Alzheimer’s disease: 6 myths about dementia and memory loss 

By | June 6, 2021

NOW THE WORLD OVER FIFTY MILLION PEOPLE WITH DEMENTIA, and the risk increases as the increase in life expectancy: 65 years after it doubles every five years. A diagnosis of dementia means a dysfunction of the brain with a gradual loss of knowledge and skills – and one in six people over 80 years old , in every third person over 85, in every second after 90 years old. It is estimated that in ten years there will be more than 80 million people with dementia, and in another thirty – 152 million. In the United States, this disease claims more lives each year than breast and prostate cancer combined. At the same time, behind the diagnosis itself, there is a train of conjectures and myths – we understand the most common ones.

Dementia and Alzheimer’s disease – one and the same

In reality, dementia is a syndrome (that is, a combination of symptoms) that can have many causes, one of which is Alzheimer’s. It is this disease that accounts for up to 70% of all cases of dementia . Less commonly, impaired cognitive function can be caused by cerebrovascular accidents, Parkinson’s disease, decreased thyroid function, chronic brain infections, and even the use of certain medications. That’s not all: sometimes dementia masquerades as deep depression, and in other cases, depression is one of the symptoms of dementia. This confusion, of course, makes diagnosis difficult.

Alzheimer’s disease is now known to arise from the abnormal accumulation of certain proteins in the brain cells and intercellular space. One of these proteins is amyloid, which is deposited as plaque around nerve cells. The second is the so-called abnormal tau protein structure, or tau protein, which is visible as tangles in the nerve cells themselves. In normal tau protein should stabilize microtubules (framework components supported whole cells), but when the disease this protein Alzheimer’s changes its structure. It is not yet known why this happens – but scientists already know that these changes begin many years before the first symptoms appear. This accumulation of proteins in and around the brain cells changes the biochemical properties of these cells and prevents them from working normally – signal transmission between them is disrupted. The areas of the brain responsible for memory are usually affected first.

Dementia and Alzheimer’s Disease Only Occur in the Elderly

Although age is indeed a significant risk factor, dementia occurs in young people as well. At the same time, a person gradually loses the skills accumulated over life, the speed of thinking, ingenuity, speech, the ability to control mood and body – and the reasons can be alcohol abuse, addiction to drugs, brain tumors, head injuries or infections. The formation of amyloid plaques is also characteristic of Down syndrome, which means that people with it are more likely to have dementia. In Alzheimer’s disease also have the earliest forms, when the diagnosis is made at around the age of forty years. One in twentieth patients with Alzheimer’s disease has not yet crossed the sixty-five years.

Alzheimer’s is only caused by a genetic malfunction

A gene for an increased susceptibility to disease has indeed been discovered , it is called APOE epsilon 4 – but even among people with this gene, only half develop dementia by the age of ninety. Genetic counseling can be useful for those who have had dementia in several generations of the family – there are, for example, familial forms of Alzheimer’s disease, but they are quite rare. And although the exact causes of dementia and Alzheimer’s have not been established, it is already clear that genes are not the main thing. In particular, the actual increase in risk due to genetic damage is much lower than due to a sedentary lifestyle.

The identified risk factors are age over 65, traumatic brain injury and diseases of the cardiovascular system. Doctors methodically urge to fight smoking, obesity, arterial hypertension and high cholesterol levels – these are factors that contribute not only to myocardial infarctions, strokes, some malignant tumors, but also the development of Alzheimer’s disease. In addition, recent studies show the importance of other factors indirectly responsible for the development of the disease. These include hearing loss, untreated depression, social isolation, and a sedentary lifestyle.

Diagnosis is made only on the basis of memory impairment

If you regularly try to remember whether the iron is turned off and whether the door is locked, do not panic. Mild memory impairment can be associated with age-related changes, stress at work, or lack of sleep. Although impaired short-term memory may indeed be the earliest manifestation of impending Alzheimer’s, it is usually at least more severe than would be expected for the patient’s age. Other signs typical of the early stages of dementia are difficulty keeping track of time, disorientation in one’s own apartment, problems with speech and problems with tasks such as paying bills.

To diagnose and determine the type of dementia , the doctor needs to talk to the patient and family members – including actually doing tests that help assess memory, thinking, and level of impairment. But the cause of dementia can be, for example, an infection, swelling, injury, or disease of the thyroid gland. Therefore, the examination should include blood tests, detailed questioning, and possibly an MRI of the brain. There are strict diagnostic criteria for dementia and Alzheimer’s disease, as described in physician guidelines.

Alzheimer’s disease cannot be slowed down

Immunotherapy – the use of drugs that help activate the body’s own immune system against harmful cells or substances – produced a revolution in several areas of oncology (eg, in some patients, it is allowed to eliminate all manifestations of melanoma, previously fatal in 100% of cases). It is believed that immunotherapeutic agents can reverse the treatment of dementia – and several such drugs are currently in development. Research has been taking many years, and some potential drugs have gone out of the way. Yet at least three immunotherapeutic antibodies ( gantenerumab , crenesumab, and BAN2401) are or are about to be studied in phase 3 trials, including in people with early disease.

The results of the phase 2 study BAN2401 were presented in July 2018: patients with early-stage Alzheimer’s who received the drug performed significantly better on the cognitive test than those who received a placebo. A decrease in the amount of amyloid in the brain has also been reported. The results persisted after six and twelve months and were found to be encouraging. Perhaps, in the coming years, the next phase of research will begin, BAN2401 will acquire its full name and, if everything goes well, it will be registered.

There are already medications that can control certain manifestations of Alzheimer’s disease. For memory impairments, cholinesterase inhibitors (donepezil, rivastigmine, galantamine) are used – by suppressing the enzyme cholinesterase, they increase the level of acetylcholine, a substance that helps neurons interact with each other. Previously, these drugs were prescribed only in the early stages, but they have recently been confirmed to be effective in severe dementia. Another drug (memantine) is somewhat different in its mechanism of action and can be prescribed in combination with them. Antidepressants, anti-anxiety, sleeping pills are used depending on the problems associated with dementia.

Individual symptoms of the disease respond to non-pharmacological behavioral therapy. This can be cognitive stimulation therapy, which involves group exercises to improve memory and problem-solving skills. Your doctor may advise you to encourage physical activity, eliminate triggers of bad mood (for example, remove a certain photo from a prominent place), communicate with pleasant people. Another method of treatment is the use of the phenomenon of reminiscence in a digital or real version. It is based on talking about objects or events from the past. This is a discussion of photographs, memorabilia, or music to help improve your mood and well-being.

If you are destined to get sick,
then so be it

By Unfortunately, there is no guarantee that the brain exercise and lifestyle changes to prevent all types of dementia – but that’s no reason not to try. There are ways to reduce the risk of illness or delay its onset – they can be boring, trivial and time consuming, but they work . The bottom line is not to let the brain go idle: you need to train short-term memory, attention, speech, logic, reaction time, hand- eye coordination .

New impressions contribute to brain function – so it is worth learning to at least stir sugar in coffee with your left hand (or right if you are left-handed). Learning new languages, memorizing poetry, memorizing a to-do list for the day, new music, drawing, lectures at the nearest institute or online courses, volunteering – all this enriches us with new experiences, which means it trains the brain. In addition, it is worth maintaining weight within the medical range, eating a varied diet, getting enough sleep, getting more exercise, and quitting smoking.

Category: Uncategorized

Leave a Reply

Your email address will not be published. Required fields are marked *