Review: Dementia and It’s Implications for Public Health

The article reviewed here is ‘Dementia and Its Implications for Public Health’ by Chapman and colleagues and freely available here.  The article is focused on the US population, but the issues here are relevant to other countries given the global demographics of aging populations. I couldn’t find an explicit aim for the review although the title suggests one itself. Looking at the methodology section, the authors specify the terms that they use in their search and also describe papers being retained as those that ‘provided definitional or diagnostic criteria for the disorders’ and they ‘specified an interval of observation’. This covers a broad remit and the authors also denote a number of search terms for the most common forms of dementia. However they state that papers were ‘primarily identified’ in this way although additional methods for identifying paper are not stated (the most common method is to hand search the reference sections of each identified paper or search relevant journals). The years delimiting the search are not stated nor are the results of the search in terms of number of identified papers and the subsequent filtering process. 

On reading through the remainder of the paper, there were introductions to several relevant areas – depressive symptoms, delirium and mild cognitive impairment. Each of these is covered in a brief section explaining how they are related to cognitive impairment. The main forms of dementia are then covered – Alzheimer’s Disease, Lewy Body Dementia, Frontotemporal Dementia and Vascular Dementia.  Demographic data is given but also consideration is given to neuropathological processes and genetics. The authors then look at interventions including anticholinesterase inhibitors, memantine, NSAID’s, vitamin supplements, mental and physical activity. The authors then finish with stigma, caregivers and a final discussion.

There were some points about the paper that I thought about further. Some of the sections contained a mix of different types of information – for instance on looking at the brief sections on dementia, pathological processes were combined with manifestations of early Alzheimer’s Disease. The sections are too brief to be able to fully develop the subjects and so they could more properly be considered overviews. Thinking of the paper in this way made more sense for me as I could then see that the paper provides a broad overview of areas that could be relevant to public health effects of dementia. However if the aim was to contextualise the issues of relevance to the public health effects of dementia then an alternative approach could have involved looking at established diagnoses (therefore excluding delirium without dementia, mild cognitive impairment and depression without dementia) focusing on outcome measures including mortality and morbidity outcomes, detailed epidemiological data and economic analyses.  

On the other hand, the paper also helps to focus on issues that are of relevance to the topic under consideration and any disagreement (as above) can results in alternative ‘models’ which can be used for comparison and further refinement. 

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Disclaimer

The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog

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