How Is Alzheimers Disease Treated
Alzheimers is complex, and it is therefore unlikely that any one drug or other intervention will successfully treat it in all people living with the disease.
Scientists are exploring many avenues to delay or prevent the disease as well as to treat its symptoms. In ongoing clinical trials, scientists are developing and testing several possible interventions. Under study are drug therapies aimed at a variety of disease interventions, as well as nondrug approaches such as physical activity, diet, cognitive training, and combinations of these. Just as we have many treatments for heart disease and cancer, we will likely need many options for treating Alzheimers. Precision medicine getting the right treatment to the right person at the right time will likely play a major role.
Current approaches to treating Alzheimers focus on helping people maintain mental function, treating the underlying disease process, and managing behavioral symptoms.
How Common Is Late
By itself, LATE is estimated to cause about 15 percent to 20 percent of all dementias. Many people with dementia also have LATE pathology in addition to one or more other pathologies in their brain. For example, an individual may have the plaques and tangles of Alzheimers pathology, plus LATE pathology, plus ministrokes . It turns out that about 40 percent of people with dementia have at least some LATE pathology in their brain. All of this means that LATE is, indeed, very common.
This is an excerpt from an article that appears on the Harvard Health Publishing website.
Other Types Of Dementia
Other conditions that contribute to dementia include:
- Mixed dementia: This happens when several conditions contribute to your dementia. Alzheimers disease, Lewy body conditions, and vascular conditions may all be present in a case of mixed dementia.
- Huntingtons disease: This genetic condition causes damage to nerve cells in your spine and brain. You may start to notice symptoms of dementia and cognitive decline after you turn 30 if you have it.
- Parkinsons disease: The damage to your nerves caused by Parkinsons can cause dementia.
- Creutzfeldt-Jakob disease: This brain condition is thought to be caused by problems with your brain proteins or by contact with brain or nerve tissue that carries a disease. Symptoms dont often appear until after you turn 60.
These conditions are often caused by a mix of risk factors, including family history and lifestyle choices. Huntingtons disease can only be passed through families and cant be developed if you dont have the genes for it.
Some risk factors for dementia cant be controlled, including:
- your age, as your risk increases after you turn 65
- losing your memory naturally as you age
- Down syndrome, which often causes early onset dementia
- your genes, as a family history of dementia can increase your risk of developing dementia
Other risk factors may respond to lifestyle changes or treatment. These include:
- drinking a lot of alcohol
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What To Do If You Notice Symptoms
If you believe you or a loved one is demonstrating symptoms of dementia, the NIH recommends contracting your medical provider for an assessment. “Don’t be afraid to get them checked out early!” encourages Dr. Fredericks. “Having an experienced physician evaluate you and determine whether there is a need for further testingwhether blood tests, brain imaging, or pen-& -paper neuropsychological testingcan help you identify the cause of your symptoms as early as possible .” And to get through this pandemic at your healthiest, don’t miss these 35 Places You’re Most Likely to Catch COVID.
Disproportionate Impact On Women
Globally, dementia has a disproportionate impact on women. Sixty-five percent of total deaths due to dementia are women, and disability-adjusted life years due to dementia are roughly 60% higher in women than in men. Additionally, women providethe majority of informal care for people living with dementia, accounting for 70% of carer hours.
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What Medications Are Available To Manage Dementia
Drugs approved for the most common form of dementia, Alzheimers disease, include:
- Cholinesterase inhibitors, including donepezil , rivastigmine and galantamine .
- NMDA receptor antagonist memantine .
- Anti-amyloid antibody aducanumab .
Healthcare providers use these drugs to treat people with some of the other forms of dementia.
Cholinesterase inhibitors and the NMDA receptor antagonist affect different chemical processes in your brain. Both drug classes have been shown to provide some benefit in improving or stabilizing memory function in some people with dementia.
Cholinesterase inhibitors manage the chemicals in your brain that allow messages to be sent between brain cells, which is needed for proper brain function. Memantine works similarly to cholinesterase inhibitors except it works on a different chemical messenger and helps the nerve cells survive longer.
Aducanumab targets amyloid proteins, which build up into the plaques seen in the brains of people with Alzheimers disease.
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, healthcare providers prescribe the appropriate drugs used to treat those specific conditions. These other conditions include sleeping problems, depression, hallucinations and agitation.
Foods With A Lot Of Trans Fats
Transfats refer to a kind of unsaturated fat that has harmful effects on brain health. The ones that occur naturally in animal products are not the problem. The issue lies with the industrially manufactured Trans fats called hydrogenated vegetable oils.
Research shows that taking too much of these oils leads to poorer memory, cognitive decline, lower brain volume, and risk of dementia.
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What Are The Causes Of Dementia
Dementia is caused by damage to your brain. Dementia affects your brains nerve cells, which destroys your brains ability to communicate with its various areas. Dementia can also result from blocked blood flow to your brain, depriving it of needed oxygen and nutrients. Without oxygen and nutrients, brain tissue dies.
Damage to your brain results in different symptoms, depending on the area of your brain affected. Some dementias arent reversible and will worsen over time. Other dementias are due to other medical conditions that also affect your brain. Another group of health issues can result in dementia-like symptoms. Many of these conditions are treatable, and the dementia symptoms are reversible.
All of the possible causes of dementia are discussed in the question, Are there different types of dementia?
Signs And Symptoms Of Alzheimer’s Disease
Memory problems are typically one of the first signs of cognitive impairment related to Alzheimers. Some people with memory problems have a condition called mild cognitive impairment . With MCI, people have more memory problems than normal for their age, but their symptoms do not interfere with their everyday lives. Movement difficulties and problems with the sense of smell have also been linked to MCI. Older people with MCI are at greater risk for developing Alzheimers, but not all of them do so. Some may even revert to normal cognition.
The first symptoms of Alzheimers vary from person to person. For many, decline in nonmemory aspects of cognition, such as word-finding, vision/spatial issues, and impaired reasoning or judgment may signal the very early stages of the disease. Researchers are studying biomarkers to detect early changes in the brains of people with MCI and in cognitively normal people who may be at greater risk for Alzheimers. More research is needed before these techniques can be used broadly and routinely to diagnose Alzheimers in a health care providers office.
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Research Into The Genetics Of Dementia
Genes carry patterns for the many proteins that form our bodies. Proteins are the essential building blocks of life – forming cells, organs, and enzymes which help the body to function. Once they are made, proteins can be folded into different structures and shapes to fulfil their many functions. Genes are found in every cell in the body in packages of twisted DNA called chromosomes. Half of these chromosomes are inherited from each parent – providing the basis for genetic inheritance. Genes explain why family resemblances occur and why some diseases can run in families.
There is still much we don’t know about the role of genes in Alzheimer’s disease and other dementias, but researchers continue to study this area. In most cases, dementia occurs sporadically, is not directly caused by a single gene and has no clear pattern of family inheritance. However, in a minority of cases, Alzheimer’s disease and some other types of dementia can be directly caused by an inherited gene mutation. The table below summarises some of the genes that have been found to cause or be involved in dementia. Each type is discussed in more detail under the relevant section below.
What Causes Alzheimers Disease
In recent years, scientists have made tremendous progress in better understanding Alzheimers and the momentum continues to grow. Still, scientists dont yet fully understand what causes Alzheimers disease in most people. In people with early-onset Alzheimers, a genetic mutation may be the cause. Late-onset Alzheimers arises from a complex series of brain changes that may occur over decades. The causes probably include a combination of genetic, environmental, and lifestyle factors. The importance of any one of these factors in increasing or decreasing the risk of developing Alzheimers may differ from person to person.
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Medications To Treat The Underlying Alzheimer’s Disease Process
Aducanumab is the first disease-modifying therapy approved by the FDA to treat Alzheimers disease. The medication helps to reduce amyloid deposits in the brain and may help slow the progression of Alzheimers, although it has not yet been shown to affect clinical outcomes such as progression of cognitive decline or dementia. A doctor or specialist will likely perform tests, such as a PET scan or analysis of cerebrospinal fluid, to look for evidence of amyloid plaques and help decide if the treatment is right for the patient.
Aducanumab was approved through the FDAs Accelerated Approval Program. This process requires an additional study after approval to confirm the anticipated clinical benefit. If the follow-up trial fails to verify clinical benefit, the FDA may withdraw approval of the drug. Results of the phase 4 clinical trial for aducanumab are expected to be available by early 2030.
Several other disease-modifying medications are being tested in people with mild cognitive impairment or early Alzheimers as potential treatments.
Dementia With Lewy Bodies
Dementia with Lewy bodies, also called DLB, is the third most common cause of dementia.
Lewy bodies are tiny, round clumps of protein that build up inside brain cells. They stop brain cells from working properly, causing dementia symptoms such as memory loss. They can cause other problems too, such as hallucinations , slowed and stiff arm and leg movements and changes with sleep, like talking or moving about during sleep.
People with DLB often have big differences between their good days and bad days. On bad days, they may be much more confused and less alert.
Some of the ways people are affected:
Changes in alertness, attention, and confusion, which may be unpredictable and change from hour to hour or day to day.
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Aluminum In Cookware And Other Products
It would be difficult to significantly reduce exposure to aluminum simply by avoiding the use of aluminum products such as pots and pans, foil and beverage cans.
That’s because the use of aluminum in these products only contributes to a very small percentage of the average person’s intake of aluminum. It’s important to remember that aluminum is an element found naturally in the environment and our bodies at levels that are normal and not harmful.
Struggling To Adapt To Change
For someone in the early stages of dementia, the experience can cause fear. Suddenly, they cant remember people they know or follow what others are saying. They cant remember why they went to the store, and they get lost on the way home.
Because of this, they might crave routine and be afraid to try new experiences. Difficulty adapting to change is also a typical symptom of early dementia.
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Impact On Families And Carers
In 2019, informal carers spent on average 5 hours per day providing care for people living with dementia. This can be overwhelming . Physical, emotional and financial pressures can cause great stress tofamilies and carers, and support is required from the health, social, financial and legal systems. Fifty percent of the global cost of dementia is attributed to informal care.
Research Into The Cause Of Alzheimers Disease
The role of plaques and tangles in Alzheimers disease
The biological causes of Alzheimer’s disease are not fully understood and research continues to examine factors involved in the development of Alzheimer’s disease.
The two most common hallmarks of Alzheimer’s disease in the brain are beta-amyloid plaques and neurofibrillary tangles. The role of plaques and tangles in Alzheimer’s disease is not fully understood. Both are present in the brains of older people who do not have Alzheimer’s disease, although they are more widespread and predominant in the brains of people with Alzheimer’s disease. Research is ongoing to determine more about the role of both plaques and tangles in the development of Alzheimer’s disease.
In Alzheimer’s disease, sticky beta-amyloid fragments clump together and form the basis of plaques. Recent research suggests that smaller clumps of beta-amyloid known as oligomers may actually be more toxic than the plaques. Researchers continue to study many aspects of beta-amyloid to establish its role in Alzheimer’s disease, including the mechanisms of plaque formation, and how plaques might be removed from the brain.
The genetics of Alzheimer’s disease
Comprehensive information about the research into the genetics of Alzheimers disease is available at the AlzGene website.
Genes that cause Alzheimers disease
Genetic risk factors for Alzheimers disease
The role of inflammation in Alzheimers disease
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Consider Palliative Care And Hospice As Part Of The Process
Palliative care addresses the overall well-being of people with chronic illnesses like progressive brain disorders and dementia. Palliative care and end-of-life hospice care are not the same thing.
- Palliative care. Palliative care providers can help you work through important decisions about which treatments and procedures will bring the biggest benefits. They can also provide medications to relieve pain, anxiety, emotional distress, and other symptoms that arise in late stage dementia. They may be able to help you access the services of social workers, nutritionists, and therapists to meet a wide range of needs.
- Hospice care. Hospice services can ease the transition to end-of-life care, supplying equipment and treatments that bring greater comfort and make it easier to care for a person in this stage.
What Can I Expect If I Have Dementia
Getting a diagnosis of dementia is certainly difficult to hear. Several types of dementia arent reversible. Others are a side effect of other serious diseases. Some dementia-like symptoms are due to conditions that can be treated and reversed.
Your healthcare team, which will probably include a neurologist and/or a geriatric-psychiatrist or a geriatrician, will order the needed tests to make the correct diagnosis. The medications available today focus on slowing the decline.
The goal is to maintain your or your loved ones quality of life. Some people with Alzheimers dementia can live up to two decades, but each person has their own unique course. Researchers continue learning about the mechanisms that cause dementia and testing different methods to slow, and someday, hopefully, cure this disease.
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There Are Many Causes Of Dementia
Any of these symptoms can be caused in multiple ways. Alan, for example, was found to suffer from cognitive impairment related to his HIV infection Martha had Alzheimers disease interfering with her short-term memory and comprehension. Bert, after his diagnostic work up, was recognized to have frontotemporal dementia leading to difficulty controlling behavior and aphasia . Mary had vascular cognitive impairment following her stroke. Bill had suffered brain damage due to oxygen deprivation during his drowning. Each was considered to have dementia, yet the differences between them were huge. In each case, however, an injury or disease process was responsible for destruction of brain cells.
Causes of dementia may include:
Metabolic Problems And Endocrine Abnormalities
Thyroid problems can lead to apathy, depression, or symptoms that resemble dementia.
Hypoglycemia, a condition in which theres not enough sugar in the bloodstream, can cause confusion or personality changes.
Too little or too much sodium or calcium can trigger mental changes.
Some people have an impaired ability to absorb vitamin B-12. This creates a condition called pernicious anemia that can cause personality changes, irritability, or depression.
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What Is Known About Reducing Your Risk Of Alzheimers Disease
The science on risk reduction is quickly evolving, and major breakthroughs are within reach. For example, there is growing evidence that people who adopt healthy lifestyle habits like regular exercise and blood pressure management can lower their risk of dementia. There is growing scientific evidence that healthy behaviors, which have been shown to prevent cancer, diabetes, and heart disease, may also reduce risk for subjective cognitive decline. To learn more about the current state of evidence on dementia risk factors and the implications for public health, please read the following summaries on Cardiovascular Health, Exercise, Diabetes and Obesity, Traumatic Brain Injury , Tobacco and Alcohol, Diet and Nutrition, Sleep, Sensory Impairment, and Social Engagement or the Compiled Report .