Where Are The Lowest Rates Of Alzheimers In The World
Written By Michael Greger M.D. FACLM on November 12, 2015
The rates of dementia differ greatly around the world, from the lowest rates in Africa, India, and South Asia, to the highest rates in Western Europe and especially North America. Is it all just genetics? Well, the incidence of dementia and Alzheimers disease is significantly lower for Africans in Nigeria than for African Americans in Indianapolis, for exampleup to five times lower.
Alzheimers rates of Japanese-Americans living in the U.S. are closer to that of Americans than to Japanese. When people move from their homeland to the United States, Alzheimers rates can increase dramatically. Therefore, when Africans or Asians live in the United States and adopt a Western diet, their increase in Alzheimers risk suggests that its not genetics.
A similar analysis in China arrived at the same conclusion. As the authors of the Japan study note, on the basis of these findings, the rate of Alzheimers disease and dementia will continue to rise unless dietary patterns change to those with less reliance on animal products. This is consistent with data showing those who eat vegetarian appear two to three times less likely to become demented, and the longer one eats meat-free, the lower the associated risk of dementia.
A few previous videos on Alzheimers and maintaining cognitive function:
Common Forms Of Dementia
There are many different forms of dementia. Alzheimer’s disease is the most common form and may contribute to 60-70% of cases. Other major forms include vascular dementia, dementia with Lewy bodies , and a group of diseases that contribute to frontotemporal dementia . Dementia may also develop after a stroke or in the context of certain infections such as HIV, harmful use of alcohol, repetitive physical injuries to the brain or nutritional deficiencies. The boundaries between different forms of dementia are indistinct and mixed forms often co-exist.
Which Medicines Are Used To Treat Alzheimers Disease
There is no cure for Alzheimers disease, but available medications temporarily slow the worsening of dementia symptoms and help with behavioral problems that may appear during the course of the disease.
Four medications representing two drug classes are currently approved by the Food and Drug Administration to treat the symptoms of Alzheimers disease. These drugs are the cholinesterase inhibitors and a NMDA antagonist.
Cholinesterase inhibitors. The cholinesterase inhibitors are all approved to treat the symptoms of mild to moderate Alzheimer’s disease . Cholinesterase inhibitors include:
These drugs work by blocking the action of acetylcholinesterase, the enzyme responsible for destroying acetylcholine. Acetylcholine is one of the chemicals that helps nerve cells communicate. Researchers believe that reduced levels of acetylcholine cause some of the symptoms of Alzheimer’s disease. By blocking the enzyme, these medications increase the concentration of acetylcholine in the brain. This increase is believed to help improve some memory problems and reduce some of the behavioral symptoms seen in patients with Alzheimers disease.
These medications do not cure Alzheimers disease or stop the progression of the disease. The most common side effects of these drugs are nausea, diarrhea, and vomiting. Some people may have loss of appetite, insomnia or bad dreams.
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How Common Is Alzheimer’s Disease
About 5.5 million Americans are living with Alzheimer’s disease. The disease is rapidly growing. By 2050, this number could potentially rise to 16 million. Every 66 seconds, someone in the United States is diagnosed. Soon, that number could increase to a diagnosis every 33 seconds. Let’s dive into these figures and how Alzheimer’s is impacting families across the world.
What Is The Average Lifespan Of A Person With Dementia
According to the National Institute on Aging, beginning treatment early in the disease process may help preserve daily functioning for some time. According to the Alzheimers Association, on average, a person with Alzheimers lives 4 to 8 years after diagnosis. However, some people live with dementia for 20 years.
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Women Over 90 More Likely To Have Dementia Than Men
- University of California – Irvine
- Women over 90 are significantly more likely to have dementia than men of the same age, according UC Irvine researchers involved with the 90+ Study, one of the nation’s largest studies of dementia and other health factors in the fastest-growing age demographic.
Women over 90 are significantly more likely to have dementia than men of the same age, according UC Irvine researchers involved with the 90+ Study, one of the nation’s largest studies of dementia and other health factors in the fastest-growing age demographic.
The researchers reviewed an analysis of 911 people enrolled in the 90+ Study. Of those, 45 percent of the women had dementia, as opposed to 28 percent of the men. The analysis did not determine when the subjects first experienced dementia.
The 90-plus age group, or the “oldest old,” is the fastest growing segment of the population, according to the U.S. Census. While there are currently nearly 2 million nonagenarians in the U.S. alone, that number is projected to increase to 10 to 12 million by the middle of the century, raising concerns that the current health care system may not be able to accommodate this population.
“Our findings show that more will need to be done to provide adequate resources to care for the increasing number of very old people with dementia,” said Maria Corrada, a UC Irvine epidemiologist and study corresponding author.
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 provide the majority of informal care for people living with dementia, accounting for 70% of carer hours.
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Dementia Cases Expected To Triple By 2050 As World Population Ages
Across the globe, more than 35 million people are living with dementia, according to recent World Health Organization estimates.1 This number is expected to more than triple to reach 115 million by 2050 in the wake of world population aging.
Fueled by declines in fertility and increases in life expectancy, the share of the worlds population ages 65 and older is on track to jump from 8 percent today to nearly 17 percent in 2050, according to new U.S. Census Bureau population projections.
Dementia is a brain disease characterized by loss of memory, speech, reasoning, and other cognitive functions Alzheimers disease is the most common form likely accounting for 70 percent of all cases. The onset of dementia is devastating for individuals and their families, profoundly affecting the quality of life and taking a severe economic toll. Treating and caring for people with dementia currently costs more than US$600 billion per year worldwide , according to WHO. This estimate includes the cost of providing health and social care as well as the reduction or loss of income of people with dementia and their caregivers.
Projected Numbers of People With Dementia, by Country Income Level, 2010 to 2050
Differences Between Women And Men In The Prevalence And Risk Of Alzheimer’s And Other Dementias
More women than men have Alzheimer’s or other dementias. Almost two-thirds of Americans with Alzheimer’s are women., Of the 5.8 million people age 65 and older with Alzheimer’s in the United States, 3.6 million are women and 2.2 million are men., Based on estimates from ADAMS, among people age 71 and older, 16% of women have Alzheimer’s or other dementias compared with 11% of men.
The prevailing reason that has been stated for the higher prevalence of Alzheimer’s and other dementias in women is that women live longer than men on average, and older age is the greatest risk factor for Alzheimer’s.- But when it comes to differences in the actual risk of developing Alzheimer’s or other dementias for men and women of the same age, findings have been mixed. Most studies of incidence in the United States have found no significant difference between men and women in the proportion who develop Alzheimer’s or other dementias at any given age., , – However, some European studies have reported a higher incidence among women at older ages,, and one study from the United Kingdom reported higher incidence for men. Differences in the risk of dementia between men and women may therefore depend on age and/or geographic region.,
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Does The Alzheimers Gene Skip A Generation
Scientists suggest that many genes can increase the risk of Alzheimers. Evidence shows that the APOE-e4 gene has the potential impact on the rate of developing late-onset Alzheimers. Every person inherits at least one copy of this gene.
The primary function of this gene is to provide the blueprint for a protein transporting cholesterol in the bloodstream. The APOE gene is present in three different forms, including e2,e3, and e4.
A recent study shows that the Alzheimers gene may be present in the younger generation, but the risk has decreased due to significant years of early life education.
Gene Variant Staves Off Alzheimer’s In Some People
- Stanford Medicine
- People with a gene variant that puts them at high risk for Alzheimer’s disease are protected from its debilitating effects if they also carry a variant of a completely different gene, investigators report in a large new study.
People with a gene variant that puts them at high risk for Alzheimer’s disease are protected from its debilitating effects if they also carry a variant of a completely different gene, Stanford University School of Medicine investigators report in a large new study.
Their findings, to be published Apr. 13 in JAMA Neurology, suggest that a substantial fraction of the estimated 15% of Americans carrying the high-risk gene variant are protected to some degree from Alzheimer’s disease by a variant of the other gene.
The findings also may help drug developers better identify clinical trial participants and treatments for what, despite billions of dollars spent in pursuit of effective therapies, remains a disease without a cure.
About 5 million Americans — including roughly 1 in 10 people age 65 or older and one-third of those age 85 or older — have symptomatic Alzheimer’s disease. Even larger numbers have a subtler precursor called mild cognitive impairment. About half with this condition move on to full-blown Alzheimer’s. There are medications that can slow development of cognitive symptoms somewhat, but no available drugs prevent the disease’s progression or extend patients’ lives.
The role of klotho
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Treatment Of Alzheimer’s Dementia
2.5.1 Pharmacologic treatment
None of the pharmacologic treatments available today for Alzheimer’s dementia slow or stop the damage and destruction of neurons that cause Alzheimer’s symptoms and make the disease fatal. The U.S. Food and Drug Administration has approved five drugs for the treatment of Alzheimer’s â rivastigmine, galantamine, donepezil, memantine, and memantine combined with donepezil. With the exception of memantine, these drugs temporarily improve cognitive symptoms by increasing the amount of chemicals called neurotransmitters in the brain. Memantine blocks certain receptors in the brain from excess stimulation that can damage nerve cells. The effectiveness of these drugs varies from person to person and is limited in duration.
Many factors contribute to the difficulty of developing effective treatments for Alzheimer’s. These factors include the slow pace of recruiting sufficient numbers of participants and sufficiently diverse participants to clinical studies, gaps in knowledge about the precise molecular changes and biological processes in the brain that cause Alzheimer’s disease, and the relatively long time needed to observe whether an investigational treatment affects disease progression.
2.5.2 Non-pharmacologic therapy
Am I At Risk For Alzheimer’s
Whether we have seen early signs in ourselves or not, many of us want to know what our chances of getting this disease may be. Research has shown a number of possible factors that can impact your chances of getting Alzheimer’s disease, although none of these are a cause in and of themselves.
Some ages are more at risk
Old age is one of the most obvious risk factors. The vast majority of people develop the disease after the age of 65, and once you reach 65, your risk of getting Alzheimer’s doubles every five years. But Alzheimer’s doesn’t only affect people over 65 it has been known to affect people half that age, although this is much rarer.
Alzheimer’s is hereditary
A family history will also increase your risk of getting the disease. The risk increases even more if you have multiple family members who have suffered from the disease.
Whilst this may be due to the hereditary genetic factors we will look at in more depth later, there may be other factors at play. These could include environmental factors that impact both yourself and your family.
Gender is another significant risk factor. The first discovery of the disease back in 1906 was in a woman, and about twice as many women as men over 65 have Alzheimer’s. This may be in part to the fact that women have a longer lifespan or may even possibly be linked to menopause.
Genetic factors of Alzheimer’s
Other risk factors
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Active Management Of Alzheimer’s Dementia
- Appropriate use of available treatment options.
- Effective management of coexisting conditions.
- Providing family caregivers with effective training in managing the day-to-day life of the care recipient.
- Coordination of care among physicians, other health care professionals and lay caregivers.
- Participation in activities that are meaningful to the individual with dementia and bring purpose to his or her life.
- Having opportunities to connect with others living with dementia support groups and supportive services are examples of such opportunities.
- Becoming educated about the disease.
- Planning for the future.
To learn more about Alzheimer’s disease, as well as practical information for living with Alzheimer’s and being a caregiver, visit alz.org.
What Are The Most Common Types Of Dementia
- Alzheimers disease. This is the most common cause of dementia, accounting for 60 to 80 percent of cases. It is caused by specific changes in the brain. The trademark symptom is trouble remembering recent events, such as a conversation that occurred minutes or hours ago, while difficulty remembering more distant memories occurs later in the disease. Other concerns like difficulty with walking or talking or personality changes also come later. Family history is the most important risk factor. Having a first-degree relative with Alzheimers disease increases the risk of developing it by 10 to 30 percent.
- Vascular dementia. About 10 percent of dementia cases are linked to strokes or other issues with blood flow to the brain. Diabetes, high blood pressure and high cholesterol are also risk factors. Symptoms vary depending on the area and size of the brain impacted. The disease progresses in a step-wise fashion, meaning symptoms will suddenly get worse as the individual gets more strokes or mini-strokes.
- Lewy body dementia. In addition to more typical symptoms like memory loss, people with this form of dementia may have movement or balance problems like stiffness or trembling. Many people also experience changes in alertness including daytime sleepiness, confusion or staring spells. They may also have trouble sleeping at night or may experience visual hallucinations .
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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 biological 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 cognitive decline and dementia by being physically active, 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, social isolation, low educational attainment, cognitive inactivity and air pollution.
Who Is Most At Risk For Dementia
The greatest known risk factor for Alzheimers and other dementias is increasing age, but these disorders are not a normal part of aging. While age increases risk, it is not a direct cause of Alzheimers. Most individuals with the disease are 65 and older. After age 65, the risk of Alzheimers doubles every five years.
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Use And Costs Of Health Care Services
6.2.1 Use of health care services
People with Alzheimer’s or other dementias have twice as many hospital stays per year as other older people. Moreover, the use of health care services by people with other serious medical conditions is strongly affected by the presence or absence of dementia. In particular, people with coronary artery disease, diabetes, chronic kidney disease, chronic obstructive pulmonary disease , stroke or cancer who also have Alzheimer’s or other dementias have higher use and costs of health care services than people with these medical conditions but no coexisting dementia.
- * This table does not include payments for all kinds of Medicare services, and as a result the average per-person payments for specific Medicare services do not sum to the total per-person Medicare payments.
- Created from unpublished data from the National 5% Sample Medicare Fee-for-Service Beneficiaries for 2014.
Diagnosis Of Dementia Due To Alzheimer’s Disease
- Obtaining a medical and family history from the individual, including psychiatric history and history of cognitive and behavioral changes.
- Asking a family member to provide input about changes in thinking skills and behavior.
- Conducting problem-solving, memory and other cognitive tests, as well as physical and neurologic examinations.
- Having the individual undergo blood tests and brain imaging to rule out other potential causes of dementia symptoms, such as a tumor or certain vitamin deficiencies.
- In some circumstances, using PET imaging of the brain to find out if the individual has high levels of beta-amyloid, a hallmark of Alzheimer’s normal levels would suggest Alzheimer’s is not the cause of dementia.
- In some circumstances, using lumbar puncture to determine the levels of beta-amyloid and certain types of tau in CSF normal levels would suggest Alzheimer’s is not the cause of dementia.
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