Tuesday, August 26, 2008

Dementia diagnosis

In a recent article about dementia drugs, one journalist cites information that should be heeded by health care providers. Drugs are fairly readily prescribed, but are not necessarily the best way to go for ailing seniors. At the time of this photo dad was on 8 different drugs.

Alzheimer’s disease accounts for 70% of dementia cases and affects 5% of the population age 65 and over (Blazer, 1996 and Regier et al., 1988, as cited in Pinel, 2008). It affects 40% of those over age 90 (Williams, 1995) and patients die, on average, eight to ten years after the onset of dementia symptoms. The number of Alzheimer’s cases is predicted to increase by twenty-five percent by the year 2010 (Cummings and Jeste, 1999). Yet no one had examined Dad for these signs. Not all dementia is Alzheimer’s disease, but the work done by the Alzheimer’s Society has provided much information on the signs that usually develop two to three years before dementia sets in: difficulty learning and remembering verbal material. The first significant sign is memory loss. It affects simple activities: eating, speaking, recognition of family members, and bladder control. Callahan, et al. (1995) found that 23.5 percent of those with moderate to severe dementia were identified as having a dementia syndrome.

Family members have to continue to be advocate for those with dementia. Those in LTC, most of whom have Alternate Decision Makers such as family members, have little control over the drugs that their loved ones receive. It is a shame, too, that so few of these drugs are tested on seniors above age 75, as it is only recently that there was enough of a population in this age group to make such research viable. Every family member should attend meetings with seniors and ask questions.

There are many contraindications for particular drug interactions and comborbidities that require monitoring of polypharmacy. Speak to your pharmacist if you have questions.

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