Question

Could someone please assist me with the following?

1. in Dementias, Including Alzheimer's Disease Briefly describe the problem indicating the “burden of disease” including morbidity and mortality and changes that have occurred in recent years.

2. Briefly describe the course of the disease or condition using the concepts of incidence, prevalence and case-fatality. If these concepts are not relevant to your subject explain what they mean and why they are not relevant.

3. Identify at least two at-risk groups (those with an increased probability of developing and/or experiencing bad outcomes). Explain why these groups are at-risk of experiencing this health issue. Be sure to connect your discussion to the key categories of social determinants of health as outlined in the text.

4. Identify 5- 8 options for potential interventions to address the problem. For each of the options identify the primary focus in terms of When (Primary, secondary or tertiary prevention), Who (individual, at-risk group, population) and How (education, motivation, obligation, invention). Number each of the potential interventions. Identify each option then bullet or create a table giving your answers to When, Who and How for each option.

Answer 1

1) The burden of dementia: in 2016, the global number of individuals who lived with dementia was 43·8 million (95% uncertainty interval [UI] 37·8–51·0), increased from 20·2 million (17·4–23·5) in 1990. In the US, the study of a national representative sample of people aged >70 years yielded a prevalence for AD of 9.7 %. Worldwide, the global prevalence of dementia was estimated to be 3.9 % in people aged 60+ years, with the regional prevalence being 1.6 % in Africa, 4.0 % in China and Western Pacific regions, 4.6 % in Latin America, 5.4 % in Western Europe, and 6.4 % in North America. More than 25 million people in the world are currently affected by dementia, most suffering from AD, with around 5 million new cases occurring every year. The number of people with dementia is anticipated to double every 20 years.

2) Dementia progresses differently in everyone. Many people will experience the symptoms associated with the following stages of Alzheimer’s disease:

Mild cognitive impairment (MCI)

MCI is a condition that can affect older people. Some of these people will go on to develop Alzheimer’s disease. MCI is characterized by losing things often, forgetfulness, and having trouble coming up with words.

Mild dementia

People may still be able to function independently in mild dementia. However, they’ll experience memory lapses that affect daily life, such as forgetting words or where things are. Common symptoms of mild dementia include:

memory loss of recent events

personality changes, such as becoming more subdued or withdrawn

getting lost or misplacing objects

difficulty with problem-solving and complex tasks, such as managing finances

trouble organizing or expressing thoughts

Moderate dementia

People experiencing moderate dementia will likely need more assistance in their daily lives. It becomes harder to perform regular daily activities and self-care as dementia progresses. Common symptoms during this stage include:

increasing confusion or poor judgment

greater memory loss, including a loss of events in the more distant past

needing assistance with tasks, such as getting dressed, bathing, and grooming

significant personality and behavior changes, often caused by agitation and unfounded suspicion

changes in sleep patterns, such as sleeping during the day and feeling restless at night

Severe dementia

People will experience further mental decline as well as worsening physical capabilities once the disease progresses to the point of severe dementia. Severe dementia often can cause:

a loss of the ability to communicate

a need for full-time daily assistance with tasks, such as eating and dressing

a loss of physical capabilities, such as walking, sitting, and holding one’s head up and, eventually, the ability to swallow, to control the bladder, and bowel function

an increased susceptibility to infections, such as pneumonia

3) Two at risk groups are:
A) Geriatric Population - The greatest known risk factor for Dementia is increasing age, but Alzheimer's is not a normal part of aging. While age increases risk, it is not a direct cause of Alzheimer's.

Most individuals with the disease are 65 and older. After age 65, the risk of Alzheimer's doubles every five years. After age 85, the risk reaches nearly one-third.

B) People with Genetic Predisposition or Family History - Another strong risk factor is family history. Those who have a parent, brother or sister with Alzheimer’s or Dementia are more likely to develop the disease. The risk increases if more than one family member has the illness. When diseases tend to run in families, either heredity (genetics), environmental factors, or both, may play a role. Scientists know genes are involved in Alzheimer’s and Dementia. Two categories of genes influence whether a person develops a disease: risk genes and deterministic genes. Alzheimer's genes have been found in both categories. It is estimated that less than 1 percent of Dementia is caused by deterministic genes (genes that cause a disease, rather than increase the risk of developing a disease).