Senile Dementia: Are They Preventable?

Posted on September 28, 2008
Filed Under Disease |

Dementias (Alzheimer’s, Parkinson’s disease with dementia and related disorders) are probably the most important clinical disorders of our time in terms of overhead for affected individuals and their families and, of course, cost to society. Alzheimer’s disease is between 60% and 80% of cases of dementia.

Lady with hat sitting in the field
It is estimated that in Spain there are currently between 600,000 and 1 million patients diagnosed with Alzheimer’s disease, the leading type of dementia after age 65. Each year in our country almost 100,000 new cases of the disease which has been described almost like a real epidemic, which concern both to society, experts and authorities.

Can we prevent dementia?
That is the question, with capitals. This article will review briefly some important details of the dementias, and then focus on the preventive measures of the disease currently in use or research.

Risk factors
Age and a family history of disease are the two main risk factors for this devastating disorder. A history of first-degree kinship with a patient suffering from the disease increases 3 times the risk. This relationship is especially true in cases where the disease appears early, ie in younger people. It has been found that women have a higher risk of Alzheimer’s disease than men.

A low educational level is a significant risk factor for developing Alzheimer’s disease. Cranial trauma with loss of consciousness also increases the risk. Finally, there is evidence that atherosclerosis is a risk factor for Alzheimer’s disease and other types of dementia known as vascular.

Parkinson’s disease, neurological disorder such as common in the elderly and characterized among other signs and symptoms for the onset of tremor is associated with an increased risk of dementia. Approximately 1 to 4 patients with Parkinson’s disease will eventually develop dementia.

What is Alzheimer’s Disease and how is it manifested?
Alzheimer’s disease, the leading type of dementia and to which we refer primarily to this article, most frequently affects people over 65 years. Basically this is a serious, progressive nature of the functioning of the brain affecting memory, thought process, speech and behavior. Its causes are not well known yet, although it is known that there are important structural and chemical changes in the brain of affected individuals. These changes impede the ability to process, store and retrieve information.

The clinical manifestations of the disease are highly variable and change as the disorder progresses. At first the changes are common in mood and personality. Later, a disturbance of memory loss and difficulty finding the words you want. These changes may be subtle and the family can adapt unconsciously contributing to this decline to a delay in its recognition. Finally, it is affecting other functional capabilities and problems arise, for example, driving a car, carry their own accounts, hygiene and meals. A gradual deterioration of language, disorientation in time and space, impairment of the ability of trial and difficulty to recognize even their own family members. They often appear as a paranoia psychiatric symptoms, psychomotor agitation, irritability, frustration, anxiety, insomnia, inappropriate social behavior, hallucinations, etc…

Mild cognitive impairment
Mild cognitive impairment is a cognitive disorder between normal forgetfulness or physiological memory that occur with age and dementia. In this situation the patient, his family or doctor detect memory complaints, the patient remains normal daily activity (autonomy, ability to live alone), but are difficult to perform complex daily activities, there is an objective memory impairment, although the overall normal cognitive function and dementia was ruled out by the various clinical trials.

It is known that patients with this dementia develop mild cognitive impairment with a frequency of 10% to 15% per year, so these patients should continue close medical supervision.

Preventive measures of dementia
In recent years, and because they are not well known causes of Alzheimer’s disease, has been much emphasis on early diagnosis of the disease rather than preventive treatment or delaying the disease.

Although there is no solid evidence that a change in lifestyle can prevent this disease, many scientific studies show that certain behaviors may help protect against mental deterioration. In particular, it has been found that some medicines and lifestyles that protect the heart may also have their role in preventing this disease. They are currently in research and many other medicines that measures briefly discussed below:
* Some epidemiological studies have suggested that nonsteroidal anti-inflammatory drugs protect against the development of Alzheimer’s disease, although there is no conclusive evidence. In addition, other studies have associated long-term use of these drugs with the preservation of cognitive function and prevention of early cognitive impairment as well as a decrease in the incidence of Parkinson’s disease. Some researchers, until they provide more conclusive data, have proposed a treatment with low doses of ibuprofen (200 mg / day) to prevent Alzheimer’s disease, especially in those patients with a strong family history of disease and knowing that this is treatment has not proven anything yet.
* Some studies have suggested that the use of a statin, a drug that is commonly used to reduce blood cholesterol, could prevent the development of dementia.
* It has been suggested that antioxidants such as vitamin E may be beneficial in delaying disease progression in patients with established Alzheimer’s disease. This substance could be administered through diet or supplements. Although no reliable data to suggest that taking this vitamin to prevent Alzheimer’s disease, given its low risk, could be a supplement of this substance to patients at high risk of developing dementia. It has been recommending the use of 400 to 800 IU of vitamin E in patients with a family history of Alzheimer’s disease risk.
* Hypertension is associated with an increased risk of both vascular dementia and Alzheimer’s disease. Some studies have suggested that reducing high blood pressure reduce the risk of dementia in elderly people with a type called systolic hypertension. It has also been suggested that these changes in lifestyle and medications that reduce risk factors for heart disease and diabetes mellitus could be important in reducing the risk of Alzheimer’s disease.
* Although some preliminary epidemiological studies suggested that hormone replacement therapy could prevent dementia prevention, it seems that finally is not so, and may even increase it so now the administration is not recommended for the prevention of dementia.
* Physical activity and exercise can help maintain cognitive function, as demonstrated by some scientific studies.
* In the same way, the cognitive activity may protect against dementia. Leisure activities like reading, playing board games and playing musical instruments in one study were associated with lower risk of developing dementia. Learning throughout life, activities and social behavior, and stress reduction measures are useful to keep the mind active and full of energy.
* It seems that a diet rich in fish and omega 3 fatty acids may reduce the risk of cognitive decline in Alzheimer’s disease and a diet rich in cholesterol and saturated fatty acids could increase, although there is no clear evidence, but many disputes respect.
* Data on alcohol use and risk of dementia are also unclear. While alcoholism is associated with cognitive dysfunction, there is abundant evidence to suggest that light to moderate consumption of alcohol may be protective.
* The research on animals has demonstrated that vaccines derived from proteins found in the brains of animals suffering from this disease might be able not only to delay the progression of brain damage, but even reverse. In any case, these investigations will not be available for use in humans within the next several years, although the findings are promising.

In conclusion, most data on prevention of dementia derived from observational studies. Currently under development-oriented studies of interventions that help clarify some of the concerns raised so far. Meanwhile it has been proposed only for preventive administration of vitamin E and low dose ibuprofen.

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