DEMENTIA ACTION ALLIANCEQuarterly meeting 12th February 2014

byPeter Ashley

© Peter J S Ashley 2014 1

* With great respect for the gentleman after whom he was named

And don’t forget me!

Boris*

A personal experience of living with co-morbidities

The devil is in the detailor

What living with a dementia is all about------------

The facts in my caseand

Others have similar problems!

© Peter J S Ashley 2014 2

© Peter J S Ashley 2014 3

ComorbidityFrom Wikipedia, the free encyclopediaIn medicine, comorbidity is the presence of one or more additional disorders (or diseases) co-occurring with a primary disease or disorder; or the effect of such additional disorders or diseases.In medicine, the term "comorbid" can be either medical condition(s) existing simultaneously but independently with another condition; or it can indicate a related medical condition or conditions.

The 3 D’s

1. Dementia

2. Depression

3. Delirium

© Peter J S Ashley 2014 4

© Peter J S Ashley 2014 5

Dementia (taken from Latin, originally meaning "madness", from de- "without" + ment, the root of mens "mind") is a serious loss of global cognitive ability in a previously unimpaired person, beyond what might be expected from normal aging. It may be static, the result of a unique global brain injury, or progressive, resulting in long-term decline due to damage or disease in the body. Although dementia is far more common in the geriatric population (about 5% of those over 65 are said to be involved),[1] it can occur before the age of 65, in which case it is termed "early onset dementia".[2]

Dementia is not a single disease, but a non-specific syndrome (i.e., set of signs and symptoms). Affected cognitive areas can be memory, attention, language, and problem solving. Normally, symptoms must be present for at least six months to support a diagnosis.[3] Cognitive dysfunction of shorter duration is called delirium.

© Peter J S Ashley 2014 6

Depression is a state of low mood and aversion to activity that can affect a person's thoughts, behavior, feelings and sense of well-being.[1] Depressed people feel sad, anxious, empty, hopeless, worried, helpless, worthless, guilty, irritable, hurt, or restless. They may lose interest in activities that once were pleasurable, experience loss of appetite or overeating, have problems concentrating, remembering details, or making decisions, and may contemplate, attempt, or commit suicide. Insomnia,excessive sleeping, fatigue, loss of energy, or aches, pains, or digestive problems may also be present.[2]

Depressed mood is also a primary or associated feature of certain psychiatric syndromes such as clinical depression.

© Peter J S Ashley 2014 7

Delirium, or acute confusional state, is a syndrome that presents as severe confusion and disorientation, developing with relatively rapid onset and fluctuating in intensity. It is a syndrome which occurs more frequently in people in their later years. Delirium represents an organically caused decline from a previously attained baseline level of cognitive function. It is typified by fluctuating course, attentional deficits and generalized severe disorganization of behavior. It typically involves other cognitive deficits, changes in arousal (hyperactive, hypoactive, or mixed), perceptual deficits, altered sleep-wake cycle, and psychotic features such as hallucinations and delusions.

Facts as they relate to me.

My primary disease

A dementia

Subtype - Dementia with Lewy Bodies (DLB)

My additional disorders/diseases

Let’s look at the timeline both pre and post DLB

© Peter J S Ashley 2014 8

My timeline.

1997 ‘98 ‘99 ‘00 ‘01 ‘02 ‘03 ‘04 ‘05 ‘06 ‘07 ‘08 ‘09 ‘10 ‘11 ‘12 ‘13 2014

CHRONIC DEPRESSION – HIGHLY CYCLICD Day

DEMENTIA WITH LEWY BODIES

© Peter J S Ashley 2014 9

LEGIONAIRRES DESEASE

MAJOR HEART ATTACK

UTIs

TYPE II DIABETIES

2ND HEART ATTACKANGINA

MOOD SWINGS

MEINPATIENT MENTAL HOSPITAL

7 SESSIONS ECTTWO SUICIDE ATTEMPTS

TWIN CATERACT OPERATION

CHRONICALLY DEAF (HIGH FREQUENCY)

SLEEP APNOEA

DYSLEXIAATAXIA

DYSGRAPHIA

OEDEMA

LEG ULCERS

PERIODS OF SEASONAL AFFECTIVE DISORDER

TO COMBAT

MY

PROBLEMS

I NEED

EXERCISE© Peter J S Ashley 2014 10

© Peter J S Ashley 2014 11

PROBLEMS???SO DOES SHE!“WHAT ME?”

“AGE IS JUST A NUMBER.”“YOU’VE GOT TO MAKE

THE BEST OF IT.”“I NEVER LET THINGS GET

ME DOWN!”

© Peter J S Ashley 2014 12

Peter and Boris