Best to Know?

Wolfgang - ClinicaBetween the bird-flu hype and the hype of the so-called swine flu there was increased coverage about dementia and the necessity of early diagnosis in the media. Maybe the film Away from Her was the trigger, maybe after all the Tamiflu had been sold to the governments, the pharmaceutical industry just looked for another bestseller.
The swine flu prevented me from writing earlier about this subject, however after it is crystal clear now that it is not depopulating vast areas, I think we have to turn back to other health scares.
Dementia; a conglomerate of symptoms, is caused by different illnesses, most commonly by Alzheimer’s disease, where in layman’s terms, rubbish is accumulating in and around the nerve cells in the brain, causing them to die or hindering the communication amongst them. The causes are not quite clear, but age, head injuries, diet and general health seem to play a mayor role – genetics less so.
The second most common form is called vascular dementia; a bundle of illnesses, which impairs the blood supply to the brain. Each time the heart contracts, a quarter of the blood is directly transported to the brain, the rest of the body has to manage with the remaining three quarters. For this form of dementia, the same risk factors apply as for heart disease, thus it can be prevented with control of the risk factors.
Dementia is not curable, so why is an early diagnosis necessary? I was searching long and hard to find any reasons. They made me conclude that with an early diagnosis you can stay depressed for longer!
Do you and your family really want to know earlier, in order “to be able to plan the future or to find sources of support and advice?” Or do you want to benefit from treatment “that can ameliorate the symptoms or slow down the disease progression in some people?” (Alzheimer Society) How many people actually are “some” people? Currently there are two different types of medication available. Although some people really do benefit, most do not. Some may function better, but without gaining quality of life. Up to a third of people discontinue the medication, owing to side effects. Therefore the hospitalisation rate in people taking the drugs is higher and some studies showed a higher rate of deaths. The time span until the need of nursing care arises remains the same.
Dementia must not be mistaken for mild cognitive imparment(MCI), where people still can look after themselves and live happy lives. MCI, often does not progress to dementia, yet at the time that people realize that they have memory problems, they usually see the doctor. That is quite reasonable as other treatable medical conditions can mimic mental decline. But at that stage it is hard to say if somebody suffers from MCI or early dementia.
My personal experience is that people who are (wrongly) diagnosed with early dementia will be depressed until they don’t remember that they have a problem. Thus I don’t think that a public awareness campaign about diagnosing dementia is helpful. Looking after your physical health, staying socially and mentally active is still your best all round protection.

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