All About Dementia

8/8/2019 All About Dementia

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All AboutDementiaA booklet for those wanting to

know more about dementia


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What is dementia?

Dementia is a gradual decline in mental ability: memory,

thinking, problem-solving, concentrating and perception.

It has many forms, and often we do not know what causes it,

although as described (see What causes dementia? ) we have

some ideas. There are other problems sometimes associated

with dementia which can often be successfully treated. These

include things like depression, sleep problems, aggression,

inappropriate sexual behaviour and incontinence.

What is the difference betweendementia and Alzheimers disease -and how common are they?

Alzheimers disease is an illness of which the main symptom

is dementia, and it accounts for about 60% of the cases of

dementia diagnosed. It was named after Alois Alzheimer,

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a German doctor, who first described it, in 1907. Alzheimers

disease cannot be diagnosed with total certainty during

someones lifet ime. It is characterized by damage ( plaques

and tangles ) seen in and around brain cells when these areexamined at a post-mortem.

Other forms of dementia differ in terms of their symptoms,

causes and the precise changes in the brain (See In what

other diseases as well as Alzheimers does dementia occur? ).

Dementia becomes more common as people age. Only about

one person in a 1,000 below 65 will develop it, but about three

in a 100 of those over 65 and between 10 and 15 in 100 of

those over 80 will be affected.

People with all forms of dementia differ in terms of which signs

and symptoms they have and the speed and extent to which

their illnesses progress - problems vary, even day-to day. The

information in this booklet is intended as a general guide - not

all the problems will be relevant to everyone. Despite this,

those w ith all types of dementia are likely to need similar care

and support and hence this booklet is relevant to the range of

diagnoses.

What causes dementia?

Dementia occurs as a result of death of cells or damage in parts

of the brain that deal with our thought processes. This may follow

other problems like lack of blood and therefore oxygen supply to

these brain areas, head injury, pressure (such as from a tumour)

or infection (such as in AIDS).

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In some cases, therefore, we can identify what is likely to be

causing dementia, and indeed treat the problem. In others - those

with Alzheimers disease, for example - we do not know why

brain cells become sick , although this is the focus of intenseresearch (See What research is going on into dementia? ).

After Alzheimers disease, the second most common type is

vascular dementia, which occurs as a result of lack of blood and

oxygen to the brain in a series of tiny strokes . Other types of

dementia are rarer, and may be due to Lewy body disease, Picks

disease, Huntingtons disease or chorea, Creutzfeld Jakob

disease (CJD) the human equivalent of mad cow disease ,dementia as part of a neurological (brain) illness such as

Parkinsons, a brain tumour, fluid build up (hydrocephalus) or

following a long period of excessive alcohol intake. These last

three causes are to some extent treatable, as is the dementia that

may result from causes such as vitamin or hormone deficiency or

syphilis. These possibilities should always be investigated and the

Alzheimers Disease Society Information Sheet Other Forms of

Dementia is very helpful. See also following sections and Boxes

1 & 2.

In what other diseases as well asAlzheimers does dementia occur?

The second most common cause of dementia after Alzheimers

disease is vascular dement ia. Mul t i-infarct dementia is

the most common sort, in which cells in certain regions of the

brain die because the blood supply to them is poor. Risk factors

for this are the same as those for stroke (See Can anything

slow down dementia? ). Dementia progresses gradually -

characteristically capacity for learning, memory, speech and

language decreases, and people may have more insight into

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their condition than do those with Alzheimers disease. Other

distinctive features may include marked emotional sw ings,

night t ime confusion, fits like those of epilepsy, and partial or

total paralysis of a limb.

Another characteristic form of dementia is related to the

presence of Lewy bodies - tiny spherical structures found

inside brain cells, which may cause them to die. About a

quarter of people with Alzheimers disease are found to have

Lewy bodies in their brain cells when these are examined after

death. They are also found in brain cells affected by Parkinsons

disease (PD), in which the ability to control movement isimpaired. Researchers disagree as to whether diffuse Lew y

body disease is a distinct condition, or a variant of Alzheimers

disease or PD, and indeed dementia linked to the presence of

Lewy bodies is known by many names. Symptoms vary, and

may be indistinguishable from those of Alzheimers disease, or

more mild in the early stages. Movement disorders like those

of PD may occur in parallel with dementia, and the severity of

dementia, confusion and hallucinations that some people

experience may be quite variable, even from hour to hour.

The main difference between Picks disease and Alzheimers

disease is that, in the early stages at least, damage occurs in

different brain areas. That most commonly first affected in

Picks disease is the front, and dementias of this origin are thus

sometimes referred to as frontal lobe dementia . Changes

in personality, impaired judgement, lack of inhibition, reduced

speech and obsessional behaviour may be early signs, and if

the disease includes cell death in the brains temporal lobes,

prominent signs include memory loss, difficulties with object

recognition and changes in eating habits - gorging, and often

craving sweet food. The age of onset is most commonly

between 40 and 65 years.

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Dementia and younger people

There are two distinct ways in which younger people may

experience dementia - through witnessing it in elderly relatives,

or, extremely rarely, developing it themselves. The vast majority

of young people affected by dementia see it develop in

grandparents or other elderly relatives. Explaining the illness to

them can be very diff icult, and the Alzheimers Disease Society

has produced leaflets on this.

A distinction used to be made between dementia occurring in

those above 60 and those under, with the term pre-senile

dementia sometimes applied to the latter. Box 1 outlines the

main dementias that people under 60 may suffer.

Treatable causes of dementia

It is important to rule out conditions which could be treated

to reverse or stop progression of dementia. The following

categories summarise the main dementias of this sort:

Head-injury related:

Internal bleeding after a head injury can lead to a clot that

presses on the brain and in turn causes dementia. Such

sub-dural haematomas can often be surgically removed.

Another problem that can occur after head injury is a build up of

cerebrospinal fluid (CSF), which normally protects and cushions

the brain. Internal bleeding and infections can also cause this

hydrocephalus which may be noticed first as problems w ith

walking and incontinence. Again, surgical treatment can help.

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Box 1: Dementias affect ing those under 60

While Alzheimers disease has been known to affect people in their 20s, there

are other dementias more associated with this age group, although even these

are rare. Dementia with treatable causes (See Treatable causes of dementia )

can occur in the young and should be ruled out if a young person develops any of

the signs. Indeed, should a young person develop these, the possibility that they

are a usually temporary effect resulting from illegal drug use should also be

looked into.

A small number of people with the HIV virus that causes AIDS develop dementia,

as a result of a direct effect of the virus on the brain, or infections or tumours that

can develop after the weakening of the immune system that AIDS causes. More

information on this can be obtained from the Terence Higgins Trust (see Where

to get further advice )

Despite a lot of publicity, Creutzfeld Jakob disease (CJD), the form of dementia

that has been linked to eating infected beef, is extremely rare, occurring in about

one in a million people in the UK. The link to eating infected beef has only been

made in the form that affects young people - no such link has been found in the

most usual form of CJD that develops in late middle age, progresses rapidly and

causes death within about a year. The form that occurs in young people can go on

longer and has early signs similar to those of AD. Disturbance of mood is

common and people affected may also become unsteady on their feet and have

spasms or jerkiness in their hands and feet.

Hunting tons disease or Huntingtons chorea is a rare dement ia that occurs in

parallel with problems controlling body movements and usually begins in the

thirties or forties, with either set of symptoms occurring first. Memory loss

progresses to severe dement ia, and anxiety and depression may also occur.

Involuntary twitching and muscle spasms, which may be controllable by drugs,

are the physical problems which give the disease the name chorea. Huntingtonsdisease usually goes on longer than Alzheimers disease, sometimes up to 25

years before death, and nursing care is almost always needed at later stages.

Some of the debate about whether people should be tested to see if they carry

the genes for certain psychiatric disorders has focused on Huntingtons disease

because those who develop it will generally not do so until after their child-

bearing years. Those at risk, where people in their family have the disease, may

be offered genetic counselling and the test before they make a decision about

starting a family. That said, it is important to respect someones wishes if they

prefer not to obtain this information.


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Dietary:

While long-term alcohol abuse can itself damage the brain and

cause dementia, people who abuse alcohol may also neglect

their food intake and become deficient in certain vitamins and

minerals. Improving diet and stopping drinking can help.

Korsakoffs syndrome, often manifest as memory loss, can

occur after prolonged heavy drinking due to vitamin B1

(thiamine) deficiency.

Vitamin deficiency alone, especially lack of B1, 3, 6 & 12 can

cause dementia-like symptoms. A simple blood test and

vitamin supplements can help.

Dementia linked to other illnesses:

An underactive thyroid gland (hypothyroidism) can lead to

dementia which may be reversible by replacing thyroid

hormone (thyroxine). The chances of this working well are

increased if the problem is recognised within two years.

Other treatable hormone problems may lead to dementia, as

can conditions such as systemic lupus erythematosus (SLE),

syphilis and brain tumours. Reduction of the blood supply to the

brain due to cardiac, respiratory failure or anaemia may also be

to some extent treatable. Finally, it is w orth remembering that a

dementia-like illness can occur in elderly people who are

severly depressed, and this possibility should always be

investigated.

Is dementia inherited?

Most studies looking into whether dementia runs in the family

have been on Alzheimers disease, and most cases do not.

Those that do, tend to begin quite young - if at least three

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people from one side of your

family have developed

Alzheimers disease betw een

35 and 60, there may be agenetic predisposition to it.

Although it is by no means

inevitable that you will

develop it, you may want to

ask your GP to refer you to a

genetic counsellor or a

specialist dementia clinic.

Box 2 explains in a litt le more depth what w e know about the

genetic link in Alzheimers disease. That most research to date

has focused on Alzheimers disease, reflects how common it is

compared with the other dementias.

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Box 2: Genetics and dementia

Finding out more about the genetic forms of Alzheimers disease may help us to

better understand the disease in general. Genes, located on chromosomes,

instruct the cells of the body to make proteins and thereby govern many aspects

of their function. Finding out which of these genes and hence proteins go wrong

in Alzheimers disease in the small number of cases that are in part inherited,

should help us work towards prevention, treatment and cure for all types, as the

fundamental problems are likely to be similar whether or not the disease is

inherited.

One of the genes that seems to be important in causing inherited Alzheimers

disease is that for a protein called amyloid, which accumulates in the brain and

which may prevent chemical messengers (neurotransmitters) which usually carry

messages from one brain cell to others from doing their job. This might help

explain why people with Downs syndrome (a mental handicap or learning


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disability where those affected have an extra copy of chromosome 21, where the

code for (instruction to make) amyloid is found) have an increased risk of

developing Alzheimers disease.

It is not only abnormalities in the genes for amyloid that may be responsible for

inherited Alzheimers disease. For example, we know that some families have

defective genes on chromosomes 1 and 14, and that these genes code for

proteins involved in the processing of amyloid in the brain.

Finally, a lot of research has focused on a gene which makes the protein

apolipoprotein E (ApoE), which is made in 3 forms (E2-4). Were not sure what

ApoE does in the brain, but in the rest of the body it is involved in transport of

fats. Most people have tw o copies of the ApoE3 subtype, which has no effect on

their risk of developing Alzheimers disease, while those with ApoE2 may have

reduced risk. ApoE4 is uncommon, but does increase the risk of developing

Alzheimers disease. Given that we inherit one ApoE gene from each parent,

those most at risk are those with two of the E4 forms and those with one or two

have a graded risk.

ApoE4 only increases risk of Alzheimers disease, and does not mean it is

inevitable. The impact of this changes as we get older. At age 50, the risk is 1 in

1,000, and ApoE4 will double this risk to 2 in 1,000. However, at 90, the usual

incidence is about 1 in 2, and it might be expected that those with ApoE4 would

therefore inevitably get Alzheimers disease at this age. This is not the case, and

is a good example of how there must be either an environmental factor which

interacts with ApoE4 to bring about the disease or another as yet unidentified

gene which, along with ApoE4, also affects risk.

The non-Alzheimers disease dementias described earlier (see In what other

diseases as well as Alzheimers does dementia occur? ) also have genetic links.

While vascular dementia, like Alzheimers disease, seems to occur as a result of

genetic and environmental interaction, Picks disease may more often run in

families and we may be gett ing close to finding out w hat gene(s) is/are involved.

The child of someone with Hunting tons disease has a 1 in 2 chance of

developing it, and can have a test to find out if they are at risk (See Box 1).


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How is dementia treated?

Whenever dementia is diagnosed, the possibility that it is

treatable as described earlier should be considered. Sadly,

Alzheimers disease and the other dementias of this sort

cannot be cured but there are things that can be done both

to help directly with the symptoms and which may also slow

disease progression.

Drug treatment

There are so many people longing for a cure or alleviation for

dementia that new t reatments are sometimes reported

which turn out to be unavailable or at an early stage in

development or evaluation.

Although currently available drugs cant cure dementia, they

can be useful for treating some of the problems associated

with it (as described in What is dementia? ) including

depression. Your doctor should be able to advise you on this.

It is important to review regularly the drugs taken by a person

with dementia, and indeed to check that none of those being

taken when the first diagnosis is made is contributing to or

causing dementia. Continuing medication for a physical health

problem existent before the dementia may be needed, or

people with dementia can develop other unrelated illnesses

that require treatment. However, some drugs can worsen

confusion, although the doctor may be able to adjust

medication to minimize this. Sedatives are especially

problematic as they can worsen confusion. There is some

concern that they may be over-used, especially in care homes.

Talk to the homes own doctor if concerned.

Major tranquilisers like Melleril or Haldol are quite commonly

used in dementia, especially when there are particular

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problems with disturbed thoughts and seeing, hearing or

smelling things that arent there. These drugs can be useful in

some patients, but sometimes only for a short time - dementias

are progressive problems and drugs useful at one point maycease to be so later. These drugs may also just replace one

set of symptoms w ith others, such as apathy. People whose

dementia occurs as a result of Lewy Body disease (see In

what other diseases as well as Alzheimers does dementia

occur? ) may react badly to major tranquilisers and their use

should generally be avoided.

There is much interest in a drug called Aricept or donepezil whichwas licensed for use in the UK in March 1997. Another in this

category but not available in the UK is Cognex or tacrine - problems

it may cause with the liver stopped it getting a UK licence.

Such drugs are not cures for Alzheimers disease, nor do they

appear to stop its progression, although well know more about

this w hen they have been in use for longer. They seem to be

most effective given in the early stages of Alzheimers diseasewhen dementia is relatively mild, which is one reason why

seeing your doctor and getting an early diagnosis may be

beneficial. Side effects (which may include nausea, vomit ing,

diarrhoea, insomnia or sleepiness), need to be balanced against

any improvement in quality of life. However, the side-effects

tend to reduce after a few weeks. Effectiveness of these drugs

is not affected by the patients age, sex or race.

Non-drug treatment for dementia

The maintenance of good general health is important, and there

are things that can be done to promote and preserve mental

ability, as described in Can anything slow down dementia? .

As described above, there may also be steps that can be taken

in rare cases where dementia is associated with a treatable

condition. As yet, there is no surgery w ith proven benefit in

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dementia, although research is looking into the possibility that

brain cell transplants might be useful, as they may be in some

cases of Parkinsons disease.

Some people w ith dementia are helped by psychological

techniques such as reminiscence therapy, in which they are

encouraged to recall events from the past, and from

complementary approaches such as homeopathy or

aromatherapy. You can find out more about these in

Alzheimers at your Fingertips and from the Institute for

Complementary Medicine (See Where to get further advice

and Further reading ).

Finally, people often ask whether it is helpful to keep the brain

exercised . It certainly seems that gentle encouragement to

use the brain and keeping the environment quite stimulating is

a good idea. But dont overwhelm people w ith demands that

may only frustrate if they cannot be met.

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What are memory clinics?

Memory clinics vary, but in general they specialise in testing

and assessment of memory and other abilities. This is

necessary to make as good a diagnosis as possible about the

type of dementia that the individual has. Some memory clinics

are also involved in testing new drugs, and may offer

participation in drug t rials (see Box 3).

Can anything slow down dementia?

Do we know how to preserve our cognitive function - for

example our memory, and if we begin to develop problems that

might herald the onset of dementia, can we do anything to

slow down or stop this? Both questions are being intensively

researched and in general, factors that protect against stroke

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Box 3: How are drugs for dementia tested?

After trials suggest that a drug may be effective at treating any condition, much

work remains to make sure that it really is effective and safe, and at what dose it

is most usefully given. This process may involve randomised controlled trials

(RCTs) in which groups of patients are divided and some given the drug while

others receive an inactive tablet (placebo) or the best drug currently available for

the problem that they have.

After an appropriate period of time, all patients are re-assessed to see whetherthose taking the new drug really have benefitted. It can be extremely frustrating

to be involved in a trial and not know if you or a loved one are in fact receiving the

inactive placebo. However, people involved in such t rials are always asked to give

consent and they are really the only way that, in the long term, effective and

improved treatments can be found and tested.


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are predicted to have value in preserving our cognitive function

by ensuring that the brain is well supplied w ith blood and

oxygen.

Similarly, while we do not know with certainty whether steps

can be taken to slow down or stop progression of Alzheimers

disease or the other dementias described, vascular dementia is

the exception, where risk factors are the same as those for

stroke. Hence drugs may be given (these may be as simple as

aspirin) to thin the blood, correct irregular heartbeat and in

some cases, surgery may be performed to remove deposits

that may be lining arteries and thereby decreasing blood flow.Treating high blood pressure in people with vascular dementia

is a difficult balance, as a relatively high pressure is needed to

supply the brain with adequate blood and oxygen despite

reduced flow.

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Is it best for people with dementia tolive at home, what support isavailable, and who pays?

Some people with dementia remain living at home, alone or

with a spouse, child or other carer. There are ways to make

home as safe as possible, as detailed in the Alzheimers

Disease Society leaflet Safe as Houses . It seems obvious,

but its worth remembering, that safe, familiar environments

and consistent routines will help reduce confusion and may

also be useful in protecting against physical dangers such as

falls.

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Box 4: How do Aricept and Tacrine w ork?

These drugs are anticholinesterases or cholinesterase inhibitors and they work by

stopping breakdown of acetylcholine (a neurotransmit ter, which helps brain cells

communicate, and levels of which are reduced in Alzheimers disease) by another

brain chemical called acetylcholinesterase. People with Alzheimers disease have

reduced levels of acetylcholine (as well as other neurotransmitters); deposits in

and around cells, and plaques and tangles, may further reduce its efficiency by

stopping enough of it get ting from one cell to another. The actual numbers of cells

sending and receiving acetylcholine are also reduced. Together, these factors may

underlie memory problems. Aricept thus may boost acetycholine levels and help

with memory problems to some degree and in some people.

Drugs that may become available in the foreseeable future include Exelon,

metr ifonate and galanthamine, which all work in ways similar to Aricept. Future

developments are likely to include drugs which to some extent copy

acetylcholine or other neurotransmitters lost in Alzheimers disease, and act

directly on the cells that respond to them.


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It is often hard to make decisions about w hen staying at home

is no longer possible and to identify the best options of

residential care. It is important to remember how hard it can be

to look after someone with dementia and that the decision to

find alternatives need not be left until the carer really feels that

they can no longer cope. Many people with Alzheimers

disease or other dementias need the services offered by

residential or nursing homes at some stage.

While people with dementia are at home, they are entitled

to receive professional support under the Care in the

Community initiative. In general, ask the GP or hospital

specialist about medical or nursing support. If you want access

to other services such as home helps or meals on wheels, you

will undergo a needs assessment from your local social

services (contact the local Council).

Social services are responsible for providing a range of help, but

whether this is free or indeed available depends on tw o things -

what the needs assessment identifies is required, and where you

live. Local authorities do not have a legal obligation to provide care

in the community if this would cost more than residential care.

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The needs assessment is usually done by a social worker or

occupational therapist and takes into account the views of the

GP and carer(s), any professionals who have been involved and

the person with dementia themselves - although thequestionnaire form that they are given may need to be filled

in by their closest carer if they cant do it themselves. Once

assessed, social services will discuss with carers what support

the person with dementia is entit led to, and w ill appoint a care

manager to co-ordinate the range of services that may be

approved, through a care plan. These may change as the

disease progresses and indeed the care manager will continue

to be involved if residential care is needed (See Residential

care for those w ith dementia - when and where?).

The services which people w ith dementia living at home may

be offered range from home helps to assist w ith daily life,

some forms of nursing care often through the district nurse,

to assistance from the community psychiatric nurse (CPN) who

will monitor patients and liaise with other supports such as

speech therapists and respite care (see What is respite

care? ). Again, depending where you live, further day-to-day

home care is provided by social services or voluntary groups

such as the Association of Crossroads Care Attendants

Schemes or private agencies, who should be members of the

UK Home Care Association.

A good relationship with the care manager can be extremely

useful, and if you disagree with any element of the care plan,

you should discuss it with them. The social services

department has a complaints procedure that you can use if you

cannot resolve differences of opinion.

Day centres can be very useful for those w ith dementia living

at home whose carer has to be out during the day. Run by local

health authorit ies, social services, voluntary organisations and

some nursing homes, often with transport to them provided,

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your GP, social services or organisations such as the

Alzheimers Disease Society and Age Concern will be able to

tell you more about whats available in your area. Try not to

choose a day centre too far from home, as long journeys canboth tire and confuse those with dementia. Charges may be

made for transport and food.

Whether services provided under community care are free will

depend on income and savings, and the needs assessment will

look into this. Not all services are available in all areas and there

may be waiting lists. It can be incredibly frustrating trying to set

up a rota of help that makes both main carers and the personwith dementia feel confident that living at home is feasible. As

a basic minimum, if the needs assessment identifies that home

help, day centre places, meals-on-wheels and advice on aids in

the home are needed, these must be provided, regardless of

where you live.

Residential care for those withdementia - when and where?

People with dementia are rarely looked after in hospital unless

they have a specialist medical need. The two main types of

residential care are residential and nursing homes, the

difference being the level of specialist care provided.Residential homes provide meals and activities and help

residents with w ashing, dressing, baths etc. People with

dementia who also have physical problems or whose behaviour

cannot be managed by non-professional staff will need the care

offered in a nursing home. Indeed, sometimes going straight

into a nursing home before these problems arise can avoid

having to move later if they do.

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Who pays for residential care ofpeople with dementia?

As mentioned in the previous sections, charges may be made

for many of the services provided for those with dementia

living at home. These vary from region to region and will be

influenced by what the individual can afford. The regulations

about who pays for residential care constantly change, as does

the extent to which financial status - of a client or their spouse -

affects this. Your local Citizens Advice Bureau can advise.

In general, peoples income and savings are taken into account

when local authorities are deciding at what level they w ill

financially assist with costs. You may be able to make the

decision to use a private home and meet all the costs yourself,

but bear in mind that it may become necessary at some stage

to move to a less expensive home or one that social services

will subsidise. They will decide whether to do this on the basisof a needs assessment (see Is it best for people with

dementia to live at home, what support is available, and who

pays? ).

If people with dementia need time in hospital, they have a right

to refuse to be discharged if this means that they w ill go into

fee-paying residential care. Should this situation arise, an

assessment involving hospital staff, GP, social services and theperson with dementia and their carer(s) must be carried out,

and the hospital consultant will make the final decision about

whether hospital care can continue. This decision can be

appealed against, and again your Citizens Advice Bureau or

legal advice centre can tell you more about this procedure.

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What help can I get as a carer ofsomeone with dementia?

The carers role can be extremely diff icult. Whether your friend

or loved one is at home or in residential care, you may have

times when you manage well, and others when it all seems too

much to bear. Ensuring that you get regular holidays from

caring - you may not want to go away, but just need some time

to yourself - is important (See What is respite care? ).

Make sure that you get as much help as you can from the other

people involved in care, from the GP and other professionals to

other carers such as yourself, who you may be able to contact

via your local branch of the Alzheimers Disease Society. When

you have appointments to see doctors or others involved in

care, it can be helpful to make a list of things you want to ask

them about as they occur, and take this w ith you when you

meet.

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The Mental Health Foundation has a free booklet called

Because You Care which is a guide for carers, to help them

deal with difficult behaviour in those with dementia.

Organisations listed in Where to get further advice also haveuseful publications.

What research is going on intodementia?

Dementia is overwhelmingly a problem associated with ageing.

With a growing elderly population, pressure to find causes,

preventions, treatments and cures is immense, not to mention

ways to alleviate the difficulties faced by carers. There is also

increasing recognition that people w ith dementia themselves

may be able to be better understood and thus their views of

the care they are receiving, and what their wishes are, be

accessed.

The Alzheimers Disease Society and Alzheimers Scotland

produce regular updates on dementia research both in the UK

and abroad, and you will also find information on the Internet.

Be careful about relying on media reports, which may not

always be accurate and may exaggerate the nature of new

findings. For example, in 1986, the w hole world seemed

suddenly convinced that aluminium was causing Alzheimersdisease, following reports that aluminium w as found in the

brain deposits that occur, but this is now largely thought to

be an unlikely cause.

To find a cure, it will be necessary to identify more accurately

the causes of dementia, and much work is focusing on this.

We may get clues from emerging drugs which seem to prolong

good mental function in those with dementia, and which some

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studies suggest may also slow progress of the condition. It w ill

be interesting to see whether other countries strategies, such

as the widespread use in continental Europe of drugs which

widen blood vessels (vasodilators), are shown to be effectiveand thus influence practice in the UK.

Much future research will undoubtedly concentrate on w hat

genetics can tell us about dementia. It is now possible to have

a test for the rare inherited form of Alzheimers disease and it

may become possible in the future to repair or replace genes

damaged and implicated in this and other dementias.

Finally, it is clearly very important to find ways that those caring

for people with dementia can be supported through what may

be extremely difficult times. Research has been and is being

carried out into w hat supports carers find most useful and, to

date, day care and respite help (see What is respite care? )

have proved to be highly effective, and eff icient, uses of

healthcare resources. It is clearly vital that the value of support

services be accurately assessed if calls for the continuingprovision of those that are helpful are to be heeded.

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* Age Concern England

Astral House

1268 London Road

London SW16 4ER

Tel: 020 8765 7200

* Age Concern Northern Ireland

3 Lower Crescent

Belfast BT7 1NR

Tel: 028 9024 5729

* Age Concern Scotland113 Rose Street

Edinburgh

EH2 3DT

Tel: 0131 220 3345

Age Concern provides

comprehensive information and

advice relating to older people.

* Alzheimers Society &CJD Support Netw ork

Gordon House

10 Greencoat Place

London SW1P 1PH

Tel: 020 7306 0606

* Alzheimers Society

(Northern Ireland)

403 Lisburn Road

Belfast BT9 7EWTel: 028 9066 4100

* Alzheimers Society

(Welsh Development Office)

Tonna Hospital

Neath

West Glamorgan SA11 3LX

Tel: 01639 641938

The Alzheimers Society is the

leading care and research charity

for those with dementia

Alzheimer Scotland - Action on

Dementia

22 Drumsheugh Gardens

Edingurgh EH3 7RN

Tel: 0131 243 1453

24 hour Freephone helpline:

0808 808 3000

Help for people w ith dementia,

their carers and families.

Crossroads Association

10 Regent Place

Rugby

Warwickshire

CV21 2PN

Tel: 0845 450 0350

Regional centres throughout the

UK providing practical support

and help for carers

Carers Association of Ireland

St Marys Community Centre

Richmond Hill

Dublin 6 Ireland

Tel: 01-497 4498

(From UK): 00 3531-497 4498

* Carers National Association

20-25 Glasshouse Yard

London EC1A 4JS

Tel: 020 7490 8818

Helpline: 0808 808 7777

Campaigns for carers rights and

provides a telephone helpline.

Where to get further advice


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* Counsel and Care

Twyman House

16 Bonny Street

London NW1 9PG

Tel: 020 7241 8555Advice Line: 0845 300 7585

Advice and information on home

and residential care for older

people, carers and professionals

* CRUSE: Bereavement Care

Cruse House

126 Sheen Road

Richmond

Surrey TW9 1UR

Tel: 020 8939 9530

Helpline: 0870 167 1677

* CRUSE: Bereavement Care

Northern Ireland

50 University Street

Belfast BT7 1HB

Tel: 028 9024 1221

CRUSE provides bereavement

counselling, support, help and

advice

* Huntingt ons Disease

Association

108 Battersea High Street

London SW11 3HP

Tel: 020 7223 7000

National helpline: 01924-280062

Support and help for those

affected by Huntingtons Disease

Insti tute for Complementary

Medicine

15 Tavern Quay

London SE16 1TX

Tel: 020 7237 5165

Provides information about

natural therapies and ensures

high standards of care

* MIND (National Association of

Mental Health)

Granta House

15-19 Broadway

Stratford, London E15 4BQ

Tel: 020 8519 2122

Info. line: 9.15-4.45

Mon, Weds, Thurs,Fri; 2-4.45

Tues: 020 8522 1728 /

08457 660163

Works for all those in emotional

distress, their carers, families,

friends, students and

professionals

* National Self-Help Support

Networks

c/o National Self-Help Support

Centre

NCVO

Regents Wharf8 All Saints Street

London N1 9RL

Tel: 020 7713 6161

Helps those wanting to set up

support and self-help groups and

maintains a database of them

* The Mental Health Foundat ion

UK Office

83 Victoria Street

London SW1H 0HW

Tel: 020 7802 0300

Fax: 020 7802 0301

Scotland Office

24 George Square

Glasgow G2 1EG

Tel: 0141 572 0125

Fax: 0141 572 0246

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This booklet has been produced

by the Mental Health Foundation

(MHF) the major UK charity

concerned with all aspects of

mental health, including mentalillness and learning disabilities

(mental handicap).

The Samarit ans

UK-wide helpline: 08457 909090

24 hour helpline offering support

to those in crisis or need

* Terence Higgins Trust

52-54 Grays Inn Road

London WC1X 8JU

Tel: 020 7831 0330

Helpline:

0845 1221 200

Provides understanding about

HIV and AIDS and practical

support for those affected

* These organisations produceleaflets etc. that may be helpful.

Their publications are not listed

individually.


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As the UKs only charity concerned with both mental health and

learning disabilities, the Mental Health Foundation plays a vital

role in pioneering new approaches to prevention, treatment andcare. The Foundations work includes: allocating grants for

research and community projects, contributing to public

debate, educating and influencing policy makers and health

care professionals.

All About Dementia

Documents

Transcript of All About Dementia