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[Editorial] Let's talk about dementia

Tags: General

On Sept 1, kicking off World Alzheimer's Month, Alzheimer's Disease International joined forces with the Pan American Health Organization, launching Let's Talk About Dementia, a campaign aiming “to demystify dementia and to get people talking”. The ambition is to encourage discussion in families and with health providers to reduce the stigma associated with Alzheimer's disease and all forms of dementia. Events elsewhere include the Age Against the Machine festival in the UK, which offers a practical workshop on making homes, workplaces, or projects dementia-friendly and a performance of How to Keep Time, which looks at the effects of dementia on speech, memory, and family life.

Encouraging openness and discussion about dementia—including those initial, often difficult, conversations within families or at work—is to be welcomed. Prevention of dementia, or delaying the onset of symptoms, is possible in as many as 35% of people, as outlined in The Lancet's 2017 Commission on dementia. As modelled in the Commission, modifiable risk factors for dementia over a lifetime include early-life education, hypertension, hearing impairment, obesity, smoking, depression, physical inactivity, diabetes, and social isolation. Individualising dementia care, providing support for family members, protecting people with dementia, and planning for the future, including end of life care, are all important aspects to be considered.

Although, so far, curative treatments for Alzheimer's disease are not available, the lives of patients and their families can be improved by early diagnosis and timely and appropriate care, concentrating on alleviating associated distressing neuropsychiatric symptoms, reducing crises, treating cognitive symptoms when possible, and improving quality of life more generally. A follow-up standing Lancet Commission on dementia, due to be published in 2020, will build upon the evidence that much dementia can be prevented. But for those with dementia, the goal should be the best possible care, which can only be achieved through discussion, destigmatisation, early diagnosis, and putting the needs of the patient and family first.

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