DEMENTIA ACTION ALLIANCE Quarterly meeting 12 th February 2014 by Peter Ashley © Peter J S Ashley * With great respect for the gentleman after whom he was named And don’t forget me! Boris*

A personal experience of living with co-morbidities The devil is in the detail or What living with a dementia is all about The facts in my case and Others have similar problems! © Peter J S Ashley 20142

3 Comorbidity From Wikipedia, the free encyclopedia In medicine, comorbidity is the presence of one or more additional disorders (or diseases) co-occurring with a primary disease or disorder; or the effect of such additional disorders or diseases.medicine In medicine, the term "comorbid" can be either medical condition(s) existing simultaneously but independently with another condition; or it can indicate a related medical condition or conditions.

The 3 D’s 1.Dementia 2.Depression 3.Delirium © Peter J S Ashley 20144

5 Dementia (taken from Latin, originally meaning "madness", from de- "without" + ment, the root of mens "mind") is a serious loss of global cognitive ability in a previously unimpaired person, beyond what might be expected from normal aging. It may be static, the result of a unique global brain injury, or progressive, resulting in long-term decline due to damage or disease in the body. Although dementia is far more common in the geriatric population (about 5% of those over 65 are said to be involved), [1] it can occur before the age of 65, in which case it is termed "early onset dementia". [2]Latincognitiveagingbrain injurydiseasegeriatric [1] [2] Dementia is not a single disease, but a non-specific syndrome (i.e., set of signs and symptoms). Affected cognitive areas can be memory, attention, language, and problem solving. Normally, symptoms must be present for at least six months to support a diagnosis. [3] Cognitive dysfunction of shorter duration is called delirium.syndromesignssymptomsmemoryattentionlanguageproblem solving [3]delirium

© Peter J S Ashley Depression is a state of low mood and aversion to activity that can affect a person's thoughts, behavior, feelings and sense of well- being. [1] Depressed people feel sad, anxious, empty, hopeless, worried, helpless, worthless, guilty, irritable, hurt, or restless. They may lose interest in activities that once were pleasurable, experience loss of appetite or overeating, have problems concentrating, remembering details, or making decisions, and may contemplate, attempt, or commit suicide. Insomnia,excessive sleeping, fatigue, loss of energy, or aches, pains, or digestive problems may also be present. [2]moodsense of well- being [1]anxiousworthlesssuicideInsomniaexcessive sleepingfatigue [2] Depressed mood is also a primary or associated feature of certain psychiatric syndromes such as clinical depression.syndromesclinical depression

© Peter J S Ashley Delirium, or acute confusional state, is a syndrome that presents as severe confusion and disorientation, developing with relatively rapid onset and fluctuating in intensity. It is a syndrome which occurs more frequently in people in their later years. Delirium represents an organically caused decline from a previously attained baseline level of cognitive function. It is typified by fluctuating course, attentional deficits and generalized severe disorganization of behavior. It typically involves other cognitive deficits, changes in arousal (hyperactive, hypoactive, or mixed), perceptual deficits, altered sleep-wake cycle, and psychotic features such as hallucinations and delusions.

Facts as they relate to me. My primary disease A dementia Subtype - Dementia with Lewy Bodies (DLB) My additional disorders/diseases Let’s look at the timeline both pre and post DLB © Peter J S Ashley 20148

My timeline ‘98 ‘99 ‘00 ‘01 ‘02 ‘03 ‘04 ‘05 ‘06 ‘07 ‘08 ‘09 ‘10 ‘11 ‘12 ‘ CHRONIC DEPRESSION – HIGHLY CYCLIC D Day DEMENTIA WITH LEWY BODIES © Peter J S Ashley LEGIONAIRRES DESEASE MAJOR HEART ATTACK UTIs TYPE II DIABETIES 2ND HEART ATTACK ANGINA MOOD SWINGS ME INPATIENT MENTAL HOSPITAL 7 SESSIONS ECT TWO SUICIDE ATTEMPTS TWIN CATERACT OPERATION CHRONICALLY DEAF (HIGH FREQUENCY) SLEEP APNOEA DYSLEXIA ATAXIA DYSGRAPHIA OEDEMA LEG ULCERS PERIODS OF SEASONAL AFFECTIVE DISORDER

TO COMBAT MY PROBLEMS I NEED EXERCISE © Peter J S Ashley

© Peter J S Ashley PROBLEMS??? SO DOES SHE! “WHAT ME?” “AGE IS JUST A NUMBER.” “YOU’VE GOT TO MAKE THE BEST OF IT.” “I NEVER LET THINGS GET ME DOWN!”

© Peter J S Ashley Peter and Boris