Although most medical schools (excluding Oxford and Cambridge)won’t be aiming to test your scientific knowledge, it’s good to have a general understanding of the most common diseases in the UK and some key medical statistics. Even if you aren’t asked directly about the diseases or figures, they may come in handy in some questions and help you demonstrate your passion for and understanding of medicine.
Dementia is an umbrella term describing a group of diseases, which cause a deterioration in cognitive abilities, including memory, language and problem-solving. It is not a natural part of ageing, but age is one of the primary risk factors for developing dementia.
There are many forms of dementia and include: Alzheimer’s dementia (60-80% of the cases), Lewy Body Dementia, Vascular Dementia, Frontotemporal Dementia, Parkinson’s disease and Huntington’s disease (source: alz.org)
Many people use these two terms interchangeably, but it’s not exactly medically correct: Dementia describes a group of diseases causing cognitive decline with Alzheimer’s being one of them.
The decline is caused by damage to brain cells. The precise mechanism, however, (why the damage happens and why it happens at this particular place and time), is generally poorly understood. However, what we know is that the way the disease presents itself depends on the area of the brain affected: for instance, if a person’s temporal lobes are most affected, they may show the most significant decline in language skills, such as speaking and comprehension. Many types of dementia, such as Alzheimer’s, affect more than one region of the brain and, therefore, provide a whole range of symptoms.
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Genetic predispositions, age (risk doubles every 5 years after age 65), less intense use of the brain throughout life, smoking and alcohol use, atherosclerosis, and high cholesterol levels. However, take these with a grain of salt, as existing research has not successfully identified these to be risk factors of high certainty and draws a causal link (sources: stanfordhealthcare.org; alzheimers.org.uk).
Currently, although there is no cure for dementia, there are several ways to manage the disease:
1. Conservative Approach: Studies have shown that being surrounded by familiar people and being in familiar places helps patients manage their symptoms, and decrease the likelihood of dangerous situations or confusion. Moreover, having carers who help such patients with daily activities (cooking, washing etc.) is also key in the management of dementia.
2. Medical Approach: Several drugs and therapies can also help patients manage their symptoms or slow down the progression of the disease. What drug is used depends on the type of dementia a given patient is dealing with. Most drugs are intended for the treatment of Alzheimer’s and include acetylcholinesterase inhibitors (e.g. donepezil or rivastigmine) or Memantine (source: nhs.uk). By no means are you required to know the names of those drugs; treat it as a fun fact.
3. Surgical Approach: Not applicable here.
As the population in the UK grows increasingly older, the number of patients with dementia will also increase. Currently, 1 in 14 people over 65 have dementia and 1 in 6 in those over 80 (source: nhs.uk). With no cure for dementia, the management of the disease may be challenging. The decline in language skills, forgetfulness and confusion common for dementia patients make communicating with patients or ensuring they take their medications much harder. Moreover, all of those symptoms can heavily affect the person’s quality of life and independence. Therefore, the involvement of multiple members of the MDT (including community workers) is often necessary and increases the cost of treatment for the NHS.
🏥 Main challenges for the NHS: Growing number of cases, no cure, more challenging communication with patients, involvement of many members of the MDT, and growing cost.
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Top 5 leading causes of death in England and Wales in 2020: COVID-19 (12.1%), Dementia and Alzheimer’s (11.5%), Coronary heart disease (9.2%), Cerebrovascular disease (various conditions that affect blood vessels in the brain, 4.9%), Lung-based cancers (4.7%). Before the pandemic, dementia was the leading cause of death for the last 5 years. Source: alzheimers.org.uk
Around 55 million people have dementia worldwide and due to the ageing population, this number is expected to increase to 140 million by 2050. Source: who.int
If you'd like to wrap your head around the topic of dementia, we've collected a few brilliant resources below: