World Alzheimer’s Month

By Daphne Alcantara, GADS Chairperson

If you are worried about your own memory or that of someone close to you it is important to consider seeking help so that you can receive an accurate diagnosis. It is generally good to start with your GP.

Discussing your concerns with your General Practitioner (GP) and having an examination can exclude other treatable conditions that can cause memory loss such as depression, urinary tract infection, vitamin deficiencies, a brain tumour or thyroid problems.

Although there are barriers to the diagnosis and care of dementia in the primary care setting GP’s are crucial in early detection of cognitive decline and have an important role in supporting people with dementia and their family and carers. They can offer referrals, advice and information to help the patient to manage their condition; GP’s will often be involved in the process of a diagnosis, either by making a diagnosis themselves or referring the patient to the Memory Clinic for specialist services.

Importance of timely diagnosis

Dementia is not a normal part of ageing, so getting a diagnosis can help you take control and plan ahead.

Taking the first steps to seek a diagnosis can be scary, but there are benefits to having an early diagnosis. You many have been wondering what is happening to you and have been worried and anxious about the changes you have noticed. Although being diagnosed with dementia can be an upsetting experience, it can also be a relief because knowing the causes of your problems can resolve the anxiety for both you and your family.

Receiving a timely diagnosis of dementia

It means that the patient’s care can be planned, managed and monitored so that they can be sign posted to supportive health and care services and (if needed) prescribed appropriate medication.

Diagnosis brings clarity to the patient and their families, in terms of what is happening to them and provides them with the ability to make choices and allow preparation for future care planning. It will enable you to :

• Explain to your family, friends and colleagues what has changed in your life and how they can help you.
• Gain access to information, resources and support for yourself and those close to you.
• Demystify and destigmatise your condition.
• Maximise your quality of life.
• Benefit from support and available drug and non-drug therapies that may improve your cognition.
• Plan for the future.

On a practical level there is a lot that can be done :

• You can start making enquiries about what social and care support that you or your family may be entitled to.
• You may wish to review your financial situation and make decisions about your legal affairs.
• If you are still at work, you could think about reducing your hours or working with your employer to make reasonable adjustments so you can continue to work.

Every person is unique and dementia affects every individual differently with no two people experiencing symptoms in exactly the same way.

Symptoms also vary by type of dementia, with Alzheimer’s disease being the most common type of dementia.

10 of the most common warning signs are shown (below) and depicted in the infographic:

1. Memory loss
2. Difficulty performing familiar tasks
3. Problems with language
4. Disorientation to time and place
5. Poor or decreased judgement
6. Problems keeping track of things
7. Misplacing things
8. Changes in mood and behaviour
9. Challenges understanding visual and spatial information
10. Withdrawal from work or social activities

If these signs are new, they may be a sign of dementia. If you think that these problems are affecting your daily life or the life of someone you know, you should talk to your doctor or seek out more information from The Gibraltar Alzheimer’s & Dementia Society.

There are many factors which have been linked to the development of dementia. Some are risk factors, while others appear to be protective.

Dementia is not a natural part of ageing, it is a set of symptoms that develop when the brain is damaged by disease. There are many things than can increase a person’s chances of developing dementia – these are known as ‘risk factors’.

There are different types of risk factors for dementia, including medical, lifestyle and environmental factors. It is possible to avoid some risk factors, while others cannot be controlled.

Risk factors are characteristics that appear to have some relationship to the development of a disease. If these risk factors are present, there is an increased chance, but not a certainty that the disease will develop. For example, not everyone who smokes develops heart disease and not everyone with heart disease has been a smoker. However, smoking is a strong risk factor for heart disease.

Some risk factors can be modified, for example lowering blood pressure reduces the risk of stroke. Other risk factors cannot be modified, such as age.

Risk factors for dementia

The greatest risk factor for Alzheimer’s disease and other dementias is increasing age. Although age increases risk, dementia is not a normal part of ageing.

We know there are more than 20 genes which affected a person’s risk of developing dementia. The gene APOE was the first know to increase a person’s risk of developing Alzheimer’s disease and it is still the strongest risk gene known. There are also genes which directly cause dementia but these deterministic genes are rare – they are estimated to account for less than 1% of dementia cases and cause young-onset forms in which symptoms usually develop before the age of 60.

Modifiable risk factors

Although we can’t change our genes or stop ageing there are changes that we can make to reduce our risk of dementia, either lifestyle changes as individuals or wider changes across society. We might prevent or delay up to 40% of cases of dementia, if we were able to modify all of the risk factors.

A growing body of research exists for 12 potentially modifiable risk factors shown (below) and depicted in the infographic:

1. Physical inactivity
2. Smoking
3. Excessive alcohol consumption
4. Air pollution
5. Head injury
6. Infrequent social contact
7. Less education
8. Obesity
9. Hypertension
10. Diabetes
11. Depression
12. Hearing impairment

Keeping active, eating well and engaging in social activities all promote good brain health and may reduce your risk of developing dementia. Keeping your heart healthy, including by avoiding smoking and excessive alcohol consumption, can lower your risk of dementia and other diseases too.

GADS call on HM Government-led Dementia Campaigns :

1. To focus on greater understanding so that people know how to spot the early signs of dementia and encourage them to speak to their GP’s if they have any concerns about themselves or a loved one.
2. To deliver Awareness Campaigns around the warning signs of dementia and the importance of a timely diagnosis, in line with the WHO Global action plan on the Public Health response to dementia.
3. To increase public understanding on dementia risk and prevention

GADS also call for :

4 For a Dementia Register; to develop an accurate picture of dementia rates in Gibraltar to enable better planning, treatment, care and support in health and social care.
5 A study into incidence of dementia within our community, analysing the annual prevalence of dementia to be able to assess how we expect dementia to be manifesting itself in our society in the future.

For information, advice and support contact :

The Gibraltar Alzheimer’s & Dementia Society
Email : gadschairman@gibtelecom.net
Tel : (00350) 56001422
Facebook : https://www.facebook.com/gadsgibraltar