Sunday, 30 June 2019

Processing information 2

A few weeks ago I wrote about problems processing information, but over the last few days I have noticed other problems, which will have an effect on others in the same position

While my eyesight and hearing give a lot of concern when I am out, and on my own these days, I think this is made much worse with the electric vehicles and bicycles we see every day. 

Having been caught by disability scooters on the footpath, I am starting to get worried when I go out on my own, but I like my independence, so I go out as often as I can on my good days.

However some of the drivers of disability vehicles, seem to think that they own the footpath these days, and are becoming a nightmare, because if they hit you, there is no way of tracing the owner, as you would with a car etc.

It’s one thing seeing a silent vehicle coming towards you, if you are prepared for it, but it’s totally different if your brain cannot accept that it’s real, of it comes up from behind

Seeing this, I often wonder if my hearing has gone all together, or is it my brain playing tricks 

Some of these electric bicycles can be very fast, and if you don’t see it coming you could end up being run over, because most don't carry a bell, something I gather is against the law these days.

While it may be good for the environment to use electric vehicles, I think it’s going to catch a lot of people out.

We live in a changing environment, and life as we knew it has changed, and is changing very fast. If only our brains could keep up with this 

Monday, 24 June 2019

World leading expertise in dementia with Lewy bodies

World leading expertise in dementia with Lewy bodies at local NHS Trust


13-06-2019
Professor John O'Brien
A global review has named Professor John O'Brien, as the world's leading expert on dementia with Lewy bodies (DLB).


Out of 2,000 peer reviewed papers published since 2008 worldwide, Cambridgeshire and Peterborough NHS Foundation Trust (CPFT) doctor and researcher, John, wrote or contributed to 86 papers on the condition.
England is the world’s top performing region in terms of expertise in dementia with Lewy bodies, according to the new data analysis published by Expertscape – a website which objectively ranks people and institutions by their expertise across more than 26,000 biomedical topics. The data also shows that worldwide, Cambridge is one of the top five cities contributing most into this disease area, topped by London and followed by Newcastle in second place.
Professor O’Brien delivers research with care as an honorary consultant old age psychiatrist at Cambridgeshire and Peterborough NHS Foundation Trust and Professor of Old Age Psychiatry in the Department of Psychiatry at the University of Cambridge. He is the National Specialty Lead for Dementias at the National Institute for Health Research.
John said: “Obviously I am delighted by this news, which reflects the hard work of study teams and collaborators in Newcastle and Cambridge with whom I have had the pleasure of working with over the last 10 years. The fact that my colleagues Clive Ballard (Exeter) and Dag Aarsland (King’s College London) also make up the top three, with England listed top country worldwide, is a testament to the real excellence of Lewy body dementia research here in the UK.
"We will continue to build on this, and I am very grateful to all our funders, including NIHR who funded the recent DIAMOND-Lewy Programme, and to the NIHR Clinical Research Network’s Dementias and Neurodegeneration specialty – who play a pivotal role in successfully delivering all our studies.”
Studies conducted by clinicians and researchers at CPFT, working closely with people living with dementia, have contributed to the knowledge base behind new care guidelines released by the National Institute for Health and Care Excellence (NICE) last year.
CPFT is a top performer in the East of England for recruitment to dementia studies. Recognising their contribution, NICE advises that all people with dementia should be provided with information on research studies they could participate in. Local residents interested in participating in dementia studies can contact the Trust’s Windsor Research Unit on 01223 219531 wru@cpft.nhs.uk.
John's research interests include the application of imaging biomarkers in dementia and late-life depression and he has particular expertise in Lewy body and vascular dementias.
Over his career, he has published over 500 peer-reviewed scientific papers on these topics and is a National Institute for Health Research (NIHR) Emeritus Senior Investigator.
The NIHR supports research into all areas of dementias and neurodegenerative disease. In 2018/19, the NIHR’s Clinical Research Network supported the delivery of 24 clinical research studies on DLB – recruiting 5,793 patients, with the DIAMOND-Lewy study contributing significantly to the total recruitment.
Notes
·        Currently it is estimated that 850,000 people in the UK are living with dementia, and the only way to find new and better ways to treat and care for those affected by the condition is to do more research. But researchers rely on people finding out about suitable studies and volunteering to take part.
·        NICE recommends that health and care professionals should help people living with dementia and their carers find out about opportunities to take part in research, and empower them to make their own decisions about getting involved.
·        One way to do this is to provide information about Join Dementia Research, a UK-wide service that enables people with dementia and their carers to register their interest and matches volunteers with the most appropriate studies, with no obligation. Current research studies range from clinical trials of new treatments to surveys identifying what works in improving the quality of life of people with dementia and their carers.
Find out more and register today: https://www.joindementiaresearch.nihr.ac.uk/
 
About Cambridgeshire and Peterborough NHS Foundation Trust
Cambridgeshire and Peterborough NHS Foundation Trust (CPFT) is a health and social care organisation, providing integrated community, mental health and learning disability services, across Cambridgeshire and Peterborough, and children’s community services in Peterborough.
We support around 100,000 people each year and employ more than 3,700 staff. Our largest bases are at the Cavell Centre, Peterborough, and Fulbourn Hospital, Cambridge, but our staff are based in over 90 locations. We are a University of Cambridge Teaching Trust and member of Cambridge University Health Partners, working together with the University of Cambridge Clinical School. Together with global, national and local partners we conduct high-quality and ground-breaking research into mental and physical health and support innovation to improve patient care.

Saturday, 8 June 2019

Dementia or the wrong diagnosis

Over the last few years we have heard of lots of people living with dementia, having their diagnosis of dementia being changed.

This is sometimes from one type of dementia, to another, or simply being told that you have not deteriorated fast enough, so the diagnosis is changed to mild cognitive impairment or something else.

Being diagnosed with this illness is bad enough, but then for someone else to come along and change it again leaves a lot to be desired, especially when they think its funny

The only change may be the term used, because more often than enough your symptoms are exactly the same, and no matter which way we look at it, there is nothing at all  mild about, Mild Cognitive Impairment, if your diagnosis is changed to that.

As one family doctor told us, these terms are changed by various hospitals and doctors etc, because they themselves don’t understand what is going on in your brain. 

Another consultant told us, the only answer will come when we die and our brain can be looked at properly.

Its one thing to change a diagnosis, but the damage done by this can cause a lot of problems, to those concerned

So many brain diseases appear to have very similar symptoms, that I guess it’s how the diagnosis is sorted out using your symptoms at the time.

In my own case, I was originally diagnosed as having Alzheimer’s, then a consultant told me the I had early onset Lewy Body Dementia, which was confusing.

Later on I was told by a young doctor that because I had not deteriorated fast enough she was changing my diagnosis to Mild Cognitive Impairment, at which stage, I was so upset and unsure of what was happening that I walked out of the hospital in tears.

My wife then demanded a second opinion from a consultant before she followed me outside

This was handled so badly that I felt as if I had being living a lie, something I knew  was wrong, but it left me in a mess for some time.

Eventually I saw a Dementia consultant, who said that he was convinced I had a slower burning type of Lewy Body Dementia, as many people don’t always follow the same pathway, and it could take longer to get to the later stages.

Here again he said that we would never know the answer until I died.

A lot of people have said that when this happens, they feel upset and humiliated because of the way they were being dealt with at the time.

I guess it’s enough to push people over the top, but I was lucky that I had a supportive wife, family and family doctor who got me back on track, and never got to the wrong end of this.

One dear friend has recently been told that a head injury earlier in life, could have caused problems later on which were then diagnosed as Alzheimer’s. So it proves that even experts can get things wrong.

I had a bad head injury years ago and woke up on the floor after falling around 15ft or so. At that point I felt as if my head had exploded, and suffered from horrific headaches for some time afterwards, but I gathered that this could not have had any bearing on my diagnosis.

I then went to have episodes of epilepsy, or so we were told, then we were later told that this could have been the start of my dementia, although I was left thinking that someone had got it wrong again

I guess one day we will be able to get better diagnosis procedures, which will be a great help to both consultants and patients, but we may have a long wait. 

I the mean time it’s a case of keeping as active and busy as possible, so that our brains can remain active.

Use it or Lose it

Tuesday, 4 June 2019

Lewy Body Dementia

Lewy Bodies Disease is similar to both Alzheimer's and Parkinson's diseases and can often be misdiagnosed. Specialist diagnosis is essential because sufferer's can have a reaction to the drugs used for other dementia diseases.
Like other dementia diseases it sadly cannot be currently cured. However, with early diagnosis treatment can slow down the disease's progress.

What is dementia with Lewy bodies (DLB)?

What are the symptoms of dementia with Lewy bodies?
Mental symptoms similar to those of Alzheimer’s disease include:
  • Problems with attention and alertness
  • Spatial disorientation
  • Difficulties with planning and reasoning
  • Memory loss – but to a lesser extent than with Alzheimer’s disease

Physical symptoms similar to those of Parkinson’s disease include:
  • Slowness and stiffness
  • Trembling of the limbs
  • Shuffling when walking
  • Loss of facial expression
  • Loss of vocal strength

Other symptoms particular to dementia with Lewy bodies include:
  • Visual hallucinations of great detail and extreme realism, usually of people or animals
  • Rapidly fluctuating abilities – changing daily or even hourly
  • Daytime sleep, contrasting with disturbed nights with nightmares, hallucinations and confusion
  • Fainting, falling and ‘funny turns’
  • Dementia with Lewy bodies is responsible for about 10% of all dementia cases, but tends to be under-diagnosed. It’s similar to both Alzheimer’s and Parkinson’s diseases, affects mostly elderly men and women, and like other forms of dementia, is treatable but not curable or reversible.

Other names for dementia with Lewy bodies include:
  • Lewy body dementia
  • Cortical Lewy body disease
  • Diffuse Lewy body disease

What are ‘Lewy bodies’?

Named after the Dr Lewy who identified them in 1912, Lewy bodies are microscopic spherical protein deposits found in nerve cells.
When they appear in the brain, they interfere with normal functioning by impeding the brain’s chemical messengers including acetylcholine and dopamine.
Lewy bodies are also associated with Parkinson’s disease, a neurological disease that affect the brain’s control of the body’s muscles. Many Parkinson’s sufferers may also go on to suffer from dementia.

The importance of specialist diagnosis for DLB

As it’s so easy to misdiagnose dementia with Lewy bodies, specialist diagnosis is essential.
The risk of misdiagnosis is that DLB sufferers have been known to have a bad reaction to some of the drugs that are normally used to treat other forms of dementia.
A positive diagnosis will also open the door to support services geared to dementia sufferers and their carers and allow the individual and their family to plan for the future.

Treating dementia with Lewy bodies

While there is no cure at present for dementia with Lewy bodies, various drugs are used to treat particular symptoms and to slow down the disease’s progress.
As the symptoms of this disease can fluctuate rapidly, care may need to be very flexible – and may require a substantial amount of physiotherapy and one-to-one support.
Cholinesterase inhibitor drugs usually used to treat Alzheimer’s disease, have been shown to be useful in some cases. Another Alzheimer’s treatment, memantine / Ebixa, may also be useful.
Physical symptoms can be treated with drugs often used for Parkinson’s disease, but these have been found to increase hallucinations and confusion. Physiotherapy and mobility aids are another option.
Neuroleptics are strong tranquilisers that may be used to reduce a dementia sufferer’s confusion and distress. However, in the case of dementia with Lewy bodies, they may induce bad side effects including rigidity, immobility, an inability to communicate and even sudden death. Neuroleptic use therefore needs to be monitored extremely carefully.

How Clinical Partners can help

Simply call our clinical team in confidence on 0203 326 9160 and we will recommend a qualified and empathetic clinician with experience and expertise in exactly the issues you are struggling with.

There is also a charity soley dedicated to Lewy Body Dementia in the UK 
For More Information, please contact 
The Lewy Body Society.  
Unity House, 
Westwood Park,
Wigan WN3 4HE

01942 914000

info@lewybody.org
We can also be found on Facebook and Twitter


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