Wednesday, January 24, 2018

Ask the Expert: Do patients with dementia who live with their family members have better outcomes, compared to those who live alone?

This is a really good question, but allow me to broaden the question a bit.

First of all, does living with a spouse or family prevent dementia? The answer is yes - married adults (and likely those living with family) have a reduced risk of developing dementia. Unfortunately, this protection disappears for widows and widowers who actually have a higher risk of dementia. Although the exact reasons for these relationships are unknown, it is likely that marriage and living with someone enriches their environment and increases social interactions and conversation which are mentally stimulating activities, and known to reduce the risk of dementia. On the other hand, grief and bereavement are stressors that are known to have negative effects on health, especially immune function, and therefore may contribute to an increased risk of developing dementia.

Once someone develops dementia, their ability to perform everyday activities inevitably becomes affected. By the time someone has moderately severe dementia, it is impossible for them to live on their own because they will require help with things like food preparation, shopping, grooming and personal hygiene. So, to answer the question, living with a family will definitely allow them to live longer in their own home, as they require more and more help with activities of daily living. This will significantly increase the time before considering moving to an institution like a nursing home is necessary. Living with family also contributes to a richer environment and more mental stimulation, and this may slow the deterioration of the disease.

Professor Nathan Herrmann

Nathan Herrmann MD FRCPC
Professor, Faculty of Medicine, University of Toronto
Lewar Chair in Geriatric Psychiatry
Head, Division of Geriatric Psychiatry
Sunnybrook Health Sciences Centre

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