Susan Kurrle

A number of diseases and conditions are frequently seen in the population of people with dementia. These diseases experienced at the same time as dementia but which may or may not be related to that dementia are known as comorbidities. Naturally these diseases have an adverse impact on the wellbeing of the individual. Efficiently identifying and treating comorbidities will benefit the quality of care provided to a person with dementia.

A new report published by Associate Professor Sue Kurrle and funded by the DCRC – Assessment and Better Care examines eight common comorbidities that are believed to be related to dementia:

  • Falls – Falls can contribute to reduced mobility, confidence and capacity which can result in earlier institutionalisation or death. Falls in people with dementia are 70-80% more common than in people with no cognitive impairment and on average result in more bone damage.
  • Delirium – Delirium is associated with longer hospital stays, higher health care costs and increased mortality, admission to residential care and functional disability. People with dementia are 5 times more likely to develop delirium than the general population.
  • Weight loss and malnutrition – Weight loss and malnutrition are associated with reduced muscle strength, increased risk of falls, loss of independence, increased risk of pressure ulceration, impaired immunity, increased chance of infection, and increased risk of death. People with dementia often lose up to 10% of their body weight throughout the course of the disease.
  • Epilepsy – Approximately 10% of people with dementia will experience a seizure during the course of their disease. These seizures are associated with unexplained falls, unconscious wandering, and short-term memory loss.
  • Frailty – Frailty which refers to when a person has reduced physical, cognitive or general health resources, leads to increased vulnerabilities.
  • Sleep disorders – Disturbances to sleep can adversely impact cognitive performance as well as on quality of life. Up to 50% of people with dementia experience sleep disturbances.
  • Oral disease – Oral disease can cause discomfort that may contribute to behavioural symptoms of dementia including refusal to eat or drink, restlessness, agitation and aggressive behaviour.
  • Visual dysfunction – Visual difficulties may impact on the ability to complete daily tasks and cognitive performance and may be linked to hallucinations.

The report reviews over 1300 journal-published articles to examine the available research on each of these comorbidities. This review of research was used to develop recommendations for the management of each of these comorbidities.

The recommendations developed by Associate Professor Kurrle cover a number of different issues including how to detect these comorbidities and factors that may complicate detection, what measures can be taken to reduce the chances of comorbidities developing – including lifestyle, dietary, environmental and medicinal means – and how best to treat somebody with these comorbidities.

This comprehensive overview of these common comorbidities will shortly be published by Cambridge University Press: Physical Comorbidities of Dementia, authored by Sue Kurrle, Roseanne Hogarth and Henry Brodaty.
Copies of the report's Executive Summary report can be found on the DCRC website below:
http://www.dementia.unsw.edu.au/DCRCweb.nsf/resources/Comorbidities+2010/$file/Comorbidities+Summary.pdf