Factors affecting the lifespan of dementia patients

Dementia is a term that is used to describe an array of symptoms that result as a consequence of the brain cells deteriorating. The most well-known symptom of dementia is continuous memory loss, which often impacts the patient's day-to-day life. Patients who suffer from this illness will have to rely on others for even the simplest of tasks, such as cooking and cleaning. As dementia is caused by the brain cells deteriorating, this disease is degenerative and, unfortunately, incurable. This means that as time progresses, the symptoms of dementia will grow more and more severe. At its end stages, people with dementia must rely on others for every aspect of their care.

The significant growth observed in the aging population globally has brought with it a growing pressure on societies and economies to deal with healthcare and social care-related challenges involved in managing aging populations with chronic illnesses such as dementia. The global prevalence of dementia is on the rise, with one new case of dementia being detected every 4 seconds, making it the most significant cause of disability after coronary heart disease in the elderly. The number of people diagnosed with dementia is expected to grow to 152 million by

2050. It is also to be noted that women, as per studies, are disproportionately affected by dementia, especially Alzheimer's disease. With over 13 million women living with dementia worldwide, the same numbers are 35% higher than men. According to international health organizations, the number of persons affected by dementia in developed and high-income countries is three times more than those in low- and middle-income countries. This is mainly due to longer life expectancy in high-income countries. However, recent studies indicate that rapid growth in dementia cases is taking place in low-income and middle-income countries, where the population of elderly people diagnosed with dementia is expected to grow to 70% by 2050.

Factors influencing the lifespan of dementia patients

Age at diagnosis

The age at which a patient is diagnosed is thought to be a crucial factor in the subsequent lifespan of patients who suffer from dementia. Inevitably, dementia sets in over the age of 65. However, approximately twenty thousand people under that age are affected by the disease in the UK. In the younger age group, symptoms can be more severe and decline faster than those over 65. In one survey conducted by the Alzheimer's Society of over two thousand people under 65 with early onset dementia, they found that 62% had to give up work, and 59% reported not receiving state benefits for the first six months of diagnosis.

Underlying health conditions

Many underlying health conditions can not only increase the risk of dementia but also decrease the timeframe in which this condition takes its toll on a patient. Vascular disease is the underlying health condition that leads to recurrent strokes and impairs one's ability to live a healthy life independently. Hiv/aids are also common underlying health conditions that can reduce the lifespan of a dementia patient. A person who already suffers from such conditions and is then inflicted with dementia is more likely to experience delirium, depression, anxiety, paranoia, or hallucinations, a condition known as Aids Dementia Complex. High blood pressure, high cholesterol, diabetes, and obesity lead to conditions that impair the flow of blood in the body, like a Stroke at A younger age than it would have in a person without these conditions. For someone who suffers from any of these conditions before dementia hits, and sometimes even after, major life changes will occur. It would drastically reduce life expectancy to as much as 20 years.

Type and stage of dementia

Type and stage of dementia are two important factors that could impact the lifespan of patients diagnosed with dementia. Certain types of dementia, such as Alzheimer's and Parkinson's, usually have predictable trajectories, but the specific duration of each stage can vary from patient to patient. For example, patients can remain in the early or middle stage of Alzheimer's for a period of about 8-10 years or even longer, and the advanced stage can extend as long as 1-5 years. However, patients diagnosed with Lewy body dementia, which most commonly affects the elderly, exhibit diminishing physical and mental health conditions in the advanced stage, and their lifespan ranges between 5-8 years from the time of the onset of the disease. Understanding the stage or type of dementia can tremendously assist families and caregivers to plan ahead and make suitable arrangements to provide care and support for the patients.

Quality of care and support

There are various ways in which poor quality of care can lead to the decreased life expectancy of a dementia patient. A poor diet can make general health and well-beingwellbeing decline rapidly and can also result in other conditions, such as malnutrition or dehydration, that may require emergency attention. The impact of psychological factors such as neglect and emotional abuse can further substantially impair a patient's mental health. A study from Norway recorded each patient's quality of medical help and social care over a two-year period. The results concluded that the quality of technical care and medical treatment made minimal difference to the patient but that non-technical measurements, such as usage policy for the care centers and attitudes and empathy, made a huge difference. This proves that irrespective of the patient's health status, the support they receive significantly affects their life expectancy.

Strategies to improve the quality of life for dementia patients

Person-centered care approach

Some professionals believe a person-centered care approach is most effective for dementia patients. A person-centered approach focuses on the individual's history, likes and dislikes, and remaining abilities. The person needs to remain a part of life and all decisions that are made. Person-centered care respects the individual and allows for choices for the person with dementia. To keep a person's life person-centered, overall planning of the care and support provided needs to address the four key areas;- daily living, physical health, mental health and wellbeing, and maintaining relationships and involvement in the community.

Medication management and treatment options

Commonly prescribed medications such as antipsychotics, anxiolytics, mood stabilizers, and antidepressants can have a powerful impact on the lifespan of dementia patients, potentially causing hastened mortality if they are not used appropriately. Patients and caregivers alike need to be aware of the potential side effects that these medications can have, as well as the need for regular monitoring by a medical professional while taking the medication. Developing a keen understanding of the medications that a dementia patient is taking can help a caregiver quickly identify and report any adverse side effects, which can, in turn, help prevent unnecessary physical decline or complications. Understanding what behaviors these medications are targeting can also be helpful, both to assist a caregiver in their identification of the drug or drug class (so that they can read about the potential side effects, etc.) and to inform a caregiver about some basic behavioral modifications that they can attempt if the use of the medication is minimized, ceased, or never introduced.

Support for caregivers and family members

Dedicated support for the family members and caregivers of those with dementia is imperative, given that they face far higher levels of stress and ill health than other people in their age groups, as well as undue financial strain. The emotional cost to carers should not be underemphasized - many feel that opportunities for normal family home life and companionship are lost, and they have to deal with depression, social isolation, and strained relations with other family members. Additionally, they may often suffer health problems of their own. Meeting the needs of carers is a policy issue in many countries. In 2002, only a third of Primary Care Trusts had a strategy for identifying and supporting carers in the community. Some countries, for example, Germany, have taken steps to establish support groups and mental health interventions for carers, and there is a need for other countries to follow suit. In 2006, a Department of Health report called for discrimination against carers to be ended and advised Primary Care Trusts to examine the circumstances of each carer. For instance, many carers are not paid for their time and may not have been able to hold down paid jobs as well. The report added that the costs of rising numbers of carers could not be met by the local government, so the support of the community as a whole would be required.

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