L‘aging it is a phase of life that, sooner or later, each of us will face and unfortunately it will often be an obstacle that will prevent us from participating in an incisive way in the healing of various pathologies: this is the case of a heart attack suffered by those who already suffer from senile dementia, a disease that impoverishes those who suffer from the possibility of reasoning and taking the right actions to take care of themselves.
“[?LadenenzaNDR)[?LadenenzaNDR)It interferes with joining a medical treatment plan, unless someone is there to support them“, Said the doctor Karen Alexander, cardiologist and professor of medicine at the Duke University School of Medicine in Durham, in the North Carolina.
Several researches have shown that individuals affected by dementia, including those who manifest mild cognitive disturbances, are less likely than those without cognitive loss to receive invasive procedures used to treat heart disease such as a heart attack, for example. These include the cardiac catheterization, used to check for blockages in the arteries and coronary revascularization, used to clear such blockages with stents to open arteries or by redirecting blood flow to the heart through bypass surgery.
Heart attack and dementia: what can be done?
Dementia, in the mass line, is determined by particular disorders such as: difficulty with memory, language, problem solving and other thinking skills.
More than 6 million US adults aged 65 and over are living with dementia caused by Alzheimer’s disease, the most common form, and that number is expected to double by 2050, according to the Alzheimer’s Association. Additionally, about 16.6% of people aged 65 and over have mild cognitive impairment, subtle changes in memory and thinking that may not always be noticeable but can turn into dementia.
Dementia is more prevalent as people age, affecting 1 in 3 people aged 85 or older, according to National Institute Hon Aging. Because heart disease and dementia share many risk factors, there is a high level of crossover between the two:theThere who are 75 years of age or older, nearly 60% have some type of cognitive impairment.
“It’s prevalent and we don’t do a good screening job for it“Explained Alexander. “We need greater awareness that this is out there”. “Doctors may not know that a patient has early stage dementia or mild cognitive impairment because conditions are often underdiagnosed“, Dr. intervenes Deborah A. Levine, associate professor of internal medicine and director of the Cognitive Health Services Research Program at the University of Michigan.
Upon admission to hospital, “Every older person should be screened for cognitive problems or a history of cognitive problems“, Levine continues. “As the population ages, every provider who treats older patients must be able to care for them holistically.”
“Patients with dementia have a higher risk of delirium when they are hospitalized for any reason, including heart attack. Delirium is associated with higher mortality, greater functional decline, and prolonged hospitalization and can be distressing for the patient and family“, Said the scientist. Furthermore, several researches have found that episodes of delirium, in addition to simple hospitalization, they can accelerate cognitive decline in older people, including those with dementia.
If doctors know that their patient has dementia, they can take precautions, Levine said. “Exist standard precautions for delirium which can be used when older patients at high risk of dementia are hospitalized. This includes trying to maintain the sleep-wake cycle, frequent orientation with staff, and avoiding medications that can exacerbate delirium“.
The expert, who conducted research and found that that patients with mild cognitive impairment were 50% less likely to receive cardiac catheterizations, and said it’s important for families and caregivers to consider where a person is on the cognitive spectrum when making treatment decisions.
Another research highlighted how 60% of people with mild cognitive impairment eventually develop some form of dementia, shouldn’t be the only reason to stop treatment, Levine said. “Many patients with cognitive impairment remain stable or return to normal. And many patients with dementia have support systems in place, caregivers who can support adherence to medical plans. “
“Revascularization procedures to unblock coronary arteries are effective treatments that can benefit many people with cognitive problems“, he has declared. “However, if a person has advanced dementia, is completely dependent on self-care, or has a limited life expectancy, then “this could be a reason for giving up invasive treatments such as bypass surgery “.
“When choosing treatments, families should ask doctors about a patient’s prognosis without treatment, as well as questions about a bigger picture, such as whether or not a procedure will improve the person’s quality of life,” Alexander said.
“They should be able to ask, ‘How will this help my beloved in general?’ Elevate the conversation to discuss care goals with questions such as, “Why are we doing this?” We are trying to help them live longer or feel better? “
“Adult children should start conversing about how to support elderly parents with cognitive problems long before other medical problems arise”Alexander said: “Family members need to know how they will help mom and dad when they need complex medical care. Who will be the contact person? It is really vital that people who do not have a good memory have a trusting relationship with a caregiver who can replace them in the hospital, especially at the time of discharge “.
Dementia, the visually impaired are more at risk of having it, regardless of the possibility of a heart attack
Heart attack in people affected by dementia is a possibility that should not be underestimated and the role of the family is fundamental, in collaboration with experts who carry out a correct early diagnosis. A new study instead brings forward a new hypothesis that goes beyond heart attack: Older people with vision loss are significantly more likely to suffer from mild cognitive impairment, which may be a precursor of dementia.
There Research was published in the scientific journal Aging Clinical and Experimental Research.
The study ofAnglia Ruskin University (ARU) studied data from the World Health Organization on more than 32,000 people and found that those with vision loss both near and far were 1.7 times more likely to suffer from mild cognitive impairment.
Individuals with near vision impairment were 1.3 times more likely to suffer from mild cognitive impairment compared to those who had no vision problems. However, people who only reported distance vision loss did not appear to have a greater risk.
Dr. Lee Smith, Reader in Physical Activity and Public Health at ARU, he has declared: “Our research shows for the first time that visual impairment increases the chances of having mild cognitive impairment. Although not everyone with mild cognitive impairment will continue to develop it. ANDthere is a likelihood of progression towards dementia, which is one of the main causes of disability and dependence in the elderly population ”.
The co-author Shahina Pardhan, director of Vision and Eye Research Institute of the ARU, he has declared: “Research now needs to focus on whether surgery to improve vision quality can reduce the risk of mild cognitive impairment and, ultimately, dementia. More work needs to be done to examine any possible causality and what the reasons behind it might be. “
The research team studied population data of China, India, Russia, South Africa, Ghana and Mexico from the WHO Study on Global Aging and Adult Health (SAGE). The overall prevalence of mild cognitive impairment was 15.3% in the study sample of 32,715 people, while approximately 44% of the total number of people surveyed had vision problems.
To date, according to the data provided by the World Health Organization in the world, individuals with visual impairment are 4% of the population of the globe, namely (about 253 million. are 217 million (3%), finally the absolute blind would be around 36 million (0.5%).