Does Surgery Cause Or Worsen Dementia
Question: My father needs surgery. Will this worsen his dementia?
Answer: This is one of the more common questions I get asked as a dementia specialist. Similarly, there are numerous families that come to me on the first visit, convinced that their relatives dementia started immediately after some type of surgery. So, does surgery cause or worsen dementia?
There have been numerous studies over the years that have attempted to answer this question. Unfortunately, the results are often conflicting, with some studies showing an increased risk of dementia and/or cognitive impairment following surgery, and others suggesting no increase risk. As you might imagine, the reasons for these discrepancies are that the results likely depend on a multitude of factors including the characteristics of the patients , the type of condition requiring surgery , the type of surgery, the anaesthetic and the operative complications .
The story of surgery and dementia is not all negative. In a future blog, I will highlight some surgical procedures that might actually improve cognition and examine new ways that might specifically help protect the brain during operations.
Who Can Diagnose Dementia
Visiting a primary care doctor is often the first step for people who are experiencing changes in thinking, movement, or behavior. However, neurologists doctors who specialize in disorders of the brain and nervous system are often consulted to diagnose dementia. Geriatric psychiatrists, neuropsychologists, and geriatricians may also be able to diagnose dementia. Your doctor can help you find a specialist.
If a specialist cannot be found in your community, contact the nearest medical school neurology department for a referral. A medical school hospital also may have a dementia clinic that provides expert evaluation. You can also visit the Alzheimers Disease Research Centers directory to see if there is an NIA-funded center near you. These centers can help with obtaining a diagnosis and medical management of conditions.
Does Dementia Impact The Brains Emotional Center
People living with dementia are experiencing deterioration of brain functions. How does dementia impact the brains emotional center?
The COVID-19 pandemic has caused mass hysteria that has touched all parts of the globe. For some, fear of not knowing when or if society will return to normal is debilitating. Others are amped up about restrictions on personal freedoms and commerce. Even the most cool-headed of us is experiencing uncertainty on some level. Whichever concerns we carry, we are all processing these circumstances the same way: via the brains amygdala region, the emotional center.
Now, if the average adult is experiencing fear, anger, or other negative emotions in response to the way life has changed during this health crisis, imagine what a person living with dementia may be experiencing.
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What Can I Do To Keep My Brain Healthy
What makes up our risk of developing dementia is a complex mix of factors such as age, genetics and lifestyle factors. While we cannot change our age or genetic makeup, we can make positive lifestyle changes that will help to reduce our overall risk of developing dementia, and that is worthwhile.
Steps to look after our heart health can help reduce our risk of dementia, especially vascular dementia and Alzheimers disease. This includes lifestyle approaches such as: stopping smoking, being physically active every day, eating a balanced diet, maintaining a healthy weight, drinking alcohol in line with government recommendations, and keeping mentally active.
If you are worried that you are experiencing any signs or symptoms of dementia, it is best to discuss these with your doctor.
If have any questions about dementia, or want to take part in research, you can contact the Dementia Research Infoline by phone on 0300 111 5 111 or by email at .
Watch Olives story to hear from someone living with vascular dementia:
What Is Dementia Symptoms Types And Diagnosis
Dementia is the loss of cognitive functioning thinking, remembering, and reasoning to such an extent that it interferes with a person’s daily life and activities. Some people with dementia cannot control their emotions, and their personalities may change. Dementia ranges in severity from the mildest stage, when it is just beginning to affect a person’s functioning, to the most severe stage, when the person must depend completely on others for basic activities of living.
Dementia is more common as people grow older but it is not a normal part of aging. Many people live into their 90s and beyond without any signs of dementia.
There are several different forms of dementia, including Alzheimers disease. A persons symptoms can vary depending on the type.
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Foods That Induce Memory Loss
Unfortunately, the foods that hamper memory are common staples in the American diet. White breads, pasta, processed meats and cheeses, all of these have been linked to Alzheimers disease. Some experts have even found that whole grain breads are as bad as white breads because they spike blood sugar, which causes inflammation.
Heres a list of foods linked to increased rates of Alzheimers disease:
- Processed cheeses, including American cheese, mozzarella sticks, Cheez Whiz and Laughing Cow. These foods build up proteins in the body that have been associated with Alzheimers.
- Processed meats, such as bacon, smoked turkey from the deli counter and ham. Smoked meats like these contain nitrosamines, which cause the liver to produce fats that are toxic to the brain.
- Beer. Most beers contain nitrites, which have been linked to Alzheimers.
- White foods, including pasta, cakes, white sugar, white rice and white bread. Consuming these causes a spike in insulin production and sends toxins to the brain.
- Microwave popcorn contains diacetyl, a chemical that may increase amyloid plaques in the brain. Research has linked a buildup of amyloid plaques to Alzheimers disease.
How Does Alzheimers Disease Affect The Brain
The brain typically shrinks to some degree in healthy aging but, surprisingly, does not lose neurons in large numbers. In Alzheimers disease, however, damage is widespread, as many neurons stop functioning, lose connections with other neurons, and die. Alzheimers disrupts processes vital to neurons and their networks, including communication, metabolism, and repair.
At first, Alzheimers disease typically destroys neurons and their connections in parts of the brain involved in memory, including the entorhinal cortex and hippocampus. It later affects areas in the cerebral cortex responsible for language, reasoning, and social behavior. Eventually, many other areas of the brain are damaged. Over time, a person with Alzheimers gradually loses his or her ability to live and function independently. Ultimately, the disease is fatal.
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Risk Factors For Dementia
Researchers have identified several risk factors that affect the likelihood of developing one or more kinds of dementia. Some of these factors are modifiable, while others are not.
Age. The risk of Alzheimer’s disease, vascular dementia, and several other dementias goes up significantly with advancing age.
Genetics/family history. Researchers have discovered a number of genes that increase the risk of developing Alzheimer’s disease. Although people with a family history of Alzheimer’s disease are generally considered to be at a heightened risk of developing the disease themselves, many people who have relatives with Alzheimer’s disease never develop the disease, and many without a family history of the disease do get it.
In most cases, it is impossible to predict a specific person’s risk of the disorder based on family history alone. Some families with Creutzfeldt-Jakob disease, Gerstmann-Sträussler-Scheinker syndrome, or fatal familial insomnia have mutations in the prion protein gene, although these disorders can also occur in people without the gene mutation. Individuals with these mutations are at significantly higher risk of developing these forms of dementia.
Abnormal genes are also clearly implicated as risk factors in Huntington’s disease, FTDP-17, and several other kinds of dementia.
Many people with Down’s syndrome show neurological and behavioral signs of Alzheimer’s disease by the time they reach middle age.
Rarer Causes Of Dementia
There are many rarer diseases and conditions that can lead to dementia, or dementia-like symptoms.
These conditions account for only 5% of dementia cases in the UK.
- problems with planning and reasoning
These symptoms are not severe enough to cause problems in everyday life.
If the underlying illness is treated or managed, symptoms of MCI often disappear and cause no further problems.
But in some cases, people with MCI are at increased risk of going on to develop dementia, which is usually caused by Alzheimer’s disease.
Read more about how to prevent dementia.
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The Link To Parkinsons Disease
Most people with Parkinsons disease have Lewy bodies in their brains. Its these clusters that cause some or all of the motor symptoms of Parkinsons disease, as well as memory or cognitive problems, visual hallucinations, and problems with alertness.
We rarely know if a living patient has Lewy bodies with certainty, however. Its not until an autopsy that they can be seen, says Liana Rosenthal, M.D., assistant professor of neurology at the Johns Hopkins University School of Medicine. If we see Lewy bodies in someones brain during an autopsy, thats considered a pathologic certainty of Parkinsons disease, she says.
As with Parkinsons, Lewy body dementia is associated with a depletion of certain neurotransmitters in the brain. These are:
- Dopamine: This neurotransmitter helps transmit signals that control muscle movement. When the accumulation of Lewy bodies blocks dopamines production and transmission, the result is the hallmark movement issues of Parkinsons disease.
- Acetylcholine: This neurotransmitter does its work in the parts of the brain responsible for memory, thinking and processing. When Lewy bodies build up in these areas, they interfere with acetylcholine, causing symptoms of dementia.
Causes Of Frontotemporal Dementia
This is an important cause of dementia in younger people. It’s most often diagnosed between the ages of 45 and 65.
It’s caused by an abnormal clumping of proteins, including tau, in the frontal and temporal lobes at the front and sides of the brain.
The clumping of these proteins damages nerve cells in the frontal and temporal lobes, causing brain cells to die. This leads to shrinking of these areas of the brain.
Frontotemporal dementia is more likely to run in families than other, more common causes of dementia.
Read more about frontotemporal dementia.
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Damage To Brain Tissue
Another major cause of vascular dementia occurs when the damaged cells are found in an area of the brain called white matter this is sometimes referred to as subcortical vascular dementia.
The brain is made up of white and grey matter, relating to the colour of your brains tissue. Grey matter is found around the outer edge of the brain and contains the parts of brain cells that communicate with each other, the synapses. The white matter is deeper inside the brain and contains the parts of brain cells that carry messages from one area of the brain to another, allowing us to do everything we usually do like eat, move and talk.
If the white matter does not receive blood supply, these cells die and so the connections across the brain become lost, causing the typical symptoms of dementia.
In dementia the damage to cells in the white matter is often related to small vessel disease, where the small blood vessels become narrow and blood cannot flow through. ;This happens naturally as we age, but conditions like high blood pressure or behaviours like smoking can make this worse.
There are also a number of other diseases that can cause damage in the white matter, and therefore cause vascular dementia, for example:
- Lacunar lesions are a type of stroke that happen in the very small arteries deep within the white matter of the brain.
- Binswanger disease is characterised by the narrowing of arteries reducing blood flow and leading to cell death.
What Are The Different Types Of Dementia
Various disorders and factors contribute to the development of dementia. Neurodegenerative disorders result in a progressive and irreversible loss of neurons and brain functioning. Currently, there are no cures for these diseases.
The five most common forms of dementia are:
- Alzheimers disease, the most common dementia diagnosis among older adults. It is caused by changes in the brain, including abnormal buildups of proteins, known as amyloid plaques and tau tangles.
- Frontotemporal dementia, a rare form of dementia that tends to occur in people younger than 60. It is associated with abnormal amounts or forms of the proteins tau and TDP-43.
- Lewy body dementia, a form of dementia caused by abnormal deposits of the protein alpha-synuclein, called Lewy bodies.
- Vascular dementia, a form of dementia caused by conditions that damage blood vessels in the brain or interrupt the flow of blood and oxygen to the brain.
- Mixed dementia, a combination of two or more types of dementia.
Key Biological Processes In The Brain
Most neurons have three basic parts: a cell body, multiple dendrites, and an axon.
- The cell body contains the nucleus, which houses the genetic blueprint that directs and regulates the cells activities.
- Dendrites are branch-like structures that extend from the cell body and collect information from other neurons.
- The axon is a cable-like structure at the end of the cell body opposite the dendrites and transmits messages to other neurons.
The function and survival of neurons depend on several key biological processes:
Neurons are a major player in the central nervous system, but other cell types are also key to healthy brain function. In fact, glial cells are by far the most numerous cells in the brain, outnumbering neurons by about 10 to 1. These cells, which come in various formssuch as microglia, astrocytes, and oligodendrocytessurround and support the function and healthy of neurons. For example, microglia protect neurons from physical and chemical damage and are responsible for clearing foreign substances and cellular debris from the brain. To carry out these functions, glial cells often collaborate with blood vessels in the brain. Together, glial and blood vessel cells regulate the delicate balance within the brain to ensure that it functions at its best.
Are There Medicines To Treat Dementia
There is no cure for dementia yet, but there are medicines that can help treat some of the symptoms of dementia. There are medications that may improve memory for a period of time. There are also medications that are effective for treating mood disorders, such as anxiety and depression, which commonly occur in people with dementia. It is also important that your provider carefully evaluates any medicine someone with dementia is taking, because some medications may make memory symptoms worse.
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Caring For A Loved One With Dementia
It can be quite challenging to care for a loved one with dementia as the specific symptoms are often difficult to predict. You may notice significant changes from one day to another, with good days interspersed between the difficult ones. It is admirable to want to care for your loved one yourself, but as the disease progresses, your loved one may require professional care to ensure their safety and well-being.
Here at Lakeside Manor, we provide memory care and assisted living services for seniors. Our caregivers are highly trained in working with dementia patients and can give your loved one the care they need. We are always compassionate and caring with our residents and their families. We welcome you to schedule an appointment to visit our facility for a tour. Well be happy to answer all of your questions to help you decide if Lakeside Manor is right for your loved one with dementia. Call us today to book your tour.
A Problem Called Amyloid
The main component of the hallmark plaques seen as lesions in the brains of Alzheimers patients is formed by a peptide called amyloid-ß . Certain neurons, particularly in the cortex and hippocampus, create amyloid-ß. Its function is not well understood, but it has a role in neurogenesis , memory, and the normal operation of message transfer betwen neurons. When too much is made, or too little cleared, clumps of amyloid-ß build up around and between neurons. As these plaques grow in size, they envelop and destroy the dendrites of neurons, interfering with their ability to communicate.;
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Risk Factors And Prevention
Although age is the strongest known risk factor for dementia, it is not an inevitable consequence of ageing. Further, dementia does not exclusively affect older people young onset dementia accounts for up to 9% of cases. Studies show that people can reduce their risk of dementia by getting regular exercise, not smoking, avoiding harmful use of alcohol, controlling their weight, eating a healthy diet, and maintaining healthy blood pressure, cholesterol and blood sugar levels. Additional risk factors include depression, low educational attainment, social isolation, and cognitive inactivity.
Infections Of The Body
In addition to the infections of the brain, another class of infections must be considered when evaluating a new cognitive change. These other diseases, located outside the central nervous system, are often treatable and sometimes cause great harm before they are discovered. Urinary tract infections or infections of the lungs are very common in older people who show confusion and the rapid change in alertness, attention, memory, and orientation called delirium. Delirium is often reversible once the cause is identified and treated. Simple blood tests and cultures of urine, blood, or sputum are used when clinicians search for these infections and for the antibiotics that will cure them.
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