Important NCDs Flashcards
Depression definition
most common mental disorder characterized by persistent sadness, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy, and poor concentration. Can lead to suicide at its worst.
Depression risk factors and causes
Genetic predisposition
o Chronic medical conditions
o Traumatic or stressful life events
o Substance abuse
o Hormonal changes
Depression PH relevance
Leading cause of disability worldwide. 3.25% of DALYs in the UK.
o Associated with increased risk of suicide
o Significant economic burden due to healthcare costs and lost productivity
Depression prevalence
13% 2022/23 QOF
Depression prevention
o Primary: Promoting mental well-being through community programs
o Secondary: Early detection through screening in primary care
o Tertiary: Providing effective treatment – reduce risk of suicide
Suicide and parasuicide definition
o Suicide: The act of intentionally causing one’s own death.
o Parasuicide: refers to non-fatal acts of self-harm or self-injury that are intentional but not necessarily with suicidal intent
Suicide risk factors
o Mental health disorders (e.g., depression, bipolar disorder)
o Substance abuse
o History of trauma or abuse, suicide bereavement, prison
o Chronic pain or illness
o Social isolation
o Deprivation
financial difficulties
gambling
PH relevance of suicide
Major cause of premature mortality, preventable
o Significant impact on families and communities
o High economic costs due to healthcare utilization and lost productivity
prevalence of suicide
there were 6,069 suicides registered in England and Wales (11.4 deaths per 100,000 people) in 2023
Time/Place/Person - suicide
o Higher rates in males
o Peak incidence around younger adults and middle age
o Elevated rates in certain regions, including rural areas, deprived industrial areas
o Decreasing since 1980s but since 2000 it has plateaued. Increase associated with the financial crisis.
suicide prevention
o Primary: Implementing community-based mental health programs, debt relief, substance misuse programmes
o Secondary: Training healthcare providers to recognize and respond to warning signs, management of mental illness
o Tertiary: Providing support and counselling to individuals who have attempted suicide
dementia defintion
Neurodegenerative syndrome. Cognitive impairment in at least two of the following cognitive domains: memory, language, behaviour, visuospatial or executive function. Two main types:
o Alzheimer’s disease - Loss of acetylcholine receptors and neurons in the brain– atrophy of cerebral cortex and formation of amyloid plaques and neurofibrillary tangles
o Vascular dementia - reduced blood supply to the brain following a stroke or multiple small strokes
dementia risk factors
o Age (most common in those over 65)
o Family history
o Cardiovascular risk factors (e.g., hypertension, diabetes)
o Smoking
o Low educational attainment, learning disabilities
o Head injury
o associated with presence of other diseases e.g. CVD, obesity, downs syndrome, depression
o higher risk with smoking, poor diet and excessive alcohol
dementia PH relevance
o Leading cause of death in the UK, increasing prevalence with aging population
o No cure
o Significant burden on healthcare and social services
o High economic costs due to long-term care needs – health and social care and informal carers
Dementia epi
o Higher prevalence in women
o Risk Increases with age (genetic has earlier onset)
dementia prevention
o Primary: Promoting cardiovascular health through diet and exercise
o Secondary: Early detection through cognitive screening and treatment with protective factors/address modifiable risk factors – use of memory and cognitive skills
o Tertiary: Providing support services and interventions to manage symptoms
dementia prevalence
o 4% prevalence in over 65s. large proportion undiagnosed.
Parkinson’s disease definition
Chronic progressive neurodegenerative disorder leading to loss of dopamine-containing cells in the substantia nigra.
o Cardinal symptoms are: resting tremor, rigidity, bradykinesia (slow and small movement), postural instability.
Parkinson’s disease risk factors
o Age (most common after 60)
o Family history
o Exposure to MPTP
o Weak evidence for head trauma, toxin exposure (e.g., pesticides)
Parkinson’s disease PH relevance
o A leading cause of disability in older adults. Increasing with ageing population.
o High healthcare costs due to long-term treatment and caregiving needs + common cause of falls and hospital admissions.
o No cure, but treatments can improve quality of life. Difficult to diagnose early.
Parkinson’s disease prevalence
o Around 153,000 people were living with Parkinson’s in the UK in 2023. (parkinsons.org.uk)
o The lifetime risk of being diagnosed with Parkinson’s disease is 2.7%. This is equivalent to 1 in every 37 people being diagnosed at some point in their lifetime.
Parkinson’s disease epi
o More common in men than women.
o Risk increases with age.
o Higher rates in areas with an aging population.
Parkinson’s disease prevention
o Secondary: Early detection and symptom management. Screening may be more widespread if more treatments/ protective agents are developed
o Tertiary: treatment of symptoms - Physical therapy, medications, and surgical treatments (e.g., deep brain stimulation).
Schizophrenia defintion
A severe psychotic disorder.
o chronic, often lifelong, psychotic condition or group of conditions characterised by three types of symptoms:
(a) positive – third-person auditory hallucinations, delusions, disrupted speech;
(b) negative – flat affect, low mood, withdrawal from social life, lack of motivation;
(c) cognitive – memory, concentration problems
Schizophrenia risk factors
o Genetic predisposition.
o Neurochemical imbalances (dopamine dysregulation).
o Substance abuse (e.g., cannabis use linked to increased risk).
o Childhood trauma or adverse experiences.
o In-utero exposures (maternal stress, nutritional deficiency)
Schizophrenia PH relevance
o A leading cause of disability (chronic illness) – shorter life expectancy, higher risk of NCDs
o High burden on mental health services.
o Associated with increased risk of homelessness and unemployment.
o Stigmatised
Schizophrenia prevalence
o 1 in every 100 people get this diagnosis at some point in their life. (mind.org.uk)
Schizophrenia epi
o First onset usually occurs in late teens to early 30s.
o More common in urban areas.
o Higher prevalence in ethnic minority groups and low income groups, migrants
o Men tend to develop symptoms earlier than women.
Schizophrenia prevention
o Primary: Early childhood intervention, reducing drug use.
o Secondary: Early identification and treatment of prodromal symptoms.
o Tertiary: Ongoing psychiatric treatment and social support.
Coronary heart disease defintion
A condition where the heart’s blood supply is blocked or interrupted by fatty deposits in the coronary arteries. Is primarily caused by atherosclerosis (plaques of fat, cholesterol or other substances which narrow the arteries and reduce blood flow) of the epicardial coronary arteries. CHD can lead to:
o Angina
o MI - ischaemia of myocardium.
o Heart failure - can result from any structural or functional cardiac disorder that impairs the ability of the ventricle to fill with or eject blood.
o Cardiac arrest - a sudden state of circulatory failure due to a loss of cardiac systolic function
stroke
Coronary heart disease risk factors
o Lifestyle – smoking, inactivity, poor diet, obesity, substance misuse
o Family history of cardiovascular disease.
o Other diseases – hypertension, diabetes, high cholesterol, chronic kidney disease, HIV and inflammatory disease, obesity
o Stress
o Air pollution
Coronary heart disease PH relevance
o One of the leading causes of death worldwide.
o Significant burden on healthcare services - 100,000 hospital admissions per year due to heart attacks
o Preventable through lifestyle changes.
o Causes health inequalities
Coronary heart disease prevalence
o In the UK, one in eight men (the biggest male killer) and one in 14 women die from coronary heart disease.
Coronary heart disease epi
o Higher prevalence in deprived areas. Higher rates in Scotland and north of England.
o More common in older adults.
o Men at higher risk than women.
Coronary heart disease prevention
o Primary: Promoting healthy eating and exercise.
o Secondary: Screening for high blood pressure and cholesterol – NHS health checks programme. Statins, lifestyle measures.
o Tertiary: Medications (statins, beta-blockers) and lifestyle modification to reduce risk of future events.
Stroke defintion
A medical emergency where blood supply to the brain is disrupted, leading to brain damage. Stroke is defined as an acute neurological deficit lasting more than 24 hours and caused by cerebrovascular aetiology. Two types:
o ischaemic stroke (caused by a blood clot, accounts for 87% of causes)
o haemorrhagic stroke (accounts for 10%, due to a weakened blood vessel supplying the brain bursting).
* Transient Ischaemic Attacks (TIAs) is <24h (blood supply temporarily interrupted)
stroke risk factors
o Family history
o Lifestyle – smoking, alcohol and drug misuse, inactivity, poor diet
o CVD disease – hypertension, atrial fibrillation, history of MI, hypercholesterolaemia
o Other diseases – diabetes, sickle cell disease
stroke PH relevance
o One of the leading causes of disability and death
o Requires long-term rehabilitation services
o Significant healthcare costs and informal carers
o Potentially preventable
prevalence stroke
100,000 strokes occur annually in the UK. (stroke.org.uk)
o 1.3 million stroke survivors in the UK.
stroke epi
o Higher rates in people of South Asian and African descent.
o More common in older adults. Increasing prevalence due to older population
o Increased prevalence in lower socioeconomic groups.
o More common in men
stroke prevention
o Primary: Healthy diet, exercise, quitting smoking. Targeted interventions for high risk (family history)
o Secondary: identifying and treating high blood pressure.
o Tertiary: Stroke rehabilitation, speech and physical therapy. Anticoagulants, statins, lifestyle modification
Bowel cancer risk factors
Age >50, male, family history.
o High red/processed meat intake, low fibre diet
o Obesity, smoking, alcohol, inactivity
