Neurological disorders: Dementia

 Neurological disorders: Dementia

Dementia is one of  neurological disorders and is caused by illness of the brain. The symptoms includes disturbance of progressive cognitive functions such as memory, problem solving, attention, calculation, language, leaning ability and judgment based on understanding of context (1). Dementia attacks mainly people aged over 65 and only two percent of cases happened in people before aged of 65 years.

A lot of underlying factors are known as causes of dementia. Alzheimer’s disease and Vascular dementia are the most common, which is responsible for one half to three quarters of all cases. But, the most important factor causing dementia is advanced age. The number of cases would be double per every five years when people aged over 65. In the case of Alzheimer’s disease, genetic factors are also influential (1). However, it is common for only one of identical twin to suffer from dementia (2).  Many studies suggested evidences of correlation between dementia and limited education and damaged brain (3). All these cases imply influence of the social environment on dementia.

 

Despite studies, far too little is still highlighted about relationship between the social and lifestyle factors and Alzheimer’s disease inducing other dementias. It may be that the focus on research in developed countries has limited possibilities to identify risk factors. The most interest thing is prevalence of Alzheimer’s disease seems to be much lower in some developing countries. This may be because some environmental factors are much less widespread in developing countries’ settings. For example, African men often are very healthy in cardiovascular issues due to low blood pressure, low serum cholesterol levels and low obesity with active lifestyles and physical activities. On the other hand, some risk factors may only be critical in developing countries, since the clinical issues do not be matter due to their effects to treat or prevent; for example, anaemia has been known as a risk factor in India (4).

Dementia has been caused disability in life of many aged people. According to the wide consensus survey from Global Burden of Disease (GBD), disability from dementia with spinal cord injury and terminal cancer was shown a higher burden than those from almost any other illnesses. Of course, aged people often have multiple health conditions including chronicle disease, venerable organ systems, and coexisting mental disorders. Even taking it into consideration, dementia has seriously influenced capacity of elderly people for independent living. Report from GBD supported by the World Health Organization in 2003 shows that 11.2 % for dementia contributed all disability that has an effects on life among people aged 60 or over. The results are different from researcher in the field of clinical research (since 2002). The papers has different priorities of dementia (1.4%): cancer 23.5%, cardiovascular disease 17.6%, musculoskeletal disorders 6.9%, stroke 3.1% and dementia 1.4%.

The major problem is there has been little work on investigating the economic costs of dementia in developing countries. Some researches (5) suggest five main reasons for this problem: lack of professional health economists, low priority for mental health, low quality of mental health services, lack of importance given to mental health services and lack of data. Social needs for vulnerable elderly people have been emerging. Mental health issues for frail older persons will become dominant public health issues. Governments and social parties care budgets in this area, more data are urgently needed.

 1. Saunders AM et al. Association of apolipoprotein E allele e4 with late-onset familial and sporadic Alzheimer’s disease. Neurology, 1993, 43:1467–1472.

 2. Breitner JC et al. Alzheimer’s disease in the National Academy of Sciences-National Research Council Registry of Aging Twin Veterans. III. Detection of cases, longitudinal results, and observations on twin concordance. Archives of Neurology, 1995, 52:763–771.

3. Ott A et al. Prevalence of Alzheimer’s disease and vascular dementia: association with education. The Rotterdam study. BMJ, 1995, 310:970–973.

 4. Pandav RS et al. Hemoglobin levels and Alzheimer disease: an epidemiologic study in India. American Journal of Geriatric Psychiatry, 2004, 12:523–526.

 5. Shah A, Murthy S, Suh GK. Is mental health economics important in geriatric psychiatry in developing countries? International Journal of Geriatric Psychiatry, 2002, 17:758–764.