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DEMENTIA
C
urrent research shows that
in 2015 there were 850,000
people living with dementia
in the UK (Alzheimer’s Society,
2015). Dementia now costs the
UK economy £26.3 billion a year,
with this figure set to rise (Prince
et al, 2014), and people over 55 are
said to fear developing dementia
more than any other disease
(YouGov, 2014). To counter this, the
government has identified dementia
as a national priority, partly because
one-third of people with dementia
currently live in residential care
(Prince et al, 2014).
Dementia leads to a progressive
decline in memory and cognitive
function, increasing functional
impairment, and eventual death
(Murray and Boyd, 2009). The
Alzheimer’s Society (2013) describes
dementia as ‘a set of symptoms
that may include memory loss and
difficulties with thinking, problem
solving or language’; whereas the
World Health Organization [WHO]
(2015) describes it as a syndrome
that is not part of normal aging and
which affects cognitive abilities such
as thinking, memory, understanding
and emotions.
WHAT IS DEMENTIA?
There are many different types of
dementia although Alzheimer’s
is by far the most common, being
responsible for 60–70% of cases. It
was first identified by Alois Alzheimer
in 1906 but until the 1960s it was
referred to as ‘senile dementia’.
Memory difficulties are often one
of the first and most commonly
recognised symptoms of Alzheimer’s.
However, there are many other
types of dementia such as vascular
dementia, dementia with Lewy
bodies and dementia that affects the
frontal lobe of the brain. Many people
experience mixed dementia where
more than one type is present at the
same time.
Nutrition
Most people living with dementia
lose weight as their illness progresses.
(Ikeda et al, 2002). There are a variety
of reasons for this, for example their
cognitive impairment may affect their
ability to recognise when they are
hungry or thirsty, or they may have
poor concentration or coordination
meaning that meals and drinks
remain unfinished. Muscles and
reflexes are also affected, causing
swallowing and chewing difficulties
(Ratnaike, 2002), while damage to
specific parts of the brain may mean
that people start to like foods they
did not like before or find foods they
Rosie Callaghan, tissue viability specialist nurse,
Worcestershire Health and Care Trust; Jola
Merrick, registered manager, Herons Park Nursing
Home, Kidderminster, qualified nurse specialising
in the care of patients with dementia and in tissue
viability, trustee of Wound Care Alliance UK
How does dementia affect patients
with wounds?
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Rosie Callaghan, Jola Merrick
JCN supplement
2015 Vol 29 No 5
9
THE SCIENCE — WHAT
CAUSES DEMENTIA?
The different types of dementia
have a variety of causes resulting
from gradual damage to the
brain. A build-up of abnormal
proteins in the brain can lead to a
decline in a person’s mental and
physical abilities. These abnormal
proteins are different in each type
of dementia. Neuron death is the
main cause of dementia and is
often related to malfunctions in the
way that neurons ‘communicate’.
However, when the brain’s
immune system becomes too active
this can cause inflammation, which
can also damage cells. Unlike most
cells, when neurons die other cells
do not divide and replace them —
this is why dementias are mainly
progressive and irreversible.
Sources:
www.nhs.uk;www.
alzheimers.org.uk