Quick Look: Dementia

Even in the good years, mental health budgets were seldom in line with what experts expected or deemed necessary. Thus, in times of budget deficits and scathing public expenditure cuts, the worry becomes even greater. For those that care most about the health service then, the Coalition government's decision to ring fence healthcare spending has been largely applauded. Fiscal hawks may feel otherwise. Yet regardless of the merits of the decision, it does not disguise the fact that substantial efficiencies in the health service must still be found. The worry here is that once again mental health budgets will be first in line for the chop. As the results of a recent study by the Medical Research Council (MRC) demonstrate, this is a political – and indeed societal - stance that we can ill afford to maintain.

According to the major research charity Alzheimer's Research Trust (ART), dementia is the "greatest medical challenge of our age". Currently well over 800,000 Britons suffer from Alzheimer's disease or another form of the condition, which costs the Exchequer an estimated £23 billion every year. And with people now expected to live longer, if not always healthier lives, the number of sufferers is expected to double by 2050. Whichever way you look at it, dementia is one of the fastest growing health concerns we face as a nation - if not as a human race.

Centering around a steady attack on one’s cognitive functions, dementia is arguably one of the most debilitating conditions you can be faced with in old age. As well as experiencing significant memory loss, sufferers of dementia are faced with a more general inability to think and can often require full-time care in their final years. While more than half of all cases of dementia are linked to Alzheimer's disease, there are over 100 different types of dementia, including vascular dementia and fronto-temporal dementia. The exact cause of the condition remains unknown. And although drugs such as Aricept and Reminyl can offer real help in managing symptoms, there is still no real cure for the illness.

Be that as it may, according to a study recently published in the British Medical Journal, lifestyle choices such as how we eat and how actively we use our minds can have a significant bearing on our chances of developing the disorder. Guided by study leader Dr Karen Ritchie, a team of researchers from the French National Institute of Medical Research assessed over 1,433 pensioners local pensioners over a seven year period in an attempt measure how factors such as reading scores and signs of depression influenced a person’s susceptibility to dementia. The results are telling. For example, while those with depression were 10 per cent more likely to develop the condition, inadequate daily consumption of fruit and vegetables contributed a further 6.5 per cent increase in risk, compared to an 18 per cent increase for those with lower reading scores. Hence in the absence of a long-term cure, what this study does show is that there is still plenty of room for prevention. Commenting on the results, Dr. Ritchie echoed this message, stating: ‘While these calculations can only provide a crude estimate of impact on incidence, they do make a significant statement about public health priorities in disease prevention in the face of current knowledge’.

More worryingly though, according to another recent study by the Medical Research Council (MRC), General Practitioners are largely failing to diagnose the condition early enough. Specifically, according to the MRC study, while those individuals diagnosed by GPs survived for just 6.7 years post diagnosis, those indentified by active screening lived for an additional 4 years on top of that. Commenting on the study, the Chairman of the MRC Neuroscience and Mental Health Board, Professor Chris Kennard said:“It's clear that too little too late is being done to diagnose dementia. Without earlier diagnosis people may miss out on the opportunity to have early interventions, as new treatments come along. It's estimated that 80 million people worldwide will be affected by dementia by 2040 so it's crucial GPs are given the support and training they need to get to grips with identifying dementia accurately and as early as possible”. Study leader Dr Greta Rait concurred, adding that: “Our findings will help clinicians to make more realistic estimates of life expectancy for patients when they are diagnosed and also assist policymakers in planning services”.

Consequently, while we may well be living for longer, failures at the primary care level, alongside a dramatic rise in the number of cases of mental disorders such as dementia, predict that those years are not necessarily destined to be healthy ones. The good news is that, if you want to take preventative measures now, there are many things that you can do to help yourself. Simple steps such as eating the recommended daily amounts of fresh fruit and vegetables and warding away depression can go a long way to lowering risk. Ultimately though, and as recent studies demonstrate, early diagnosis is the greatest key to longevity. And until our GPs are doing better by that measurement, dementia care in this country still has a long way to go.