Dementia
Dementia is a combination of ailments that affect a person’s ability to think, thus
reducing their overall ability to function normally (Hamilton, 2011). The prevalence of
dementia varies across countries. However, in general, dementia cases have been on an
upward trend. This essay will look at the prevalence of dementia in three countries namely,
Australia, America, and China. The essay will also describe two treatment or prevention
methods that are critical in mitigating dementia. Further, the essay will discuss the role of two
healthcare providers in administering each of the identified treatment or intervention
measures.
Dementia is defined as a “progressive disorder characterized by problems with
memory and thinking” (Hamilton, 2011, p. 97). Dementia is not a single type of ailment.
However, the term encompasses a set of mental health complications that can include the loss
of memory and Alzheimer disease among others. The severe mental lapses mean that the
affected person might be incapacitated in undertaking activities of daily living in a normal
way. Dementia is classified into two categories: reversible and irreversible dementia.
Reversible dementia, such as depression, brain tumor among others, can be treated and
possibly cured (Hamilton, 2011, p. 97). However, irreversible dementia has no known cure
and intervention methods only help in delaying its effects on the patent. The two categories
of dementia are summarized in Figure 1.
Figure 1: Types of Dementia
Reversible Dementia Irreversible Dementia
Depression
Vitamin B 12 Deficiency
Alcohol-induced dementia
Hypothyroidism
Normal pressure hydrocephalus
Brain tumor
Subdural hematoma
Neurosyphilis dementia
AIDS dementia
Alzheimer disease
Diffuse Lewy body disease
Vascular dementia
Parkinson dementia
Huntington chore
Multiple system atrophy syndrome
Creutzfeldt-Jakob disease (CJD)
Binswanger’s disease (BD)
Wilson’s disease
DEMENTIA 2
Adapted from Hamilton, p. 97
Various countries have different prevalence rates of the dementia disease. In 2011,
Australia projected that about 219, 200 were suffering from dementia (AIHW, 2012, p. 207)
for people aged 60 and above. Projections show the trends will persist in the coming years. If
there are no breakthroughs in the medical science, the figure will almost reach 6 million
people by 2050. In Australia, dementia is the leading cause of disability among the elderly.
Moreover, Australia does not have enough people to provide care to people suffering from
dementia (AIHW, 2012). The country estimates that Australia will have a shortage of
caregivers for those suffering from dementia. The challenges will arise because of the need to
provide high quality care. This is further compounded by the expected number of people who
will be seeking treatment for dementia in Australian healthcare facilities (AIHW, 2012).
In America, it is estimated that over 4 million people are affected by dementia. In
addition, about 11% of the people above 65 years suffer from dementia. A large number of
dementia relate to Alzheimer disease (AD). According to Fargo and Bleiler (2014), 15% of
people aged 65 are diagnosed with the Alzheimer diseases (AD), while 38% of people above
85 suffer from the Alzheimer disease (Figure 2). Indeed, statistics show that the number of
American suffering from dementia is projected to reach 13.2 million by 2050 (McNamara
2011, p. 2). Prince and Cummings (2010) write, “The number of people over 65 in the USA
is expected to double from approximately 35 million in 2007 to more than 70 million by
2030” (p. 137). Another challenge in the USA is the lack of proper diagnosis of the disease in
the early stages. Various factors contribute to the problem of diagnosis including poor
communication among service agencies as well as the lack of interdisciplinary teams with the
right expertise (Prince and Cummings 2010).
DEMENTIA 3
Figure 2: Proportion of people with AD in America by age
Source: Fargo, K and Bleiler, L. (2014), p 71.
In China, the prevalence of dementia is around 5% of the population (Waal, Lyketsos
& Ames, 2013). According to Waal, Lyketsos & Ames (2013) people are over 65 have
increased from about 5% in 1982 to about 9% on 2010 (p. 159). Age is closely related with
dementia, and the Chinese government has put in place health promotion initiatives to create
awareness, increase knowledge of dementia, and assist in early detection of dementia cases.
For example, the National Plan for Ageing Development requires the Chinese people to
promote overall well being of the elderly (Waal, Lyketsos & Ames (2013). Despite the
efforts put in place by the government, the management of dementia continues to poses
significant challenges to the Chinese authorities because of the limited resources. However,
despite the scarcity of resources, healthcare providers continue to offers valuable services as
well as undertaking research related to dementia (Waal, Lyketsos & Ames, 2013).
Most of the dementia-related cases are progressive and therefore, the condition has no
immediate cure (Hamilton, 2011, pp. 97-98). However, dementia occasioned by vitamins and
hormone deficiencies can be contained using vitamin supplements. However, for other cases
of dementia, medication can help in treating mild, moderate, and severe dementia (Aihw,
2012, p. 81). Medication depends on several factors (Sadowsky and Galvin, 2012). The
DEMENTIA 4
treatment of severe dementia is different from a mild one. Therefore, the doctor will prescribe
the right medication after carrying out thorough diagnosis of the patient.
One method of treating dementia is through pharmacological interventions (Sadowsky
and Galvin, 2012), which must be administered under the guidance of the GP. The
pharmacological interventions currently available do not halt the degenerative process of
dementia (Sadowsky and Galvin, 2012). Sadowsky and Galvin, (2012) observe that current
therapies are deficient in dealing with dementia. However, pharmacological procedures can
help in the maintaining functional capabilities of patients besides addressing the behavioral
patterns of the patient (Sadowsky and Galvin, 2012, p. 350). Therefore, medication is only
helpful in delaying the progression of dementia or one of its related ailments such as AD.
One type of medication is acetylcholinesterase inhibitors such as Donepezil (Sadowsky and
Galvin, 2012) that re able to treat mild to moderate Alzheimer disease. The aims of these
medication interventions are to ensure the patient can preserve his or her cognitive abilities
and reduce behavioral problems (Sadowsky and Galvin, 2012, Marwjik and Spiegel, 2009).
The role of the GP is making adequate diagnostic process of the patient and recommending
the right medication. People who suffer from dementia are most likely to be depressed. The
GP can prescribe antidepressants to address depression.
However, one of the most significant treatments in dealing with dementia involves
support and care. If a member in the family suffers from dementia, the family should plan
how a person will be getting care and support. One method of taking care of the patient can
be through behavioral therapy. This involves the change of behavior of the affected persons
such increasing the patient’s social interactions (Sadowsky and Galvin, 2012). The caregiver
can be a trained friend or a family member who will be ready to help the patient in reversing
the behavior-related activity. A patient suffering from dementia could have a history of
wandering in their home or in the nursing facility (Aihw, 2012, p. 52). Therefore, if the
DEMENTIA 5
patient has this type of history, behavior change would involve having the patient take part in
exercises in order to reduce restlessness. The role of the family physician in this case would
be supervisory. The family physician will help the caregiver administer the right kind of
behavior-change activities (Sadowsky and Galvin, 2012). In addition, the family physician
can help the patients with by evaluating and treating any visual and hearing effects, which are
mostly associated with the elderly. Nurses also play an important part in the management and
treatment of dementia. The nurse provides education to the family caregivers on how to
undertake the non-pharmacologic therapies in order to enhance corrective behaviors (Powers,
2008). There are different opportunities through which psychologist can see people suffering
from dementia. These can be in the home, clinics, and hospitals or in nursing homes.
Psychologists undertake various duties including assessments for suspected dementia,
providing education as well as counseling family members (Powers, 2008, p. 252). In
addition, psychologists help caregivers in managing challenging behaviors. They also provide
advice on how to improve evidence-based treatment for the patients (Powers, 2008, p. 254).
In conclusion, dementia is a general term that refers to a host of mental ailments that
affects a person’s ability to carry out their normal duties. The rate of dementia varies across
the three countries noted with China reporting the highest number of patients. The country
has the largest population and this explains, in part, the reason for the high prevalence. In the
US, over 4 million people are affected while in Australia, the figure is slightly above 300,
- The number of patients is expected to continue increasing inn the coming years.
Intervention or treatment of dementia depends on the nature of the problem. If the condition
is vitamin-related, such dementia cases can be treated by giving the patient vitamin
supplements. However, other cases of dementia cannot be treated, but can be delayed through
various approaches. Pharmacological interventions aim at delaying the progression of
dementia. On the other hand, behavioral interventions can be effective in overcoming some
DEMENTIA 6
of the behavior-related problems associated with dementia such as wandering. The family
physician is helpful in guiding the patient in behavior change. For example, the family
physician can help the family to get community resources or social services that will
complement any other treatment the patient might be undergoing.
DEMENTIA 7
References
Aihw. (2012). Dementia in Australia. Canberra: Australian Institute of Health and Welfare.
Fargo, K. and Bleiler, L. (2014). 2014 Alzheimer’s Disease Facts and Figures, The Journal of
the Alzheimer’s Association, 10 (2) 47-92
Hamilton, S. I. (2011). An Introduction to Gerontology, Cambridge: Cambridge University
Press.
Marwjik, V. H. and Spiegel, W. (2009). Overuse of antipsychotic medication in elderly
people with dementia? A view from general practice, Mental Health in Family
Medicine, 6(4): 191-193
Powers, D. V. (2008). Psychotherapy in long-term care: I. Practical considerations and the
link to policy and advocacy. Professional Psychology: Research and Practice, 39,
251-256
Prince, J. M. and Cummings, L. J. (2010).Dementia: A Global Approach. Cambridge
University Press.
Sadowsky, H. C. and Galvin, E. J. (2012). Guidelines for the Management of Cognitive and
Behavioral Problems in Dementia, Journal of the American Board of Family
Medicine, 25(3):350-366.
Waal, H., Lyketsos, C. & Ames, D. (2013). Designing and Delivering Dementia Services,
New York: John Wiley & Sons.