Tonight I rise to speak about the most common form of dementia, Alzheimer’s disease. It is a disease that has a significant impact on many Australians. Not only do people with Alzheimer’s suffer but it also affects their families, friends and carers. In raising awareness about Alzheimer’s disease, I would also like to highlight the excellent work done by Alzheimer’s Australia, which provides advocacy and support to Australians living with dementia. I know my colleague present here tonight, Senator Carol Brown, would also bear witness to the hard work they do.
Alzheimer’s disease is a physical condition which attacks the brain and results in impaired memory, thinking and behaviour. It falls into two categories. The first category is sporadic Alzheimer’s disease which affects adults at any age but most commonly occurs in people over the age of 65. Sporadic Alzheimer’s disease is by far the most common form. It is quite often known as late onset Alzheimer’s and is not thought to occur through direct inheritance. However, if people have relatives with Alzheimer’s disease, they have a greater chance of developing it themselves.
The gene is carried by 25 per cent of the Australian population and is known to be associated with an increased risk of late onset Alzheimer’s disease. That said, approximately half the people carrying the gene who live to be 85 do not have the disease at that age. Researchers are trying to find other genes and environmental factors that make Alzheimer’s disease more or less likely but, to date, the only clear risk factor for developing the condition appears to be a history of a severe head injury earlier in life.
The second form of the disease is known as familial Alzheimer’s disease. This is a less common form and involves the disease being passed from one generation to the next. A child of a person carrying the mutated gene will have a 50 per cent chance of their children inheriting the disease. If people with this gene develop Alzheimer’s disease, it usually occurs when the person is in their 40s or 50s. Familial Alzheimer’s disease affects a very small number of Australians—thankfully.
In the early stages the symptoms of Alzheimer’s disease can be very subtle. The first signs are often lapses in memory and difficulty in finding the right words for everyday objects. Other symptoms experienced may include: persistent and frequent memory difficulties especially of recent events; vagueness in everyday conversation; apparent loss of enthusiasm for previously enjoyed activities; taking longer to undertake routine tasks; forgetting well-known people or places; an inability to process questions and instructions; deterioration of social skills; and emotional unpredictability. Symptoms can vary from person to person and the disease progresses at different rates. How fast the disease progresses is dependent on the area of the brain affected. A person’s abilities may fluctuate from day to day or even throughout the course of a single day. The disease can become worse in times of stress, fatigue or ill health. It is progressive and degenerative and it is, unfortunately, currently irreversible.
Researchers are rapidly learning more about the chemical changes that damage brain cells in Alzheimer’s disease but, apart from the few individuals with familial Alzheimer’s disease, it is not known why one individual develops Alzheimer’s and another does not. A variety of suspected causes are being investigated including environmental factors, biochemical disturbances and immune processes. Any person can develop Alzheimer’s disease but it is much more common after the age of 65 years. The prevalence rate for dementia rises with age. For females aged 65 to 69 years dementia affects one person in 80 compared to one person in 60 for men. In the 85 and over age group, the rate is approximately one person in four for both males and females.
Currently there is no single test to identify Alzheimer’s disease. The diagnosis is made after a thorough evaluation of the patient’s health, usually including a detailed medical history, a thorough physical and neurological examination, a test of intellectual function, a psychiatric assessment and a neuropsychological test. Sometimes blood and urine tests may also be taken. Conducting a wide range of tests and examinations helps doctors to eliminate other possible conditions that have similar symptoms, such as nutritional deficiencies or depression.
Once other conditions have been eliminated, a diagnosis of Alzheimer’s disease can be made with about 80 to 90 per cent accuracy. Unfortunately, the disease leads to complete dependence and eventually death. At present there is no cure for Alzheimer’s disease. However, some drugs can be used to assist to stabilise a patient’s condition. Doctors may also prescribe medication to help with secondary symptoms. Those symptoms may include restlessness, inability to sleep and depression.
There is now good evidence that we can reduce our risk of dementia by taking control of alcohol use, blood pressure, body weight, cholesterol, depression, diabetes, diet, head injury, mental activity, physical activity, smoking and social activity. It is also estimated that significant numbers of dementia cases could be prevented by addressing risk factors. For example, around 100,000 fewer Australians would have dementia in 2050 if physical inactivity rates were reduced by five percent every five years.
I have just spoken a bit about the actual disease, and I would like to look at some statistics for my home state of Tasmania. The report Dementia across Australia: 2011-2050 by Deloitte Access Economics indicates that in 2011 there are 6,732 known Tasmanians suffering from dementia. That number is expected to rise to 7,818 in 2015 and to 20,653 by 2050. If the onset could be delayed by five years, the number of people with dementia would be halved between 2000 and 2040. Dementia will become the third greatest source of health and residential aged-care spending within the next two decades. Australia-wide, there are thought to be over 266,500 people living with dementia this year and this is expected to rise to 565,000 in 2030 and 942,600, give or take, by 2050.
As with any serious medical condition, a strong support network is obviously important. Alzheimer’s Australia can provide support not only to the patient but to their families and carers as well. The organisation provides support, information, education and counselling for people affected by dementia and can also provide up-to-date information about drug treatments. This support can make a positive difference to managing the condition. Alzheimer’s Australia Tasmania has an administration centre in Hobart as well as another office in Devonport. Hobart also has a training facility and the Old Vicarage Respite facility.
The Old Vicarage provides overnight respite for patients for up to five nights and the individual’s carer is welcome to stay if needed. While staying at the Old Vicarage, people have access to a day club. People can attend the day club to give their normal carer a break, and up to 10 people can attend at any one time. Activities at day club focus on improving wellbeing, offering cognitive stimulation and also encouraging participants to socialise. Day clubs are offered in Hobart, Launceston and in Woodbridge, south of Hobart.
In Launceston, there is a dementia and memory centre, and the Commonwealth government funded dementia and memory community centre offers a range of services to the general public, including those with memory loss, their carers, family and friends. Services include access to computers and the internet to learn about the disease, a library and the opportunity to learn about the ‘seven signposts’ of the Mind your Mind program. There are also an art therapy program, which I have spoken about previously, and community information sessions.
A qualified counsellor, psychologist or social worker is available to talk confidentially, face-to-face, with people. There is also in-home respite, which means a care worker visits the home to give the primary carer a break. This service also allows for the respite carer to take the client on outings, which can of course be of great benefit to the people at home caring for the person suffering. In-home respite is usually used if a person is reluctant to attend a day club or if they are unable to attend because of issues with mobility, continence or behaviour.
Both Hobart and Launceston have a mobility sensory van that offers multisensory therapy for people living with dementia. The van operates throughout the state, visiting rural and remote areas to promote the Mind your Mind program and to ensure that people who do not live in the main cities have access to assistance. There are also a number of other support groups which operate in rural areas for people with dementia and their carers. With our ageing population and the associated increase in dementia, it is important that the community is educated about the signs, symptoms, treatment and support available to them and those that are suffering from this disease.