What Are The Treatments For Dementia
There is no cure for most types of dementia, including Alzheimer’s disease and Lewy body dementia. Treatments may help to maintain mental function longer, manage behavioral symptoms, and slow down the symptoms of disease. They may include:
- Medicines may temporarily improve memory and thinking or slow down their decline. They only work in some people. Other medicines can treat symptoms such as anxiety, depression, sleep problems, and muscle stiffness. Some of these medicines can cause strong side effects in people with dementia. It is important to talk to your health care provider about which medicines will be safe for you.
- Occupational therapy to help find ways to more easily do everyday activities
- Speech therapy to help with swallowing difficulties and trouble speaking loudly and clearly
- Mental health counseling to help people with dementia and their families learn how to manage difficult emotions and behaviors. It can also help them plan for the future.
- Music or art therapy to reduce anxiety and improve well-being
Dementia And The Brain
Knowing more about the brain and how it can change can help to understand the symptoms of dementia. It can help a person with dementia to live well, or to support a person with dementia to live well.
These pages explain which areas of the brain are responsible for certain skills and abilities, and how these are affected by dementia. We explain how changes to the brain relate to changes a person may notice as the condition progresses.
This information is helpful for anyone who wants to find out more about how the brain is affected by dementia.
What Typical Changes Occur In The Brain Of Alzheimers Patients
Autopsy studies reveal that several biochemical and cellular alterations take place in the brain of Alzheimers patients. The majority of these changes can only be visualized during microscopy performed after death and they include the following:
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What Happens To My Brain When I Have Alzheimer’s
02 February, 2017
Sad as it is to say, we are all used to hearing about different kinds of dementia, but we often do not receive clear explanations of what is happening to a brain suffering from it. For that reason, the goal of this article is to explain,in the simplest way possible, what is happening to a brain that has been diagnosed with Alzheimers disease.
Moreover, I will include one of the most recent and most hoped for advances in terms of treating . This advance, which was recently published by the journal Nature, is so important that its results may change the course of Alzheimers disease as we know it.
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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What Is Cognitive Reserve Could It Help Reduce The Risk Of Dementia
To help define cognitive reserve we will draw an analogy between car tires. Cognitive reserve is like having more tread on the car tires. Cheap tires are thinner and wear out faster and expensive tires that have more tread, last longer.
Some studiessuggest that lifetime exposures including educational and occupational attainment, and leisure activities in late life, can increase this reserve. So, cognitive reserve holds out the promise of interventions that could slow cognitive aging or reduce the risk of dementia.
Lets look at it this way: if my brain has more cognitive reserve I may be able to compensate for the ravages of Alzheimers disease for a longer period of time.
We have intuition that cognitive reserve is important but to actually study it in a fair way across large groups of people is very difficult. We would need a way to measure or score cognitive reserve and theres not a clear way to do that.
If the key to Alzheimers disease were how strong your legs are, we have a very easy way to measure how strong everybodys legs are. But such an approach is lacking for cognitive reserve. This makes the understanding of the importance of cognitive reserve difficult to fully assess. This is one of the reasons why the brain is so hard to study.
Keeping your brain active is good and may delay or slow down the symptoms of dementia.
What Are The Signs And Symptoms Of Dementia
Many people associate dementia with memory loss. This is because memory problems are often one of the early symptoms of a dementia disorder, but they are not the only one. The symptoms of dementia can vary, depending on the type of dementia and what areas of the brain are affected. Symptoms may include:
- Memory loss, poor judgment, and confusion
- Changes in the ability to speak, understand, and express thoughts and/or words and to write and read
- Wandering and getting lost in a familiar neighborhood
- Trouble handling money and paying bills
- Repeating questions
- Using unusual words to refer to familiar objects
- Taking longer to complete normal daily tasks
- Loss of interest in normal daily activities or events
- Hallucinations, delusions, and paranoia
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The Brain With Alzheimers Dementia
When someone is affected by Alzheimers disease, a serious degeneration of the brain takes place, particularly in the hippocampus, the entorhinal cortex, the neocortex , the basal nucleus, the locus coeruleus, and the raphe nuclei.
But what is all of this? These are different areas of the brain that, explained in the simplest way possible, are involved in the process of learning, memory, and emotional regulation. As you can see, all of these functions are strongly affected in patients with Alzheimers.
And how do these areas degenerate? Well, with the development of amyloid or starchy plaques and neurofibrillary tangles. However, before explaining what these plaques and tangles are, we have to know the parts of a neuron:
- Soma: this is the body of the neuron, where its nucleus is located and where the information that each neuron receives from others around it is stored.
- Axon: this is the largest projection that comes off of the soma and serves the purpose of sending information from one neuron to others.
- Dendrites: these are the small extensions that come off the body of the neuron and receive information from other neurons.
The amyloid plaques are deposits that are located outside of brain cells, made up of a nucleus whose protein is called amyloid-beta. These deposits are surrounded by axons and dendrites that are degenerating. This degeneration process is natural in every human brain it is not pathological.
Can Dementia Be Prevented
Although dementia cannot be prevented, living a health-focused life might influence risk factors for certain types of dementia. Keeping blood vessels clear of cholesterol buildup, maintaining normal blood pressure, controlling blood sugar, staying at a healthy weight basically, staying as healthy as one can can keep the brain fueled with the oxygen and nutrients it needs to function at its highest possible level. Specific healthful steps you can take include:
- Follow a Mediterranean diet, which is one filled with whole grains, vegetables, fruits, fish and shellfish, nuts, beans, olive oil and only limited amounts of red meats.
- Exercise. Get at least 30 minutes of exercise most days of the week.
- Keep your brain engaged. Solve puzzles, play word games, and try other mentally stimulating activities. These activities may delay the start of dementia.
- Stay socially active. Interact with people discuss current events keep your mind, heart, and soul engaged.
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Dementia With Lewy Bodies
What happens in the brain?
Tiny, spherical protein deposits develop inside nerve cells in the brain and interrupt the action of chemical messengers including acetylcholine and dopamine.
What are the symptoms?
- Problems with attention and alertness
- Spatial disorientation and problems with planning ahead
- Slowness, muscle stiffness, trembling
What Part Of The Brain Does Alzheimers Affect
Alzheimers disease is a progressive disorder that starts and develops gradually in older people. As it progresses, the brain undergoes several changes, affecting memory, language, and thinking skills.
Brain shrinkage to a certain extent is normal in healthy aging but, surprisingly, the neurons are not lost in substantial numbers. In Alzheimers, however, the brain shrinks significantly due to extensive damage and neuron loss. The neurons lose the connections between them, stop functioning, and die since the disease obstructs their critical processes, including communication, metabolism, and repair.
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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.
What Happens To The Brain With Alzheimers
During Alzheimers progression, several cellular and molecular changes occur in the brain that can be seen microscopically in an autopsy after the patients death. Researchers are still trying to determine which changes cause Alzheimers and which changes are the results of the disease. The most prominent effects on the brain 3include the formation of beta-amyloid plaques, neurofibrillary tangles, loss of neuronal connections, and cell death.
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How Is Alzheimer’s Different From Other Forms Of Dementia
Alzheimer’s disease is distinguished from other forms of dementia by characteristic changes in the brain that are visible only upon microscopic examination during autopsy. Brains affected by Alzheimer’s disease often show presence of the following:
Fiber tangles within nerve cells
Clusters of degenerating nerve endings
Another characteristic of Alzheimer’s disease is the reduced production of certain brain chemicals necessary for communication between nerve cells, especially acetylcholine, as well as norepinephrine, serotonin, and somatostatin.
How Is Dementia Diagnosed
Confirming the diagnosis of dementia can be difficult due to the many diseases and conditions that cause it as well as because its symptoms are common to many other illnesses. However, doctors are able to make the diagnosis based on the results of personal medical history, review of current symptoms, neurological and cognitive tests, laboratory tests, imaging tests and by interacting with the patient.
Current general symptoms that would indicate dementia are, by definition, a decline in such mental functions as memory, thinking, reasoning, personality, mood or behavior that are severe enough to interfere with the ability to accomplish everyday tasks. Patients undergo mental function testing to identify problems in these areas. Interviews with family members and/or close friends who may have noticed changes in these areas are helpful as well.
Laboratory tests rule out other diseases and conditions as the cause of dementia, such as thyroid problems and vitamin B12 deficiency. Similarly, brain scans can look for signs of a stroke or tumor that may be the source of the dementia. A PET scan can determine if amyloid proteins are present in the brain, a marker for Alzheimers disease.
Oftentimes, neurologists and geriatricians assist in making the diagnosis.
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What Are Tau Tangles
Tau tangles or neurofibrillary tangles are clumps of a protein called tau and happen inside the neurons, inside brain nerve cells that are important for memory.
Tau protein is abundant in neurons and helps stabilize their axons. Thus, tau is important for normal neuron function.
During Alzheimers disease tau changes and clumps together, like the amyloid beta. But in this case the clumps happen inside the cells.
These clumps are called tangles because the tau protein looks like a helix similar to DNA but its a single helix. And these helices tangle up like a hairball.
What Medications Are Available To Treat Dementia
Drugs approved for the most common form of dementia, Alzheimers disease, are discussed below. These drugs are also used to treat people with some of the other forms of dementia.
- cholinesterase inhibitors
- NMDA receptor antagonist memantine
These two classes of drugs affect different chemical processes in the brain. Both classes have been shown to provide some benefit in improving or stabilizing memory function in some patients. Although none of these drugs appear to stop the progression of the underlying disease, they may slow it down.
If other medical conditions are causing dementia or co-exist with dementia, the appropriate drugs used to treat those specific conditions are prescribed.
Do Brain Cells Die As We Age
With normal aging, we dont find that neurons die in massive numbers. While with Alzheimers disease, the neurons or brain cells die in large numbers in certain areas of the brain.
This is the end product of the process of Alzheimers disease. Alzheimers causes neuron death. And this neuron death manifests as memory, thinking, and behavior changes.
But your brain is so resilient that it is able to adapt for many decades to this cell death.
Neuroscientists believe that when the very first signs of memory, thinking or behavior changes appear in an Alzheimers patient, their neuron loss is approximately 70% in certain areas of the brain.
This 70% loss represents a massive number of dead neurons in brain regions that are earliest affected by Alzheimers disease.
It is a truly remarkable process. Your brain is fighting and largely maintaining cognitive skills until you reach some sort of critical point. It is at this juncture, where a very large percentage of neurons are missing from the brain regions critical for memory formation, that Alzheimers becomes evident.
It is one of the most impressive things, that our brain is able to fight this process, and do a pretty good job of fighting for so long.
What causes this cell death? Alzheimers affects two proteins, beta-amyloid and tau. It causes tangle and plaque formation, brain inflammation, lost connections, and neuronal death.
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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Why Do Protein Deposits Form In The First Place
Researchers want to know why these protein aggregates form in the first place, how they distribute in the brain, how their signalling works, and how they and their precursors cause neurodegeneration.
A range of theories have been put forward to explain what kickstarts damaging protein aggregation. In the case of Alzheimers, this includes problems with the way oxygen is metabolised in brain cells and the movement of internal cell contents. The brains response to inflammation, and its systems for clearing waste could also play a role.
One main theory is that once amyloid-ß begins to accumulate, it then promotes the build-up of tau. But the relationship is not simple, because tau also has a role in influencing the toxic effects of amyloid-ß.
Although some genetic risk factors for dementias have been identified, particularly for Alzheimers disease , we still dont know how these act to influence protein aggregation and cause degeneration. This is a key area of research focus, and knowing the answers to these questions is crucial to the prevention and treatment of dementia.
Dementia Care: What Happens In The Brain
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In scene 1 of Louise’s story, Louise is diagnosed with dementia, the umbrella term for various diseases affecting the brain and the way it functions.
There are many different types of dementia, while they might share common features, they are all distinct. Some types of dementia, such as Korsakoffs syndrome, are secondary to the effects of alcohol while others currently have no known cause. Some forms of dementia progress more rapidly than others: for example, CJD can lead to a rapid death within months. People can be affected by more than one type of dementia. Further, different types of dementia are likely to affect different age groups. Many people are not aware of the range of types of dementia and how they produced different symptoms. See an outline of the different types here:
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