweden, and Italy we have found that the risk of dementia is higher in the north of these countries compared to the south.

We’re working hard to try and identify why this is but it could be an environmental factor, possibly sunlight. 

Are there any differences between men and women in terms of disease rates?

Prof Craig Ritchie, psychiatrist and co-director of CDP:

Studies that look at rates of dementia across whole regions or countries – so called epidemiological studies – suggest that women are slightly more likely to develop dementia than men.

This is true even after taking into account the fact than men tend to die younger and have higher rates of heart disease, which is a known risk factor for dementia.

Why this is the case is not fully understood.

Women are also far more likely to be carers for people with dementia whether the person with dementia is a man or women.

In fact in the UK about 80 per cent of non-professional carers are women. It is therefore clear that dementia affects women whether as patients or carers much more than men.

What role can antidepressants plan in managing dementia symptoms?

Dr Tom Russ, psychiatrist:

Dementia isn’t just about memory. Symptoms like anxiety, depression, and agitation are very common, and often very distressing for the person and their family.

Antidepressant medications – along with psychological approaches and support for the person themselves and caregivers – can make a big difference to these symptoms and greatly improve the quality of life of the person with dementia and their family.

Does brain deterioration follow a similar pattern or are different parts of the brain affected randomly?

Dr Tom Russ, psychiatrist:

In the most common illness that causes dementia – Alzheimer’s disease – there is quite a predictable pattern of how the brain is affected and how these brain changes progress.

The next most common cause of dementia, vascular dementia, is less ordered and the parts of the brain that are affected depend on which parts of the brain’s blood vessels are most affected.

Are there any prevention exercises, for example eating or avoiding certain foods and drinks or having a lively interest in current affairs?

Prof Charlotte Clarke, co-director of CDP and Head of the School of Health in Social Science:

Some forms of dementia are linked to the health of the cardio-vascular system – so anything that is good for the prevention of strokes and heart attacks will also help to prevent some forms of dementia.

This includes, for example, avoiding smoking, maintaining a healthy body weight and taking regular exercise.

Whatever ‘form’ dementia takes, it is a disease that is socially experienced – other people’s reactions and wider society can make a great deal of difference to someone’s quality of life.

It is possible to prevent some of this social impact by reducing the stigma of dementia, continuing to involve people in day to day life, and finding ways in which people with similar experiences can connect to each other.

 

Can different drugs be used at different times to manage different symptoms?

Dr Tom Russ, psychiatrist:

The main memory treatment (cholinesterase inhibitors) are most helpful for the symptoms in the early or middle stages of dementia.

In moderate or severe dementia, a different medication (memantine) can be helpful for distressing behavioural symptoms like agitation.

Other medications not specific for dementia (such as antidepressants) can also be helpful at different stages.

If there is a vascular component to the dementia, it is important to control risk factors like high blood pressure and high cholesterol.