03 Jun 2014
PROFESSOR DAVID AMES
A geriatrician, a psychiatrist and a nurse (no this isn't the start of a joke!) have written a useful review outlining what is known about nine medical conditions that occur more often in people with dementia (PWD) than in other people. These syndromes are falls, delirium, epilepsy, weight loss and nutritional disorders, incontinence, sleep disturbance, visual dysfunction, oral disease and frailty.
After an introductory chapter, nine further chapters outline published evidence about dementia and these nine co-morbidities. The writing is clear and concise and, as the book is, in effect, a lengthy literature review, copious references are provided. There is a set of key points given at the end of each chapter and some case studies are included, though my own personal favourite (putting dysfunction due to the visual misperception as the first symptom of Alzheimer's disease in an enthusiastic golfer) is not.
Among the most interesting factors reported here are that PWD experience thrice the number of fractures compared to people without dementia, that dementia quintuples one's risk of getting a delirium and increases seizure risk sixfold, and that weight loss may precede the onset of the cognitive symptoms of dementia by up to twenty years in some cases (best news I've heard in a long time in relation to my inability to lose any weight, ever!).
Any health professional working with PWD ought to have access to a copy of this useful little tome, and I think I will be a better doctor to my patients for having read it.
Physical Comorbidities of Dementia
Susan Kurrle, Henry Brodaty and Roseanne Hogarth
New York: Cambridge University Press, 2012
This article was first published in International Psychogeriatrics 2014 (volume 26, issue 5).