The Northern Rivers Times
November 2, 2023
44 HEALTH & SENIORS NEWS
Dementia is Not Just About Memory Loss Centre for Healthy Brain Ageing (CHeBA) We focus too much on memory loss in relation to dementia and not enough on difficulties with identifying emotions in social situations, according to researchers from UNSW Sydney’s Centre for Healthy Brain Ageing (CHeBA)and the MARCS Institute for Brain, Behaviour and Development at Western Sydney University. The perspective paper, published in Frontiers of Psychiatry, has highlighted the importance of assessing standard emotional responses to situations in order to improve diagnosis and management of dementia. Lead author and social health expert Dr Suraj Samtani said that individuals with many types of dementia can identify most emotions such as happiness, sadness, surprise
and fear, but have difficulties identifying other basic or primary emotions, including disgust or anger in facial expressions, as well as sarcasm and jokes in conversations. “The value of assessing social cognition in older adults with dementia is to improve early intervention and treatment,” said Dr Samtani. “It can also help identify dementia pathways for individuals from type of dementia such as frontotemporal dementia, to development of behavioural symptoms. Early signs of Alzheimer’s disease the most common form of dementia - involve memory loss, but for other types of dementia such as frontotemporal dementia, difficulties with social cognition are often the earliest signs of change. Humans are inherently social beings, and having social connection is considered a basic
human need. As individuals age, a variety of physical, cognitive and social changes take place, which can influence daily functioning and subsequently overall wellbeing. Dr Samtani explained that in this context social cognition is “our ability to recognise emotions, social cues, inhibit inappropriate behaviour and act appropriately in social situations.” Social cognition is a key component of how we function as social beings and includes the ability to understand other people’s mental states, and being able to
feel and respond to what other people feel. “Deficits in any of these social cognitive functions are a core feature of mild cognitive impairment and dementia, and may represent an early decline in cognitive function,” said Dr Samtani. “These can manifest through behaviours such as difficulties with eye contact, behaving rudely or offensively and a clear failure to detect social cues in conversations.” Routine social cognition assessments would ensure timely and appropriate interventions to improve social functioning and
strengthen social health for individuals with dementia. Another important factor noted in the paper is the link between social cognitive skills and the maintenance of social relationships. Dr Joyce Siette from the MARCS Institute and senior author on the paper explained that individuals experiencing difficulty responding to social cues or having trouble reading emotions will likely become isolated and lonely. “With recent evidence indicating that social isolation is a known modifiable risk factor for dementia, it is time to consider how we can reliably detect social cognitive deficits, as well as identify changes in them over time,” said Dr Siette. However, identifying these deficits has many challenges, notably that there is no standard or accepted approach to measuring them. While social reasoning and identifying and
remembering faces add great value to the assessment of social cognition, the lack of measuring skills such as eye contact, asking open ended questions, using humour, understanding puns and keeping conversations going marks a flaw in the dementia diagnosis process. “The majority of social cognition measures have either not been rigorously developed or psychometrically validated with people experiencing cognitive changes, with social behaviour the key component that remains to be assessed properly,” said Dr Samtani. Internationally acclaimed leaders in the ageing brain and Co-Directors of CHeBA, Professor Henry Brodaty and Professor Perminder Sachdev, said that “more work was needed to develop an effective measurement of social cognition that have functionality in the clinic.”
LIFELINE AND ON THE LINE AMALGAMATE TO BETTER SUPPORT PEOPLE IN CRISIS Lifeline Australia • Lifeline take on national clinical service responsible for MensLine, National Suicide Call Back Service, SuicideLine Victoria and other mental health, counselling, and family violence services. • Move brings in clinicians who currently provide 100,000 free counselling sessions a year. • Amalgamation creates an exciting opportunity to address the ‘missing middle’ in mental health. Lifeline Australia and On the Line Australia (OTLA) have completed a voluntary amalgamation designed to increase the impact of crisis support, mental health, suicide prevention, and family violence prevention services for people across the nation. On Sunday 1st October, OTLA completed the
final transfer of business, operations and workforce to Lifeline Australia, the country’s leading crisis support service. Even though the transfer has been completed, OTLA’s and Lifeline Australia’s service lines will continue to operate as before. Over the course of the past 18 months, and with the help of independent lived experience and clinical experts, Lifeline and OTLA determined that there would be considerable benefits of integrating OTLA’s clinical service with Lifeline’s crisis service to provide wrap-around care for anyone reaching out for support. Lifeline Australia CEO Colin Seery said that the organisation considers this a significant and exciting opportunity to take a more integrated approach to crisis support, mental health, and suicide prevention to ultimately improve
support through a variety of channels. “There is increasing interest from governments and the sector to improve both service quality and accessibility for help seekers by exploring the consolidation of helplines and the possibility of providing warm referrals,” said Mr. Seery. “Help seekers are at the heart of what we do and joining forces empowers us to build a more efficient and personalised response. It will also provide us with the foundation to help address the very real service gap for hundreds of thousands of people who cannot get access to care due to distance, workforce shortages, and financial pressures.” “Lifeline Australia is committed to continuing to look at ways in which we might be able to provide capability and infrastructure
foundations for smaller services that are targeted towards specific, vulnerable populations.” On the Line CEO Angus Clelland said the amalgamation was about considering the benefits of tailoring support to help seekers’ needs while taking a ‘no wrong door’ approach. “On the Line’s clinical services are a natural complement to Lifeline’s national crisis service and will create an exciting opportunity to
address the ‘missing middle’ in mental health care across Australia,” he said. Established in 1963, Lifeline is Australia’s leading suicide prevention service, with forty-one centres around the nation. The service expects to respond to over one million requests for support this year, creating an average of 130 safety plans to keep a person experiencing suicidal ideation safe every day.
If you, or someone you know are feeling overwhelmed, we encourage you to connect with Lifeline in the way you feel most comfortable. You can phone Lifeline to speak to a Crisis Supporter on 13 11 14, text 0477 131 114, chat to Lifeline online or access the Support Toolkit to self-manage what you’re going through at www.lifeline. org.au (all services are available 24/7).
