Women and Neurological Diseases

Women and Neurological Diseases

Overview

Neurological diseases are among the leading causes of mortality and disabilities in the elderly population. Parkinsonism, strokes and Dementia come under the umbrella term of Neurological diseases. These neurological diseases have a detrimental effect on not only the patient but their family and caregivers. They are also known to show substantial co-occurrence, therefore an individual with Dementia has an increased risk of stroke.

The study 

My name is Lucy Field and I am research Scientist at Future Genetics. I have recently read an article which was published by University medical centre in Rotterdam which focuses on Neurological diseases. They conducted a study; the objective of this study was to ‘quantify the burden of common neurological disease in older adults in terms of lifetime risks such as co-occurrence and preventive potential. In this study the health of 12,102 people was monitored over a 26-year period in the years 1990 to 2016. The long duration of the study allows clear identification of co-occurrence of a disease and allows a large sample size giving more reliable data and conclusions

Study conclusion 

The  overall conclusion of this research study was that one in two women and one in three men will develop a Neurological disease in their lifetime. This shows it is more common in women than men, throughout the study data on women was compared with men. The study mainly focuses on age, as all of the individuals involved were above the age of 45. There was evidence to show women are more likely to develop a neurological disease. Not only as a female but a female scientist I believe it is important to raise awareness. Through this article I hope to educate more women about the risk of these common disease allowing us to further educate more women.

 Study Findings

In the study Dementia was seen to be the most common disease with a total of 1489 individual’s being diagnosed, then 1,285 suffered from a stroke. Ischemic strokes were more common at 64.7% and 9.8% had a hemorrhagic stroke. Parkinsonism was the least common neurological disease with 263 individuals’ being diagnosed. A lot of individual’s are only diagnosed with one of the diseases in their lifespan. However, at the age of 45 there was a substantial risk of being diagnosed with multiple diseases. A total of 438 individuals were diagnosed with multiple diseases. Following the trend of more women being affected by one neurological disease, more women were diagnosed with multiple diseases a total of 4% Versus 3% of men. Women were also almost twice as likely to be diagnosed with both stroke and dementia. These high figures show the importance of the need for better prevention strategies.

Neurological disease versus Other common diseases

Neurological diseases get under investigated in comparison to common diseases such as cancer and heart disease. This is because Cancer and Heart disease commonly affect middle aged individual and and neurological diseases normally have a later onset. According to this study, this should not be the case as the lifetime risk of developing Breast cancer in 1 in 8 compared to 1 in 2 developing a neurological disease. The same principle applies for heart disease which affects 1 in 4 people. Those who had been diagnosed with one of the neurological diseases had a higher prevalence of high blood pressure, type 2 diabetes and an abnormal heart rhythm.

Importance of Preventative interventions

These findings clearly display the importance of preventative interventions which will delay the onset. It has been estimated that if the onset of the diseases is delayed by 1 to 3 years, the remaining risk of developing would be reduced by 20% in 45-year olds and 50% in those older than 85. This huge reduction in both age categories, this demonstrates the importance of the development of a treatment to delay the onset and to maintain a healthy brain. This is one of Future genetics aims.

Licher SDarweesh SKLWolters FJ, et al
Lifetime risk of common neurological diseases in the elderly population

Diabetes – The Time is Right for the Revolution

future genetics, NHS, patients, clinical outcomes, morbidity, mortality, diabetes, type 2 diabetes, t2d, healthcare, genetics, glucose, glucose monitoring, ethics, Diabetes Professional Care, HbA1c, opportunistic test, Quality Outcomes Framework, QOF, Clinical Inertia, Department of Health, Diabetes Burnout, asymptomatic type-2 diabetes, diabetics

Diabetes:

As the CEO and Medical Director of Future Genetics, I have attended (so far) 7 healthcare and scientific conferences/ symposia this autumn:

NHS Expo 2017 (Manchester Central)

UK Health Show (Olympia)

Data Science – Basis of Precision Medicine (Imperial College)

Best Practice National Association of Primary Care (NEC)

Better Science through Better Data (Springer Nature) (Wellcome Collection)

Ethics of research involving children (Manchester)

Diabetes Professional Care (Olympia)

 

Each attendance has highlighted a common message, which is also aligned to my deep-rooted focus to contribute to the delivery of personalised medicine and care for individuals, which is the cornerstone of Future Genetics.

 

The common message is illustrated using my latest experience at the Diabetes Professional Care (DPC) conference and the key learnings that I have gleaned from Day 1.

Dr Mohammed Kamran @ Diabetes Professional Care (DPC)

 

Diabetes Learning No.1. Treating the Disease or the Patient? A question of perspective… and I daresay outcomes

There was a great presentation by Dr Kevin Fernando on blood glucose management, which was energetic and enthusiastically forward looking – congratulations Kevin on a fab delivery.  I am of the view that he saved the best and most fundamentally important message till last (see below).

  

Dr Kevin Fernando quoting Sir William Osler “The good physician treats the disease; the great physician treats the patient who has the disease”. Sir Osler has been described as the “Father of Modern Medicine” and one of the “greatest diagnosticians ever to wield a stethoscope”

 

Diabetes Learning No.2. T2D Patients identified by “Opportunistic testing”. Consider this: Had they not been tested then their disease could have progressed unchecked to a more advanced stage.

 

With five lecture theatres and so many great sessions running simultaneously, difficult choices had to be made. I sat in on a session looking at Type 2 diabetes (T2D) in general practice, where Prof Sir Denis Pereira-Gray pointed out that 95% and 85% of T2D patients were diagnosed and managed in primary care respectively. This was followed by a presentation by Dr Kate Sidaway, PhD. She reported on findings that use of the HbA1c diagnostic test showed that the majority of “opportunistically tested” patients who were positive for T2D were asymptomatic. This demonstrated that there was an opportunity for early management of these patients, which for me opens up a key issue on what should be the basis of testing asymptomatic people?

 

Like all the sessions that I attended, the “T2D in General Practice” session was full to capacity. Featuring Kashiff Arfan

 

Diabetes Learning No.3. There is an unacceptably high proportion of patients who slip through the net, so do not receive the care and management they need

The talk on Clinical Inertia by Dr Suzy Hope was great as it highlighted the challenges faced in delivering the best possible healthcare to diabetic patients. A key statistic from the Quality Outcomes Framework (QOF) data shows that 49% of diabetic patients did not undergo the full spectrum of BASIC tests (please refer to the below slide for this and other figures).

Clinical Inertia Talk: Department of Health 2012-13 Report on management of adult diabetic services
  1. Only 20% achieve recommended levels of blood glucose, blood pressure and cholesterol
  2. 24,000 premature deaths per year due to ineffective management
  3. 80% of diabetes costs due to avoidable complications
  4. Less than half (49%) of patients do not receive all the basic tests (QOF)
  5. Absence of the simple tests increase risk of developing complications.

 

Diabetes Learning No.4. Similar to learning No.3, there is an unacceptably high proportion of patients who slip through the net, so do not receive the required personalised support to overcome BurnOut

I then went to listen to a presentation by Debbie Hicks on Diabetes Burnout which can be described as the development of a complete disregard for the management of blood sugar levels by diabetics. The speaker quoted a figure of 44% of diabetics being affected by this phenomenon, which has clear implications for the safety and wellbeing of these individuals.

 

Diabetes Burnout – Debbie Hicks (Co-Chair of TREND-UK)

 

Diabetes Learning No.5. “Money Can’t Solve Our Problems…   ”

 

Keith Vaz, MP had given a Key-note presentation around the theme of prevention being better than cure. He eloquently shared an insightful and humorous anecdote, which unfortunately I cannot fully capture here in a few words. However, the key point from my perspective was that around 10 years ago the Member of Parliament had attended an opening ceremony of a diabetes centre and gave a blood sample for the cameras (yep, the things politicians do for cameras). He was later informed that the blood had been analysed and he was an asymptomatic type-2 diabetic, which ties into the earlier talk by Dr Kate Sidaway. So, this story again emphasises the problem of not identifying patients who should ideally be managed at the earliest possible stage.

 

Rt Hon Keith Vaz MP and Dr Mohammed Kamran

Keith Vaz informed the audience that the government invests £10 billion per annum for diabetes management, although diabetes.co.uk estimates the figure at £14 billion per year. Either way, it’s a lot of money. Whilst I like to think that the money spend is focused and hopefully wisely spent, it is clear that there are cracks that need mending with respect to helping those patients that are currently being missed by the system. Therefore, a meaningful re-think at some level is needed if we are to avoid falling foul to Einstein’s view of insanity (repeatedly doing the same thing and somehow expecting a different outcome).

 

Future Genetics is mapping out clinical studies that address the health inequalities that exist in the UK

 

Let us know your thoughts on this article, and please feel free to share any experiences you have had.