Dementia

Citation

(2012), "Dementia", Health Education, Vol. 112 No. 4. https://doi.org/10.1108/he.2012.142112daa.001

Dementia

Article Type: Internet review From: Health Education, Volume 112, Issue 4

Dementia is not an illness as such, rather it is a syndrome that is associated with the ongoing decline of cognitive functions as a result of physiological deterioration in the brain. This is usually, though not necessarily, associated with the ageing process. The cognitive functions impaired include memory, thinking, language, understanding and judgement. These cognitive impairments can also have implications for other aspects of psychological wellbeing. For example people with dementia may become apathetic, have difficulty in social situations as well as in controlling their emotions.

Dementia is a large-scale problem now with over 600,000 people diagnosed, but as people live longer this will get worse and this figure is expected to double over the next 30 years. There are several different types of dementia including Alzheimer’s disease, vascular dementia, Lewy bodies dementia and frontotemporal dementia, though Alzheimer’s is by far the most common accounting for over two thirds of all demetia diagnoses.

There is at present no cure for dementia and the symptoms will progressively get worse over time. Therefore the focus of this review is to look at what the Internet can do to help people avoid getting dementia, if anything, and to examine how individuals and their carers can be helped to cope, once dementia has been diagnosed.

NHS Choices: www.nhs.uk/Conditions/Dementia/Pages/Introduction.aspx

NHS Choices has existed in its present form since October 2008 and is probably the most comprehensive health website in the UK. It describes itself as a website that helps individuals make choices about their health, be that decisions about lifestyle, i.e. smoking drinking, diet and exercise, or about which NHS services to access. The section dealing with dementia has a home page that gives users a basic introduction to the condition, a few facts and figures and a video clip of Singing for the Brain, a service provided by the Alzheimer’s society and that is designed to bring together people with dementia or memory loss through the medium of song

The home page also provides links to information on symptoms causes and diagnosis, each approximately one page of text written in an easily accessible style. For the purposes of this review it is the sections dealing with prevention and coping that are of most interest. The information on prevention is rather disappointing in that what it advises is what all good health education might advise, eat a healthy diet, do not drink too much, exercise, do not smoke and maintain a healthy weight. All the things we should be doing anyway and nothing that users would particularly associate with dementia. The website makes it clear that there is no evidence that “brain training” helps prevent dementia although it is acknowledged that some activities can be beneficial in this respect. For example reading and writing for pleasure, learning to play a musical instrument, playing things like golf or tennis and even just walking can be helpful. This could be all summarised as adopt a healthy lifestyle and keep active physically and intellectually if you want to minimize the risk of dementia. Surely there must be more to it than that?

The section on Living with Dementia is probably the best part of this website. It is extensive and covers a whole host of topics including staying independent, sleeping well, driving, financial matters, and even support for carers, something we sometimes forget about. The advice given is practical and often includes links to other resources and organisations. The NHS has come a long way since the early ventures into online health advice and this website is an excellent example of what can be done, and done well.

The Conscious Life: http://theconsciouslife.com/brain-foods-prevent-dementia-alzheimers-disease.htm

We are what we eat someone once said and the content of this North American website is based on this adage. At first sight the advice given here looks like a foodies dream! In order to prevent the onset of dementia you should be eating lots of dark chocolate, drinking red wine, and feasting on clams, asparagus and wild salmon; what could be better! There is a logic to this, though it may be based on a false premise. The premise put forward by this organisation is that dementia is linked to long term inflammation in the body and therefore foods that have anti-inflammatory effects may be able to delay the age-related cognitive disorders associated with dementia.

Following this logic the website then goes on to cite various research findings that are compatible with this premise. For example, flavonoids, found in chocolate and red wine have been shown to have beneficial effects on blood flow and cognitive functioning. Similarly, clams contain vitamin B12 and people with Alzheimer’s disease have been found have lower levels of this vitamin. People low in folate are at increased risk of dementia and since one cup of asparagus provides us with 66 per cent of our daily folate needs, keep eating the greens! Finally another study reported on this website claims that eating oily fish three times a week will reduce the likelihood of developing dementia. It seems that it is the Omega 3 found in fish like wild salmon that has the beneficial effects.

While the research cited to support these claims appears to be from reliable sources, it is of course very easy to be selective with these sources to promote a particular point of view. If it was as easy as this website makes out, and as much fun, you might wonder why anyone develops dementia at all!

The Alzheimer’s Society: http://alzheimers.org.uk/

The Alzheimer’s Society is one of the UKs major charitable organisations that provides support for those people with dementia and their carers. From the Home page onwards it is obvious that this website contains an abundance of information all packaged and presented using highly professional design. The Home page itself is attractive and has a good balance of text and images. The content of this website is extensive and the About section alone contains dozens of resources including fact sheets that can be downloaded as pdf files for printing if needed. There is a Dementia Brain Tour that comprises nine video clips dealing with the physiological aspects of the condition and a Dementia Map which maps the state of dementia and diagnosis levels across the UK.

There is a section for Health Professionals that provides users with a wide range of resources including free publications, a Living with Dementia magazine, and there is also an online shop that stocks everything from books, CDs, daily living products that include all sorts of electronic devices, talking watches, and even some rather fetching nightwear!

The Living with Dementia is one of the most impressive sections of this website but it is so extensive it is difficult to do it justice in a short review. Suffice to say that whatever you might need to know about living with dementia in terms of remaining independent, finding support networks, sharing experiences, or dealing with legal and financial issues, it is all to be found here in this section.

Similarly, the section that deals with Caring for a Person with Dementia, also contain content that is rich, relevant and varied. Here users can find information on everyday care, relationships, how to cope with unusual behaviour, and information on the care services that are available. There is even a postcode based search engine to locate local services provided by the Alzheimer’s Society, the local authority and other charities.

There is no doubting the excellence of this website. The only criticism that might be voiced is that there may be just a little too much information available and for some people they may well find it somewhat overwhelming; sometimes less can be more.

Dementia Web: www.dementiaweb.org.uk/index.php

This is a very interesting little website because the main focus in on Living with Dementia, rather than the condition itself. There is of course some information on dementia, symptoms, diagnosis and treatment, but this is hidden away from the Home Page. The design is novel with a central blue circle labelled Living with Dementia surrounded by eight smaller circles each labelled with a factor that impacts on living with dementia. For example there are circles labelled, Getting a Break, Practical Help, Support for Carers and Family Members and even one dealing with Younger People with Dementia. Each of these circles is a link to further information which again is presented in a similar format with a large central circle and smaller circles of information around the periphery. It is a design that not only looks good but works well.

Finally, another novel feature of this website is that users can change the design. The website as described above is in Basic Blue, but users, if they prefer, can view the website in bright yellow (Buzzy Bee). Users can also strip away some of the distracting side bar menus (Wide Zebra) making for a highly simplified version of the website. It is not made clear whether this feature is designed to help users who have dementia or their carers, or whether it is just an interesting design feature. Either way it is innovative and could well be used in many other types of website.