New insights into Alzheimer’s disease, but the reality…? „Vascular aging and dementia-the interdisciplinary modifiable landscape“

There is still a large gap between the prevalence of dementia and its treatment. Even in most high income country settings, where only around 50% of people living with dementia receive a diagnosis. In low and middle income countries, less than 10% of cases are diagnosed. 80% of the general public are concerned about developing dementia and 1 in 4 people think that there is nothing we can do to prevent dementia. 75% carers globally say “I am often stressed between caring and meeting other responsibilities” and over 50% of carers said their health suffered as a result of their caring responsibilities. Are we doing enough for carers? 62% of healthcare providers worldwide think that dementia is part of normal aging. 40% of the general public think doctors and nurses ignore people with dementia – time for primary healthcare practitioners to look closely at their practice and for governments to increase dementia training.The COVID-19 pandemic has caused big changes for families. A study, 160 persons with dementia, 91% with Alzheimer’s and 9% with vascular and other dementia. People with dementia have been heavily impacted by isolation, and contributing to the onset or worsening of BPSD (anxiety, irritability, aggression) and of cognitive disorders, creating a greater workload and higher stress levels for carers.
About 100 days after the lockdown, the cognitive symptoms worsened in 54% of the participants. Behavioural symptoms worsened in 53% of the people and decline in motor skills. This disruptive time has greatly affected the clinical course of the disease and people’s quality of life, but distance support has helped to mitigate BPSD. This support has also reduced some anxiety and uncertainty among carers. Nothing, however, can replace face-to-face contact. Clinical study shows that COVID-19 raises the risk of psychiatric and neurological disorders, including dementia are associated with an increased risk of severe COVID-19. People who have had COVID-19 may be at increased risk of developing depression, stroke and dementia among other conditions.
Focusing on a time period between January and December 2020 among over 236,000 people diagnosed with COVID-19 during this time period, over 33% received a psychiatric or neurological diagnosis within 6 months, with 12.84% receiving their first such diagnosis. The most common diagnosis overall was anxiety disorder, affecting over 17% of individuals. COVID-19 severity influenced the likelihood of diagnosis: people who had been admitted to intensive care and/or suffered from delirium due to COVID-19 were at greater risk. For example, 2.66% of people aged over 65 years received a first diagnosis of dementia after recovering from COVID-19, increasing to 4.72% of those who had delirium due to COVID-19. More extended studies are now required, to see whether this increased risk remains in the longer term.
20-40% of cognitively impaired elderly persons exhibit depression or depressive symptoms. Depression worsens dementia and also accelerates the conversion of mild cognitive impairment to dementia, highlighting the importance of treating it effectively. Case report: NN a 73-year-old femail patient, living in a village in Skopje, in a family house with her husband.