3 things the UK can teach us about dementia

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Three studies from the United Kingdom provide new insights into the diagnosis of dementia and the treatment of those with the condition.

1. Dementia is about more than memory loss.

A change in sense of humor could be an early sign of dementia, according to researchers from University College London. Through questionnaires, the team discovered that people with behavioral variant frontotemporal dementia had an altered sense of humor compared with those who had Alzheimer's disease and those who were healthy. This altered sense of humor included laughing inappropriately at tragic events on the news or in their personal life.

The researchers found that people with behavioral variant frontotemporal dementia or Alzheimer's disease tended to prefer slapstick humor to satirical and absurdist humor when compared with healthy people of a similar age. In fact, friends and relatives reported seeing those changes an average at least nine years before the start of more typical dementia symptoms.

“We've highlighted the need to shift the emphasis from dementia being solely about memory loss,” said Camilla Clark, M.D., who led the research at the UCL Dementia Research Center. As well as providing clues to underlying brain changes, subtle differences in what people find funny could help differentiate between the different diseases that cause dementia, she added.

The study was published in the Journal of Alzheimer's Disease.

2) Those with dementia and diabetes risk dehydration.

Those with dementia, diabetes and kidney problems are at most risk of dehydration, according to research from the University of East Anglia.

Older people are particularly at risk of water-loss dehydration, which is caused by not drinking enough fluid, according to researchers. It can lead to poor health outcomes such as disability and even death.

“We know that dehydration is difficult to identify, but it can lead to increased risk of hospital admission, urinary tract infections, disability and even death,” said lead researcher Lee Hooper, Ph.D., from UEA's Norwich Medical School. Older adults, she added, tend not to feel thirsty when they don't drink enough, and their kidneys are less able to preserve fluid.

Researchers studied 188 adults aged more than 65 years who lived in residential care homes. Highlights of their findings:

  • 20% of older people living in long-term residential care were dehydrated.
  • Diuretic medication, gender (men) and bladder incontinence also are associated with dehydration.

“We found that elderly people who had been in poor health — those who had been to the doctor more often or had a recent history of emergency admissions — were more likely to be dehydrated,” Hooper said. Those with swollen ankles, chronic obstructive pulmonary disease, arthritis, continence issues, dementia and those using medications for diabetes, laxatives, diuretics also were particularly at risk, she added.

“We hope that this research will enable carers to pinpoint which frail older people are most likely to suffer dehydration,” Hooper said.

The research is published in the Journal of Gerontology: Medical Sciences.

3) Collaboration through music has beneficial effects.

A special orchestra for people with dementia has helped boost their confidence and mood, according to a research project by the Bournemouth University Dementia Institute in Dorset.

The orchestra, also including professional musicians, caregivers and students, initially was set up in partnership with Bournemouth Symphony Orchestra and had a repertoire ranging from Ravel's “Bolero” to Henry Mancini's “Moon River.” Rehearsals have demonstrated a positive effect on all participants, who have learned new skills and rediscovered old ones, according to Anthea Innes, Ph.D., head of the institute.

“Performing and showcasing skills of those with dementia creates a well-deserved opportunity for them to demonstrate their abilities and to challenge the negative public perceptions that surround the diagnostic label of ‘dementia,' ” she said. “Working together to produce a collaborative output is a powerful way to bring out the best in people, not just in terms of their musical skills, but their communication skills, friendships, care and support for one another.”

The effort included a course of two-hour sessions once a week for eight weeks. Previous workshops with the orchestra identified that most of the people with dementia learned a new skill, Innes said, and the sessions were highly enjoyed by all who participated.

Innes and her research team have produced a guide (PDF) in collaboration with the professional musicians for those interested in setting up their own community-based music groups.

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