There are about 850,000 people in the UK with dementia (Alzheimer’s Research Trust 2014). Some will be people living with an undiagnosed dementia.

The number of people with dementia in Ireland is estimated to be 55,266. The number of people with dementia is expected to grow at an average rate of 3.6 per cent per year over the next thirty years.

• Dementia has no gender barriers and affects both men and women.
• Dementia mainly affects older people. The longer a person lives the higher the risk of developing a type of dementia.
• There are 42,000 people in the UK under the age of 65 who have dementia. The fact that dementia can affect younger people is something that can be over looked by families, the person themselves, even professionals can be slow to consider dementia as a possibility with younger people.
• The number of people with dementia is forecast to increase to over 1 million by 2025 https://www.alzheimers.org.uk

• Dementia is a term that is used to describe a collection of symptoms including memory loss, problems with reasoning and communication skills, and a reduction in a person’s abilities and skills in carrying out daily activities such as washing, dressing, cooking and caring for self.Memory loss – this can be one of the first symptoms that people notice. The observations people report include – noticing their loved ones forgetting things that have happened earlier in the day, getting confused about messages and who people are, getting lost whilst out and about, repeating themselves, and appearing not to be paying attention or following conversations.
  Problems with communication – Some people experience problems with expressing themselves, talking and understanding things. They get confused about words and might use the wrong words for common things and mix words up. Reading and understanding written text can become problematic.There are a number of different types of dementia the most common being Alzheimer’s disease, vascular dementia, Frontotemporal dementia and Dementia with Lewy bodies.Some people get diagnosed as having mixed dementia; this is when the presentation shows the person to have elements of more than one type of dementia.

  Dementia is a progressive condition, which means the symptoms will gradually get worse. This progression will vary from person to person and each person will experience dementia in a different way. Although the person will have some of the above symptoms, the degree to which they affect an individual will vary and not all people will have all of these symptoms.

• Mild Cognitive Impairment (MCI)Sometimes a doctor will assess and diagnose a person as having Mild Cognitive Impairment (MCI). This diagnosis is given when the person has mild memory problems but a diagnosis of dementia cannot be given, as the symptoms do not warrant this diagnosis.
  Examples might include a person becoming aware that their memory is not functioning as effectively as normal / noticing they are becoming forgetful / having difficulty concentrating.Having a diagnosis of MCI does not mean you will go on to develop dementia.Alzheimer’s Disease

  Alzheimer’s disease is the most commonly diagnosed type of dementia affecting around 417,000 people in the UK. It was first recognised by the German neurologist Alois Alzheimer, hence how Alzheimer’s disease got its name. Alois Alzheimer noticed ‘plaques’ and ‘tangles’ in his subjects’ brain which were causing brain cells to die faster than they would in normal ageing.

  Alzheimer’s is a gradually progressive form of dementia, this means the illness gradually gets worse over time. The first signs are commonly forgetfulness of recent events, repetition, confusing things or getting lost. Signs of depression or irritability may also be seen together with a loss of interest and lack of initiative. Over time the person may lose more and more of their every day skills and abilities and may eventually be unable to perform the simplest of every day tasks without encouragement, support and supervision.

  Families may notice a person becoming more and more forgetful (for example) often people cannot pinpoint a day they first noticed “something was wrong" moreover they gradually become aware that a person is experiencing what might be a dementia.

  It can be some months or years before family members fully recognise the extent of the deterioration in the person with dementia.

  Down’s Syndrome

  People with Down’s Syndrome are at an increased risk of developing Alzheimer’s disease.

  Vascular Dementia

  Vascular dementia is the second most commonly diagnosed dementia (after Alzheimer’s disease).

  The brain, like all other cells in the body needs a regular supply of blood and oxygen. If this supply is affected in any way the cells suffer damage and may die. When these brain cells no longer function properly/ die a person may develop Vascular Dementia.

  Some areas of the brain may be more affected than others, and as a result, some areas of the brain may remain relatively unaffected. People with Vascular Dementia as a result may be aware of problems they are experiencing and this can lead to an increased risk of depression.

  As Vascular Dementia affects different areas of the brain of each person may have different symptoms.

  The symptoms are similar to those of other types of dementia however the way the illness progress is very different.

  Vascular Dementia often progresses in a step like fashion; that is to say, symptoms may remain at a constant level for a period of time and the illness progresses in obvious steps rather than a gradual reduction in skills/ abilities as with Alzheimer’s Disease.

  There are different types of vascular dementia:

  • Stroke-related dementia, Small vessel disease-related dementia
  • Vascular dementia and Alzheimer’s Disease (mixed dementia)

  Who is more at risk of developing Vascular Dementia?

  People with conditions such as high blood pressure, heart problems, high cholesterol and diabetes are more at risk of developing vascular dementia. It is therefore recommended that these conditions are identified and treated as soon as possible.

  Frontotemporal Dementia / Frontal Lobe Dementia (FLD)

  People who are affected by FLD may not have the type of memory problems normally associated with other types of dementia. A person with FLD may behave very differently as a result of their illness. For example a person with FLD who was previously very quiet and unassuming might become loud and aggressive and use offensive language.

  Some people become withdrawn, while others may become disinhibited or even sexually inappropriate and may exhibit sexual behaviour in public.

  Whenever such dramatic changes of personality occur a diagnosis of FLD should always be considered.

  Dementia with Lewy Bodies

  Dementia with Lewy Bodies takes its name from abnormal collections of protein, known as Lewy bodies, which occur in the nerve cells of the brain. In addition to the symptoms of Alzheimer’s disease, people with Lewy Body Dementia are likely to experience hallucinations (seeing things that do not exist).

  The condition tends to fluctuate and can include Parkinson type symptoms such as falls / difficulty walking. Dementia with Lewy Bodies is associated with Parkinson’s Disease however it can and does occur without this.

  Many people with this type of dementia are very sensitive to neuroleptic medication, which can lead to severe side effects and even death.

  This disease often progresses more rapidly than Alzheimer’s disease.

• If you suspect you or a person you know may have a type of dementia it is essential you get a diagnosis as soon as possible.There are many conditions or situations that can cause confusion and symptoms similar to dementia.The person who is experiencing the problems must see their GP as soon as possible.The GP will be able to refer you to a specialist for an assessment.

  The following conditions can cause similar symptoms to those of dementia but may be reversible and should always be explored.

  • Chest and urinary infections
  • Infected pressure sores
  • Severe constipation
  • Depression
  • Side effects from medication
  • Taking medications incorrectly or taking medication that has not been prescribed
  • Vitamin and thyroid deficiencies
  • Brain tumours and normal pressure hydrocephalus
  • Syphilis
  • Sudden changes such as moving house or bereavement
  • Poor sight or hearing
  • Alcohol (even in small amounts)

  A full physical examination should take place as part of the assessment. This may include an assessment of heart and lung functioning and will include blood pressure, full blood count, vitamin B12 and foliate testing, glucose testing, thyroid testing and a mid stream urine assessment.

  So far there is no medical test for dementia. A diagnosis is made by excluding other conditions. It is therefore essential that the person’s carers, friends and relatives be invited to give a history of the problems.

  The assessment process will vary depending on the services that are available in your area. You may have a memory service in your area and your GP may refer you for further assessment and diagnosis.

  Other areas do not have a dedicated memory service and the GP will refer to your local mental health service and someone from the mental health team will contact you to arrange an assessment.

  Some GPs refer to neurologists, who are specialists in disorders of the brain, for assessment. These professionals will often conduct a home visit to assess the person in their own home.

  The actual assessment will include the above-mentioned tests and whoever is making the diagnosis will take a detailed history. An assessment of a person’s behaviours or abilities might be made and referral to a day hospital or to an occupational therapist might be suggested.

  There are a number of scans which can be conducted which help the diagnostic process, and the professional making the diagnosis might refer you for a scan during the assessment process.

  You may have Admiral Nurses® working in your area and your GP / psychiatrist will be able to provide you with the information you need about how to access this service.

• Talking to peopleTalking to people and accepting that you or a loved one has a diagnosis of dementia can be very difficult. Many carers are reluctant to tell/ discuss the diagnosis with the person with dementia themselves. The person with dementia might well know that something is wrong and may be worried about the changes they are noticing in themselves.It is important that once a diagnosis is reached the person has the opportunity to discuss this diagnosis, what it means, what the future might hold and the types of support they might need. The person with the dementia should be informed of this diagnosis, ideally when a family member or close friend is present, by the professional who has completed the assessment, or the professional who knows the person best.People should be allowed time to process what this diagnosis means and be encouraged and allowed to ask questions about what it means. It is a good idea to tell close family and friends about this diagnosis, however you might want to consider who else to tell.

  Some people (especially when the person with dementia lives alone) inform a close neighbour so that they are aware and can provide some support for the person with dementia.

  Talking to young children can be difficult. Children however, are normally very aware that something is wrong and are normally easily able to accept the diagnosis for what it is and not let if affect their relationship with the person with dementia.

  Families of younger people with dementia will face different challenges and may want to get professional help/ support and advice about dealing with the dementia and coping with this diagnosis – help lines such as Admiral Nursing DIRECT will also be able to provide support and advice. Admiral Nursing DIRECT 0845 257 9406

  Medicine

  A number of medications are available which can help to slow down the deterioration.

  The use of these medications was recently restricted to people whose dementia is in the mid-stages. This is something that you should discuss with the person making the diagnosis.

• Admiral Nurses are specialist dementia nurses, working in the community, with families, carers and supporters of people with dementia.The Admiral Nurse model was established as a direct result of the experiences of family carers. Admiral Nurses are named after Joseph Levy, who had dementia. He was known by his family as ‘Admiral Joe’ due to his keen interest in sailing.Admiral Nurses:
  • Work with family carers as their prime focus
  • Provide practical advice, emotional support, information
    and skills
  • Deliver education and training in dementia care
  • Provide consultancy to professionals working with people
    with dementia
  • Promote best practice in person-centred dementia care.

• Admiral Nursing DIRECT0845 257 9406
  Admiral Nursing DIRECT is a telephone information and support line for family carers, people with dementia and professionals.
  Admiral Nursing DIRECT is delivered by experienced Admiral Nurses and has been developed in response to the rising number of enquiries being received by Dementia UK.