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People with dementia may develop behavioural and psychological symptoms including restlessness, aggression, delusions, hallucinations, and apathy and sleep disturbances. This factsheet looks at the different types of drugs that can be used to treat these symptoms if non-drug treatments have not worked. It explains when and how they should be prescribed and what the side-effects might be. Other psychological symptoms that people with dementia may develop include depression and anxiety.
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The most common type of dementia is Alzheimer's disease which makes up 50% to 70% of cases. Other common types include vascular dementia (25%), Lewy body dementia (15%), and front temporal dementia. Globally, dementia affects 36 million people. About 10% of people develop the disease at some point in their lives. It becomes more common with age. About 3% of people between the ages of 65–74 have dementia, 19% between 75 and 84 and nearly half of those over 85 years of age. In 2013 dementia resulted in about 1.7 million deaths up from 0.8 million in 1990.
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Alzheimer's Association: Alzheimer's disease and Dementia,
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Dementia is a broad category of brain diseases that cause long term loss of the ability to think and reason clearly that is severe enough to affect a person's daily functioning. Dementia is not thought to be a specific disease but it is an overall term that describes a wide range of symptoms associated with a decline in memory or other thinking skills severe enough to reduce a person's ability to perform everyday activities. The most common disease of dementia is Alzheimer's disease which accounts for 60 to 80 percent of cases. The second most common dementia type is vascular dementia, which occurs after a stroke.
However there are many other conditions that can cause symptoms of dementia which includes thyroid problems and vitamin deficiencies. Some relief from the symptoms of Alzheimer’s disease has been offered by cholinergic treatments for some people for a limited time. Acetyl cholinesterase inhibitors a type of drug used for the treatment work by blocking the actions of an enzyme called acetyl cholinesterase which destroys an important neurotransmitter for memory called acetylcholine. However, current cholinergic treatments are approved for use for people with mild to moderate Alzheimer’s disease. Large number of the acetyl cholinesterase inhibitors is available as subsidized medicines under the Australian Pharmaceutical Benefits Scheme. A patient can receive these drugs at nominal cost if a physician or psychiatrist has found them to have a diagnosis of Alzheimer’s disease but they must need to show improvement on a commonly used test of mental function in the first six months of treatment in order to receive further supplies of subsidized medication.
Glutamate, a type of memantine targets is present in high levels when someone has Alzheimer’s disease. It blocks glutamate and prevents too much calcium moving into the brain cells causing damage. Memantine is the first in a new class of therapies and acts quite differently to the acetyl cholinesterase inhibitors that are currently approved for treatment in Australia. However, memantine is currently approved for use for people with moderately-severe to severe Alzheimer’s disease. Memantine is also available at subsidized rates under the Pharmaceutical Benefits Schedule for those who meet the criteria for diagnosis and stage of disease. However, Dementia often causes a number of behavioral and psychological symptoms which can be very distressing. Symptoms may include stress, worry, loss of sleep, different kinds of hallucinations, persecution, loss of identification of relatives or places, agitation and aggressive behavior. These sighns may respond to reassurance, a change in the environment or removal of the source of any distress such as pain.
Sometimes medication may be required for relief. One of the most common drug which is used for the treatment is Haloperidol. This drug tends to cause symptoms similar to Parkinson’s disease in modest doses. Symptoms may include tiredness, shakiness and shuffling gaits. It should be noted that older people are very prone to these side effects. Most of them are unable to tolerate even low doses of Haloperidol. Fewer Parkinson’s like side effects have been studied in Newer tranquillisers such as Risperidone (Risperdal). Due to increased cases of dementia there has been increased number of conferences of dementia throughout the globe.
As more people are living longer, dementia is becoming more common in the population as a whole. For people of a specific age, however, it may be becoming less frequent, at least in the developed world, due to a decrease in risk factors. It is one of the most common causes of disability among the old. It is believed to result in economic costs of 604 billion USD a year.
The number of cases of dementia worldwide in 2010 was estimated at 35.6 million. Rates increase significantly with age, with dementia affecting 5% of the population older than 65 and 20-40% of those older than 85. Around two thirds of individuals with dementia live in low and middle income countries, where the sharpest increases in numbers are predicted. Rates are slightly higher in women than men at ages 65 and greater. In 2013 dementia resulted in about 1.7 million deaths up from 0.8 million in 1990.
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This page was last updated on 11th Sep, 2015
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