Alzheimer’s and other types of dementia - few things scare us more than the possibility of what might happen when our brain stops functioning
Dementia is a broad term used to describe a severe loss of memory and other cognitive abilities, which can have a negative impact on one’s daily life and independence. This collection of conditions originates in changes in the brain that damage nerve cells. Different regions of the brain are responsible for different functions, and when a region is damaged it cannot fulfill its function. Many types of dementia begin with mild symptoms and gradually worsen over time. As the disease progresses, more and more brain cells die and the network of connections between them becomes impaired. The nature of the disease depends on the location of the damage and how it affects the patient’s behavior, communication, thinking and emotions.
Dementia can present with a wide range of symptoms, but in order for us to suspect its presence, at least two of the following functions must be impaired: memory, communication and language, concentration, judgment and decision-making, or visual perception. In advanced stages, patients may experience changes in behavior and personality, such as irritability, stress and depression. Subsequently, as the disease progresses, symptoms may also include aggression, anger, anxiety, emotional stress, physical and verbal outbursts, restlessness, delusions and sleep disturbances.
Types of Dementia
Many conditions fall under the “dementia” umbrella term. In many cases it can be difficult to distinguish between them due to the similarity of their symptoms. While dementia usually appears in old age, there are also genetic factors that may trigger degenerative brain diseases at a younger age.
The most well-known and common type of dementia is Alzheimer’s disease, which affects 60–80% of dementia patients. The disease is characterized by a gradual loss of memory, thinking, and judgment. Typically, the first region of the brain to be affected is the hippocampus, responsible for learning and memory. Therefore, memory loss is usually one of the first symptoms of Alzheimer’s disease. The changes in the brain leading to Alzheimer’s disease begin years before the initial symptoms appear.
The progression of the disease varies from person to person and it’s usually divided into three levels of severity. On average, patients live for four to eight years after diagnosis, but some survive for up to twenty years. Individuals with Down syndrome have a higher risk of developing a type of dementia that resembles Alzheimer’s disease.
The second most common type of dementia is vascular dementia, which often appears following stroke. It occurs when a full or partial blockage of blood flow to the brain starves the nerve cells of oxygen, leading to their death.
Parkinson’s disease is another well-known type of dementia, which is manifested among other things, in impaired thinking and judgment. The brain damage begins in the regions responsible for movement and is manifested by involuntary tremors and other symptoms, but as it progresses it may also affect mental abilities such as memory and attention.
Another type of dementia is seen in prion diseases, such as Creutzfeldt-Jakob disease, also known as “mad cow disease”. This name originates from the analogous disease in cattle, bovine spongiform encephalopathy, which affects cattle behavior. The disease is caused by a misfolded form of a protein known as prion, which accumulates in the brain, impacting the functioning of other prions and killing nerve cells. The disease is rare and leads to a deterioration in thinking, involuntary movements, confusion, walking difficulties and mood swings.
A similar type of brain degeneration is caused by Lewy bodies, which lead to a decline in thinking, judgment, and independent functioning. Lewy bodies are microscopic protein accumulations that affect the brain over time in 10–25% of dementia patients. These same bodies are also often present in the brains of people suffering from other types of dementia, such as Alzheimer’s disease and Parkinson’s disease.
Some conditions have clear hereditary or environmental causes. For example, Huntington’s disease is a genetic condition that causes changes in the brain region responsible for movement, mood, and cognitive abilities. Korsakoff syndrome, on the other hand, impairs memory and is caused by a severe deficiency of vitamin B12, which is essential for energy production by nerve cells. This syndrome is observed primarily in individuals who struggle with alcohol addiction, but it may also be caused by conditions such as AIDS, malnutrition, chronic infections and more. Patients with Korsakoff syndrome have difficulties learning new information and remembering recent events.They can hold a conversation with another person, only to forget about it moments later.
Hydrocephalus is another rare syndrome that occurs when cerebrospinal fluid accumulates in the ventricular system of the brain (the system of brain cavities), exerting pressure on the tissues inside. This can lead to difficulties with cognition and judgment, walking, and bladder control.
There are, of course, many other types of dementia, such as frontotemporal dementia, which involves degeneration of the frontal part of the brain, posterior cortical atrophy, which affects the posterior region of the brain, and mixed dementia that combines several types of dementia. Dementia symptoms may also be present in individuals who suffer from depression and consume medication or alcohol. Thyroid issues and vitamin deficiencies can also impair thinking and memory.
Comprehensive testing is necessary to diagnose Alzheimer’s disease and other types of dementia. This typically involves personality tests, mental function tests, examination of family health history, physical tests, neurological tests and imaging of the brain to evaluate its function. The diagnosis also includes blood and urines tests to rule out other conditions that can cause confusion, such as diabetes, anemia and malnutrition.
Brain imaging by MRI or CT is performed to rule out other conditions that require different treatment, such as tumors, stroke, accumulation of fluid or other brain damage. Researchers have found that the brains of Alzheimer’s patients shrink as the disease progresses, but standardized values for diagnosis that would be based on brain size have yet to be determined.
While these tests can identify whether a person is suffering from dementia, they may not be able to determine the underlying cause for it or to diagnose the specific type of dementia. Currently there is no one single definitive sign that can unequivocally diagnose whether an individual is truly suffering from Alzheimer’s disease.
Unlike damaged or scratched skin, nerve cells in the brain usually cannot regenerate. Therefore, when a nerve cell is damaged and dies, no new cell can grow and take its place. Thus, the existing damage is permanent, and we can only try to prevent further deterioration.
Early diagnosis and supportive treatment can help maintain a patient’s quality of life. The earlier the disease is detected, the better the chances of minimizing symptoms and maintaining an independent lifestyle for a longer period of time. Treatment is determined according to the type and cause of the dementia. In cases of metabolic deficiency or other reversible characteristics, it may be possible to treat the underlying cause of the problem. However, most cases of dementia cannot be cured.
Currently, there is no cure for Alzheimer’s disease, or even a way to slow its progression, but treatments are available to relieve or stabilize the symptoms. Medications, for example, can treat changes in sleep patterns, improve memory, and so on. On average, they can delay the deterioration of symptoms for six months to one year for half of the patients who take them. In addition, there are behavioral and alternative treatments that can provide mental and physical relief for patients without the use of medication.
A Few Numbers on Alzheimer's Disease and Dementia
According to estimates from the Alzheimer’s Association, approximately 5.7 million people in the US alone suffer from Alzheimer’s disease, and their number is projected to rise to 14 million by 2050. Additionally, there are millions more patients with other forms of dementia. One in three adults will ultimately die from some form of dementia, which is more than the combined number of deaths from breast cancer and prostate cancer. Alzheimer’s disease is currently the sixth leading cause of death for individuals over the age of 65, and is also the only one with no prevention plan or cure. According to the World Health Organization, there were 50 million dementia patients globally in 2015, and their number is expected to triple by 2050.
Despite these discouraging numbers, research shows that brain health in the general population improved from 2000 to 2012. While the exact social, behavioral and health factors contributing to this improvement are not yet fully understood, it is believed that it may be related to an increase in IQ and better control of risk factors for cardiovascular disease.
Dementia also exacts a heavy economic toll. Patients are forced to give up their incomes, driving licenses, and their independence, while their family members are often left to provide both mental and financial support. In advanced stages, patients require nursing support and extensive care.
At the micro level the economic price is also expected to worsen. Treating a patient at an intermediate or extreme level of severity is estimated to cost 1.4 or 2 times greater, respectively, than treating a patient at a low level of severity. Since the cost of treating a patient with dementia increases with disease progression, early intervention and disease management that can delay progression and maintain the patient’s functioning, is crucial for reducing the economic burden. It’s estimated that early and accurate diagnosis of dementia can save up to 7.9 trillion US Dollars in treatment costs in the United States alone. According to the World Health Organization, the current cost of treating dementia patients is 800 billion US Dollars per year, and this amount is projected to increase 2.5-fold by the end of the next decade.
How Can We Reduce the Risk of Dementia?
Many factors are known to increase the risk of developing Alzheimer’s disease. Some of these factors are beyond our control, such as age, family history and heredity. Nevertheless, there are some factors that we can control.
As a general guideline, adopting and maintaining a healthy lifestyle as we age can help maintain a healthy brain and may lower the risk of developing Alzheimer’s disease. The rule is that what’s good for the heart is good for the mind, and it’s never too late or too early to begin taking care of them. High cholesterol, high blood pressure, diabetes and obesity increase the risk of developing heart attack, stroke, and dementia later in life. Thus, it is recommended to maintain a healthy, balanced diet.
And one more valuable tip to keep in mind is that challenging your brain with new stimuli can strengthen the connections between nerve cells and potentially delay the decline in cognitive capabilities. Research suggests that knowledge of an additional language can even delay the onset of dementia by up to five years. Engaging in activities that require problem-solving, such as solving sudoku puzzles and cryptic crosswords, can also train the working memory and delay its deterioration. So, get together with family and friends and join us in solving our Brainwash scientific trivia puzzles. It can only do you good.