IDENTIFICATION AND RANKING OF LIFESTYLE AND HEALTH RELATED RISKS FACTOR FOR VASCULAR DEMENTIA

Abstract
Vascular dementia has recently become one of the health concerns in England. Patients who suffer from this condition experience declined quality of life. The good thing is that the condition is preventable. Unfortunately, there lack enough academic and empirical evidences that shows and rank risks factors that are common to people in England. This makes it hard to put in effective measure to prevent the condition. This research was conducted mainly to identify and rank risks factor for vascular dementia among the England citizen so that better preventive measures can be put in place.
The research was conducted using the quantitative method. This means that data was statistically collected and analyzed.
The finding of the study shows that smoking, Physical inactivity and hypertension are the highest risks factor for vascular dementia. People who spend most of their youthful ages smoking, physically inactive and those who have hypertension condition are more likely to be attacked by vascular dementia in their old age. Other risks factors with moderate contribution to vascular diseases as indentified by the finding of the study include vascular diseases, Diets, Social interaction, Alcoholism, Stroke, obesity, Cardiac disease and diabetes.
Based on the finding of the study as highlighted above, there are several recommendation made in this paper. First, the study recommends behaviour changes to reduce prevalence of diseases. The first two risks factors as identified in this paper are related to lifestyles choice. Therefore, encouraging behaviour changes can help reduce future prevalence of the condition. Secondly, the paper recommends proper management of health problem such as hypertension, diabetes and vascular diseases which are also risks factor for the condition.

Chapter one; introduction
Background
According to NHS choice (2015), vascular dementia is form of dementia that is characterized by loss of memory and gradual death of brain’s cell. It is estimated that 150, 000 people in UK has vascular dementia. This makes it the second most popular form of dementia after Alzheimer diseases.
Vascular diseases have been closely linked to vascular diseases. NHS choice (2015) Highlight that, vascular dementia is caused by vascular change and diseases that affects the flow of blood to the brain. According to Alzheimer society (2015), the brains need blood to function properly. The vascular system which supplies the brain with blood will therefore affect the blood flow to the brains if it get damaged or leaked. Insufficient flow of blood into the brain lead to death of brain cells hence cognitive impairment. Despite, vascular diseases becoming so common, there is a general agreement that vascular disease is preventable (Haanan and Wallance 2004). Better prevention of vascular dementia requires that all the risks factors contributing to the diseases are identified, and ranked so that that a more focused approaches is used to the diseases in older people. Unfortunately, previous studies have only identified risks factors vascular diseases but have never ranked them to know which risks factors is common and more likely to cause the diseases among the UK older population. What we have in term of literature is so generalized information that does not provide clear guide for prevention of vascular dementia. This study wants to fill these knowledge gaps for better prevention of the diseases.
Aims of the study
This study aims to explore the various risks factor for vascular dementia and ranks them according to their popularity in UK citizen for better prevention of the diseases.

Objectives of the study
To determine the various risks factors for vascular dementia
To determine the lifestyles choice that act as risk factor for vascular dementia
To determine Health problems that act as risk factors for vascular dementia
To ranks risks factors for vascular dementia based on how common they are in UK population
To provide a better framework for preventing vascular
Research question
What are the lifestyles and health related risks factors of vascular dementia?
Which are the most common lifestyle and health related risks factors for vascular dementia?

Chapter two; Literature Review
Introduction
This section highlights the summary of the available literature review on identification and ranking of risks factor for vascular dementia.
Risk factors for vascular dementia
According to the available literature, vascular dementia has so many diverse risks factors. these risks can be classified as modifiable and un-modifiable factors (Alzheimer Scotland 2011) Modifiable risks are those that can be controlled and modified and include smoking, hypertension, etc while un-modifiable factors include those that beyond the control of human being. Some of the un-modifiable risks factors for vascular dementia are Age, gender, family history and genetic. The condition is said to affects those over 65 years of age. Men are also more likely to be affected by the diseases than women. This study is interested in the modifiable factors as they present an opportunity to prevent vascular dementia.
Modifiable risks factors for vascular studies.
The available literature suggests that there are numerous risks factors for vascular dementia that can be modified and controlled. According to Alzheimer Scotland (2011), some of the modifiable risks factor for dementia includes smoking, alcohol consumption, hypertension, diabetes, and vascular diseases.
Research has shown that smoking is a risks factor for vascular diseases. Splaine and Berg (2007) argues that smoking causes damages to the blood vessels that supply the brains with blood increasing the changes for Vascular dementia . According to Alzheimer society (2015), people smoker are at 45% likely to be acquire vascular dementia as compared to non- smokers.
According to Alzheimer society (2015), too much consumption of alcohol increases individuals’ risks for vascular dementia. Over consumption of alcohol can cause brain damage and short-term memory loss.
Hypertension is also linked to vascular diseases. As argued by Yaffe (2014), hypertension exerts more forces on blood vessel due to high blood pressure which damages the vessel that supply the brain with blood. For the brains to function they must be supplied with enough oxygenated blood. Insufficient Blood supply to the brain cause cognitive impairment (Woodward et al 2007).
Vascular diseases and other cardiac diseases also work to damage blood vessels which lead to insufficient blood supply into the blood (Yaffe 2014, Alzheimer Scotland 2011).
There are enough evidences to shows that social activity and interaction has influences on vascular disease. According to as argument made by Pillai and Venghes (2011), People who with limited social interaction are more likely to acquire vascular dementia as compared to those that are socially active. They however fail to give substantial scientific evidences to support his argument.
Which among the risk factor are more common in UK?
The identification of the above risks factors was based on diverse and wide population that include those outside UK. We have therefore been made to believe that this risks factor also affects UK populations. There is no available data that shows the most common risks factors in UK. This study acknowledge that risks factor may varies with population due to differences in factors such as environment, social economic factor, culture and many others and it is therefore wrong for vascular dementia to continue be based on generalized information. More specific information that identifies risks factors in UK population and ranks them according to their commonness for the purpose of developing more effective prevention strategies is thus required.

Chapter three; research methodology
Introduction
In this chapter, the underlying methodology used in the research will be discussed. The chapter is organization into 9 sections that include research perspective, research method, sample and sampling techniques, data collection instrument and procedure, data analysis, ethical issues, study limitation.
Research perspective
Research perspective is a term used to describe the underlying assumption made by and guide the researcher in their work (Kothari 2004). While there are many research perspectives, this section will only discussed the one that guided this study.
Positivist research perspective was held for the study. According to definition give by Gray (2009), Positivist theoretical perspective has three underlying principle. 1) Reality consist of what we can see, hear, smelt or touch, (2) investigation of reality should be based on scientific method and, (3) research methodology should deal with facts and not values.
Sample size
Sample is referred to a group that represent the entire population (Kothari 2004).To achieve the objectives of this study, purpose sampling techniques was used. This technique involves the judgement of the researchers as to whom the participants of the study will be (Kothari 2004). To be including in this study, individuals needed to meet one requirement. They should have or had one of their families member diagnosed with vascular dementia. The reason for the above requirement was to allow gathering of relevant and more focused data that would help achieve the objectives the study. In total, 25 participants were successfully recruited to participate in the study.
Research methods
This research used quantitative methods. According to Labaree (2013), quantitative method accentuates on the objective measurement and statistical/numerical analysis of data collect through survey or questionnaire. Quantitative approach is appropriate when the researchers want to test hypothesis or when looking for breadth in understanding (Tashakkori and Teddlie 2000). The method was therefore chosen for the current study since the aims to the research was to look for breadth of information that would help develop effective strategies for preventing vascular dementia
Data reliability and validity
To ensure the data gathered help achieve the objective of this study, A pilot test was conducted. In this pilot test four participants were involved. Data was collected from them using the questionnaire with the aims of testing it reliability and validity. Therefore, two test namely reliability test and validity test was done. The reliability test assessed whether the questionnaire was able to gather consistent data from different participant. The validity test was used to assess whether the questionnaire was in position to gather appropriate data that would help achieve the objective of the research. The results from these two tests were satisfactory and such the questionnaire was adopted.
Data collection
In every research data, can be gathered using various tools and methods including interview, focus group interview among others. However, to better achieve the objectives of this study questionnaire was used as the only data collection tool.
Data analysis
The methodology adopted in this study aims to bring about objective measurement through statistic analysis and as such data gathered was statistically analysed using a Microsoft excel 2007 software. The finding of the analysis are presented later in this report using tables
Ethical consideration
The researcher acknowledges and was committed to adhere to the ethical requirement. First, the consent of participant sought. This was done giving the consent letter which provided details about the research. This was done to ensure participation in the study was on willingness basis only. Secondly, the questionnaire used to gather data was carefully drafted to ensure no personal identification information that may put participants’ privacy and confidentiality in jeopardy was collected. In that ways, the researcher was able to protect confidentiality of participants as required by research ethics.
Limitation of the study
This study is limited by the facts that the sample sizes is small to represent over 150, 000 patients with vascular diseases in UK. However, due to financial and time constraint the small sample was appropriate for the study
Overcoming the limitation
To overcome the above mentioned limitation, two strategies were used. First, the samples selected even though small, was carefully selected to ensure it was statistically significant.
Secondly, the finding of the research is presented with some caution. They are not generalized. They are actually presented to represent the situation in England and as such cannot be taken as representation of facts in other parts of the world.
Research specification
Task Duration ( year 2015) Time
Research proposal approval 15 may-30 may 2 weeks
Identifying participants 30 may- 14 June 2 weeks
Gathering data 15 June-30 July 6 weeks
Data entry 30 July-30 August 4 weeks
Analysing the data 30 August -15 Sept 2 weeks
Drafting first report 15Sept- 30 Sept 2 weeks
Proofreading and Preparing final draft 1 Oct- 30 Oct 4 weeks
Submitting final report November

Chapter four finding
4.1 Introduction
This chapter present the finding of the table which will be mainly done through tables and graphs.
4.2 Response rate
At the initial stage of the research, a sample size of 30 participants were targeted and identified. Unfortunately, only 25 participants were accessible during data gathering period. This number was assessed and approved as statistically significant. This was an 83 percent response rate which was satisfactory for the progression of the study to then next stage of data collection.
Response rate; table 1.1
Targeted sample Actual sample used Target sample missed in the study
Number of participants 30 25 5
percentage 100 83 17

Figure 1.1; response rate in percentage

4.3 Demographic characteristic of participants
All of the participants engaged in this study were above 65 years. 12 of them were between 65-70 years, 10 of them were between 71-75 years old while three of them were above 76 year old.
17 of the participants were male while only 8 participants were female.
Table 1.2; Demographic characteristic of participants
Characteristic Number of participants Percentage
Age
65-70 years old 12 48
71-75 10 40
Above 76 3 12

Gender
Male 17 68
Female 8 32

4.4 Risk factors for vascular dementia and their ranking
The research aims to identify and ranks the lifestyle and health risks factor for vascular diseases. Based on the survey data, the summary of the results are as follows.
Identified risks factors Number of participants Percentage Ranking
Smoking 20 80 1
Physical inactivity 16 64 2
Hypertension 13 52 3
Vascular diseases 13 52 3
Diets 10 40 4
Diabetes 9 36 5
Alcoholism 8 32 6
Stroke 7 28 7
obesity 7 28 7
Cardiac disease 6 24 8
Social interaction 4 16 9

Chapter five: Discussion
Vascular dementia has become so common that it now affect almost equal number of people to Alzheimer diseases. Previous studies have made it clears that Vascular dementia can be prevented (Haanan and Wallace 2004). Although, there has been awareness of the risks factors of dementia, such knowledge is has been generalized missing the opportunity for better prevention of the diseases. The current study makes a major contribution by providing more specific information that shows the ranking of risk factors among UK population. The study was conducted to reaffirm that indeed the said risks factor indeed are true and if so, to ranks them according to their commonness.
In identifying the Risks factors for vascular dementia, the current study reaffirms the Finding of most of the available literature. The risks factors identified in the current study are Hypertension, smoking, alcoholism, diabetes and obesity, cardiac diseases, vascular diseases, physical inactivity, stroke and diet. These finding reaffirm most of the literature available. For instance, mayo clinic staffs (2015) Highlight risks factor for vascular dementia as Blood pressure, High cholesterol, diabetes, Obesity and smoking. Similar risks factor are also highlighted by Alzheimer Scotland (2011), Woodward et al (2007), Splaine and Berg (2012), and Yaffe (2014).
The current research is the first of its kind to ever Rank risks factor for vascular dementia In UK. The ranking made on the research was based on commonness of the risk factors among vascular dementia patients that were apparent before diagnosis of the diseases. Smoking was ranked as the number one. 80 percent of the participants were active smoker even before they were diagnosis with the vascular dementia. Physical inactivity was ranked as number two among all the vascular dementia risk factors. 64 percent of the participants expressed to have been physically inactive. Third on the ranking is hypertension and vascular diseases. 52 % of the participants have been diagnosed with hypertension and vascular diseases before being diagnosed with vascular dementia. Fourth on the ranks is Diets. 40 % of the participants did not mind about consumption of balanced diets before being diagnosed with vascular dementia. Fifth on the ranks is diabetes. 36 percent of the participants had been diagnosed with diabetes before being diagnosed with vascular dementia. Sixth on the ranking is stroke and obesity. 28 % of participants were either obese or had been diagnosed with obesity, before they were diagnosed with Vascular dementia. Seventh on the ranks are cardiac diseases. 24 % of participants were diagnosed with a disease in the cardiac family before being diagnosed with vascular dementia. And the last in the ranking is social interaction. 16 percent of participant had lack proper social supports from their social interaction way before being diagnosed with vascular dementia.

Chapter six; Conclusion
Based on the finding of this research, it is very true that, vascular diseases are caused by wide ranges of lifestyles and health related factors. This finding just reaffirms the available evidences and literatures including those provided by Alzheimer Scotland (2011), Splaine and Berg (2012), among others.
Based on the commonness of the risk factors, the current study went a step further to ranks the risks factors. Smoking, physical inactivity was the first three most common risks factors for vascular diseases. The other risks factors were ranked as vascular diseases, Diet, diabetes, alcoholism, stroke obesity, cardiac diseases and social interaction in that order.
An observation can be made that the first two risks factor in the ranking are lifestyles choices, it can also be noted that most of the health condition identified in this study are high risks factors for vascular dementia are lifestyles related condition e.g. hypertension, diabetes, Vascular diseases and stroke are all linked to lifestyle choices such as smoking ,alcohol consumption, poor diet and physical inactivity. It can therefore be said that almost all if not all of the modifiable risks factors for vascular dementia are lifestyle related.
Recommendation
Since almost all modifiable risks factors for vascular disease are lifestyles related, proper strategies to prevent the condition in older population should be focus on encouraging behaviour change in all generation. People need to be encouraged to desist from smoking, alcohol consumption and consumption of fast food. They should also be encouraged to be physically active in their life. Lifestyle behaviour changes would not only help prevent lifestyle risk factor for vascular diseases, but would also help prevent other health conditions such as diabetes, hypertension, stroke, vascular disease which have negative impacts on individuals’ health and also act as risks factor for Vascular dementia leading to further deterioration of health and death.
Early identification and intervention for the various lifestyles related diseases can also help prevent vascular diseases. As evidences has shown, earlier identification and intervention of diseases such as hypertension, diabetes, vascular diseases among other lead to better management of the condition which help to prevent severe impacts on the healthy including causing other health related condition. It would therefore be essential that, the diseases screening and monitoring in older people older people be heightened to ensure possible health condition leading to vascular dementia are identified as earlier as possible and proper management of these condition put in place.

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