Cardiovascular disease and the seeds of innovation: a call for papers
The acquisition of global impairment of cognitive function is the scientific definition of dementia. The two commonest forms are the senile dementia of Alzheimer's disease and vascular dementia, both of which are progressive and more common in older people. As we as a population are living longer, it follows that dementia will increase in frequency and affect more and more families. Alzheimer's, put simply, is a degenerative brain condition with no cure and no effective long term treatments. Cruelly, the victim dies inside long before the heart stops beating. We all joke about our 'senior moments' but we recover and remember later, whereas with Alzheimer's memory loss continually disrupts daily life. Other symptoms include confusion, forgetfulness (names, places, recent events) mood swings perhaps linked to fear brought on by recognising the memory loss, and subsequent withdrawal from regular contact with family or friends (lack of confidence, problems trying to communicate and difficulty concentrating) As a society, we recognise and are usually sympathetic to individuals with a physical disability. The ubiquitous walking stick gives the person confidence and support and sends a signal to others that help may be needed and welcomed for example offering a seat on a bus or train. Alzheimer's is an invisible disability no stick, no wheelchair just a lonely person trying hard to remember or decide on what to buy in a supermarket, or which bus to catch home. Alzheimer's is indeed a lonely disease which progresses despite modern therapies donepezil, rivastigmine, galantamine and memantine which are expensive and not always indicated or available (because of funding issues) The burden this progression places on families (who usually act as carers) and friends increases relentlessly over time. Alzheimer's affects about 450,000 people in the United Kingdom, 5 million in the USA (and predicted to increase to 13.4 million by 2050) and 35.5 million worldwide, with predicted greater increases in Asia, Latin America, and Africa compared with the USA or UK. Although thought of predominantly as an elderly condition, a significant number of sufferers are aged less than 65 years. Although there is no standard diagnostic test for Alzheimer's, and inevitably the diagnosis is therefore made after death, there are potential lifestyle issues we can adopt to try to reduce the risk of it developing (incidence one in 14 over 65, one in six over 80 years of age) These include avoiding smoking, excessive alcohol, controlling diabetes, hyperlipidaemia and hypertension, and exercising regularly. As we personalise the risks of coronary disease and cancer, so we should personalise Alzheimer's disease. In comparison with cancer and heart disease, Alzheimer's is one of the Cinderellas for funding. Considering its increasing incidence and prevalence, this needs to be addressed and corrected as a matter of urgency. As we get older, we should be able to treasure more and more memories, not less and less. The cloak of invisibility needs to be removed from Alzheimer's 'forgetting' about Alzheimer's because you cannot see it or cure it denies researchers the path toward success and the victims and their carers a quality of life everyone deserves.
International journal of clinical practice