DSM-5 alters dementia diagnosis criteria
MEMORY loss will no longer be a requirement for diagnosing dementia, according to an architect of the latest version of the controversy-plagued DSM-5, which was released last weekend.
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dementia
The following articles have the tag dementia
Warning on rising costs of dementia
DEMENTIA care models must be tweaked to stem rising costs and decrease hospital stay times, the Australian Institute of Health and Welfare (AIHW) says.
‘Alarming’ number of carers contemplate suicide
AN “ALARMING” one quarter of people caring for a family member with dementia have contemplated committing suicide, an Australian study shows.
Man who attempted to kill wife avoids prison
A 73-YEAR-OLD man who attempted to end his own life along with that of his wife, who was suffering severe dementia and Parkinson's disease, has avoided a prison sentence.
Alzheimer’s risk could be lowered through beta-blockers
BETA-BLOCKERS may lower the risk of developing Alzheimer’s disease and other types of dementia, a US study has suggested.
Safety caution over antipsychotics in older patients
OFF-label, long-term use of atypical antipsychotics in middle-aged and older patients requires considerable caution due to a lack of safety and efficacy, US research suggests.
Link between dementia and surgery needs more study
THE effects of anaesthesia and surgery on cognitive function and the development of dementia need to be better studied, a researcher says.
PBAC eyes anti-dementia drug cuts
CONCERN persists that PBS access to anti-dementia drugs could be restricted, after a review found at least 80% of subsidised prescriptions were for use beyond six months.
Home visits key to identifying dementia
DISTRICT nurses visiting the elderly in their homes could hold the key to identifying those at risk of dementia, the Royal District Nursing Service (RDNS) says.
Chewing ability a test for dementia
THE ability to bite into an apple may be taken as a sign that an elderly person is less likely to experience dementia, researchers say.
Aspirin neuroprotective in elderly women at high CV risk
LOW-dose aspirin may slow cognitive decline, at least in elderly women at increased risk for cardiovascular events, research suggests.
Computer users at less risk of dementia, study finds
OLDER men who use computers have a decreased risk of dementia independent of age, education, depression and other factors, Australian research suggests.
GPs want more progress on addiction, dementia
BLOOD pressure, diabetes and cholesterol have all been nominated by MO’s GP readership as areas in which they and their colleagues have had the greatest impact on patient outcomes during MO’s 25 years of publication.
Dementia gets national priority status at last
AFTER a lengthy campaign dementia has been designated the ninth National Health Priority Area by government, with stakeholders now calling for increased funding for research and services.
Call to relax anti-dementia drug restrictions
RESTRICTIONS on the use of anti-dementia drugs beyond six months should be relaxed to allow clinical judgement to determine their continuance, experts have told the PBAC.
Dementia surge: Australia not prepared
AUSTRALIA faces a two-pronged public health and financial crisis as the health system struggles to accommodate an expected one million people with dementia by 2050, leading Alzheimer’s disease groups have warned.
Research to test driving skills in dementia patients
RESEARCHERS in Victoria are set to examine whether people with dementia should be given a second attempt in the test that determines how long they keep their driver’s licence.
Daily brain training may prevent Alzheimer’s
A LIFETIME of daily intellectual stimulation could help prevent the formation of plaques that are the hallmark of Alzheimer's disease, researchers say.
Rebate call for family consults in dementia diagnosis
A SPECIFIC Medicare item number should be allocated for GPs to consult with family members of individuals suspected to have dementia to facilitate earlier diagnosis, experts say. The call follows this week’s publication of two separate reports on the need for diagnosing dementia early. The World Alzheimer Report , produced by Alzheimer’s Disease International, found that only 20–50% of dementia cases were recognised in primary care in high income countries. And a report from Alzheimer’s Australia, Timely Diagnosis of Dementia: Can We Do Better? , estimated that in ...
Cortical atrophy seen 10 years before Alzheimer’s onset
SUBTLE atrophic changes can be seen in the brain almost a decade before its cognitive impact will become evident in patients with dementia, US researchers have found. An MRI can reveal early signs of “cortical thinning” in the same region of the brain affected by the disease, according to two long-term studies conducted at Harvard Medical School, Boston. In one group of initially cognitively normal subjects, eight developed dementia after an average of 11 years, while in another group, seven developed the condition after an average of seven years. Their serial MRI scans were compared to ...
Dementia development more likely with maternal history of disease
PEOPLE are more likely to develop dementia if their mother had the disease compared with those whose father had it, a study suggests. Having a first-degree relative with Alzheimer’s disease confers a fourfold to tenfold increased risk of developing dementia. Now, a brain-imaging study of 53 people without dementia at age 60, followed for two years, found those with a maternal history of dementia had twice as much grey matter shrinkage and 1.5 times as much whole brain shrinkage compared with those with paternal history or no parental history of the disease. Neurology 2011; 76:822-29 ...
Hong Kong children spot dementia in elderly
SCHOOLCHILDREN in Hong Kong are being trained to spot signs of dementia in their elderly relatives, in an innovative project that has attracted Australian attention. The pilot program involved 43 schools in which children filled out questionnaires with their parents to identify possible dementia in elderly family members. The survey asked about noticeable declines in the memory of elderly family members over the previous two years and if they had ever complained of losing personal belongings or accused a family member of stealing. The survey found 17% of respondents had an elderly family member with ...
The rising rate of AF
A decade ago, atrial fibrillation was considered an emerging epidemic – has it now reached its peak? Kate Woods looks at the rise and rise of AF.
Concerns over voting rights for mentally impaired
WITH Australia’s electorate failing to deliver a decisive verdict, one might wonder how much influence lay in the hands of a large but silent minority. Some 257,000 Australians have dementia, and the number is predicted to reach a million by 2050. It is unclear how many of these chose not to vote, but there is no doubting the growing significance of this demographic. UK academics, at least, are taking up their cause. In an editorial in the BMJ last month, experts called for greater respect for the voting rights of ...
Driving change
Draft guidelines on assessing fitness to drive may make life a little easier for GPs, but some experts say they need to go much further. Caroline Brettingham-Moore reports.
Revised standards will clarify grey areas in fitness-to-drive decisions
REVISIONS to fitness-to-drive standards are set to make life easier for GPs and preserve the doctor-patient relationship. The draft of the new standards was released by the National Transport Commission (NTC) last week, and contains stricter criteria that GPs must check before signing off on a patient’s ability to drive. The major changes include new restrictions on granting unconditional licenses to people with dementia, substance abuse problems and epilepsy. Associate Professor Ernest Somerville, neurologist and chair of the Australian and New Zealand Association of Neurologists’ driving committee, said he was pleased with the changes, as they ...
Worrying about dementia only makes it worse: study
ELDERLY people with memory problems are more likely to develop dementia if they are concerned about it. German researchers have found a strong general link between memory impairment and subsequent development of dementia, but this was particularly pronounced for those who worried about the problem. Worriers were twice as likely as non-worriers to develop any dementia over three years, the study of 2415 over-75s found. Professor Henry Brodaty, director of old age psychiatry at Prince of Wales Hospital, Sydney, said subjective complaints of memory impairment were almost ubiquitous among the elderly. “The message of this paper ...
Cholesterol lowering and dementia
Q: Can statins prevent dementia? A: High concentrations of serum cholesterol can contribute to vascular dementia and may be involved in the pathogenesis of Alzheimer’s disease. Observational studies have suggested that dementia is less frequent in people taking statins, so randomised trials of the drugs have been carried out. These have now been included in a Cochrane review. Although only two placebo-controlled trials were included in the review these European studies involved 26,340 people, aged 40-82 years, all at risk of vascular events. Their mean total cholesterol was 5.8 mmol/L. Each ...
Clues to common dementia syndromes
THERAPEUTIC Guidelines: Psychotropic , version 6, includes a section outlining the features of the common dementia syndromes. Alzheimer’s disease is characterised by an insidious onset of symptoms, with initial forgetfulness progressing over time to profound memory impairment with accompanying dysphasia, dyspraxia and personality change. In frontal dementias , personality change and alteration in behaviour are the earliest manifestations of this condition. Social disinhibition and lack of insight may be a problem. A small number of patients with frontal dementia present with word-finding difficulty, which progresses to a profound nonfluent dysphasia ...
Doctor-shopping alert on fitness to drive
FITNESS-TO-DRIVE guidelines have once again been thrown into the spotlight, following an incident in North Queensland where an elderly man with dementia went ‘doctor-shopping’ until he was cleared as able to hold a licence. The incident prompted the Mackay Division of General Practice to send letters warning GPs about the practice, and division CEO Mr Christian Grieves voiced concerns it could become more prevalent as the population aged. A long-awaited Federal Government review of fitness-to-drive guidelines is expected to be released later this month, with consultation to follow. Adelaide GP Dr David Tye, a former RACGP ...
Alzheimer's risk rises among heavy users of NSAIDs
HEAVY use of NSAIDs may actually increase the incidence of dementia and Alzheimer’s disease, a US cohort study suggests. The study included 2736 community-based adults aged 65 and older who were dementia-free at baseline. Compared to moderate or light users, heavy users of NSAIDs had a 66% increased risk of developing dementia and a 57% greater risk of Alzheimer’s disease over 12 years of follow-up. Heavy use was defined as more than 500 standard daily doses of an NSAID being prescribed for an individual within a two-year period. The findings differed from earlier studies in younger cohorts, the authors ...
Oz screening test best for Alzheimer’s
AGE bias should be avoided when determining which patients need cognitive screening to detect Alzheimer’s disease, Australian experts say. And they say an Australian-developed screening test is superior to the widely used Mini-Mental State Exam (MMSE) as a screening tool for dementia. In a recent editorial, a US geriatrician said opportunistic screening prevented delayed diagnosis of Alzheimer’s. Professor John Snowdon, of the department of psychological medicine at the University of Sydney, agreed, saying in people older than 75, one in 10 would have significant cognitive difficulties. “Therefore [cognitive screening] is worth doing because a lot ...
A stitch in time saves mind
LIKE many children of my generation, I grew up to the sound of clacking needles and the mutter of “knit one, purl one; knit one, purl one...” I thought it was a lost art until my son started high school and emerged from a home economics class with a mess of wool he claimed was destined to become a scarf. Well, I thought, at least the boys get to do it as well as the girls these days. And perhaps more of us should take it up. Research presented to an American Academy of Neurology meeting ...
Abuse common in dementia
PATIENTS with dementia may be suffering abuse at the hands of their carers at alarming rates, according to a new British survey. One third of the 220 carers surveyed reported various levels of abuse, while just over half admitted they had engaged in some form of abusive behaviour – with screaming or yelling, and insulting or swearing, the most common forms of abuse reported. Only three carers reported actual physical abuse, where a patient was hit, slapped, shaken or otherwise handled roughly. However, the authors said those carers exhibiting the most abusive behaviour might have been reluctant ...
Ginkgo has no benefit in dementia prevention
GINKGO biloba has been found to be ineffective in the prevention of dementia by the first large, randomised controlled trial of its safety and efficacy. US researchers found, in a study of 3000 people with normal cognition or mild impairment, that a twice-daily dose of 120 mg extract of ginkgo did not reduce the dementia rate compared to placebo. After six years, there were slightly more people with dementia in the intervention group compared to placebo (17.9% vs 16.1 per cent). The researchers said this was a “puzzling” finding and should be treated with ...