Tania Melnyczuk

Study notes

My Study Notes record what I am learning. They're mostly about molecular and cell biology. They reflect my knowledge and understanding at the time, and are subject to extensive revision.

Preventing, treating and managing dementia

Preventing, treating and managing dementia

When my father got dementia, the incompetent psychiatrist (a dementia specialist!) didn’t tell us about the latest research. He probably didn’t even read it. Later, a neurologist lambasted this psychiatrist for his inappropriate treatment of my father, which had given him Parkinson’s Disease on top of his Lewy Body Dementia. I mean, the psychiatrist was very sweet and all. Good bedside manner, bad doctor.

Did anyone ever tell you what oxalates do and how that increases Parkinson’s risk? Probably nah, even though scientists have written about it. Did they tell you that autistic people may be at increased risk of Parkinson’s? And that adults with ADHD are also at increased risk of dementia? I even asked that psychiatrist about these things back then, and he said no, there were no such risks. He was wrong. The research was out there. He answered as though he knew, but he didn’t know. Did you know that ignorant psychiatrists are prescribing citalopram oxalate to many autistic people in the form of Cipralex, Citalopram or Lexapro without telling them of the risks? Did you know that oxalates may be a major contributing factor to health issues in some autistic people and their families? Did you know that Vitamin B12 is really important to brain health? And that intestinal health can affect brain health? Nope? News to you?

OK, enough moaning. I’m off on a tangent here. Let’s switch to something helpful and brand new.

First, a little disclaimer: dementia isn’t smallpox; we’re not going to eradicate it through a worldwide vaccination programme and then one day it’s all gone. But we can jolly well prevent it, treat it, slow it down and manage it better in a lot of people.

A major report on dementia prevention, intervention and care has just been published by the Lancet Commission. This is very thorough and should guide government policy.

Here’s a little glimpse into that report:

We judge that sufficient new evidence supports adding three additional modifiable risk factors for dementia to our 2017 Commission model (excessive alcohol, traumatic brain injury, and air pollution). We have been able to add updated evidence on the nine risk factors implicated in the 2017 Commission (education, hypertension, hearing impairment, smoking, obesity, depression, inactivity, diabetes, and social contact). Reduction of these risk factors might be protective for people with or without a genetic risk, although study findings have not been entirely consistent. As we noted in the 2017 Commission, others have previously calculated an estimate of the risk associated with APOε4 at 7% taking into account some other risk factors and this estimate highlights how relatively important potentially modifiable risk factors are in dementia.

Let’s go and educate the world.

In fact, let’s go and change the world.