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Managing other health problems in people with dementia

It is known that people with dementia often have other health issues, such as diabetes. Dementia is also associated with cardiovascular risk factors, like hypertension. These different conditions can interact in complex ways and the presence of dementia will affect the ability of individual to manage other diseases. The role of the carer is crucial.

A recently published NIHR study has looked into the issue of comorbidities for people with dementia, with a particular focus on stroke, diabetes and visual impairment. This included a scoping review of published evidence, analysis of population databases and qualitative research with carers, people with dementia and healthcare professionals.

From these different sources, the team found that that a substantial proportion of those living with dementia have other serious health problems - often more than one at the same time. Population comparisons showed that people with dementia had slightly higher rates of comorbidity than others of similar age without dementia. Despite these high rates of multiple health problems, services and teams were often set up to deal with single conditions, with poor communication between different services.

The carer often provided the only point of coordination and information about the health needs of the person with dementia. The evidence suggests that people with dementia and diabetes may not always get regular eye and foot checks. The reasons for this were not clear. Interviews and focus groups with professionals showed they were often not aware that people attending diabetes or similar clinics had dementia and what extra help they might need. Carers (and health professionals) noted the need for more time in consultations to discuss health problems and how to manage them.

The study used consensus methods to identify some areas where practice could be improved. This included some practical suggestions particularly relevant to carers, from including family carers in correspondence when booking appointments to having systems for clinics to identify people with dementia and make longer consultation times.

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