When it comes to dementia, it hits very close to home for many people and is a disease many people have heard of. According to the World Health Organization, the number of patients with dementia worldwide is currently estimated at 47 million, and this is expected to increase to 75 million by 2030 and nearly triple by 2050 (Kim 2019). Most people relate dementia to memory problems but it is so much more than that.
Dementia can affect many different things within the body, and some will seem to be more severe than others. The things affected by dementia can be the persons memory, their ability to complete their activities of daily living, having different types of behaviors, and how they are able to think and process information. Once a person with dementia develops these issues, it makes the person with dementia, more dependent on others for their activities of daily living.
The damage caused by the disease is irreversible. There are pharmacological treatments for dementia, but only 4 drugs out of 100, was authorized to be used. These drugs can only be used to help manage the symptoms caused by dementia and not the disease itself. One problem is, there are unfortunately a lot of people that cannot access these four drugs. The types of drugs that they can get easy access to, are donepezil, galantamine, and rivastigmine which prevent an enzyme know as acetylcholinesterase from breaking down the neurotransmitter that keeps memory functioning. The other type of drug is memantine, which will help some ones memory, by restoring homeostasis in the glutamatergic system. Memantine blocks effects of glutamate, which is released in huge amounts in the brain caused by Alzheimers disease.
The most common form of dementia is Alzheimers disease, which is mainly known to be caused by old age. If a scan is done, you will see white markings on the brain, atrophy in some places and enlargement of the temporal and frontal cortices. The primary motor and the somatosensory cortices will usually appear as if they have not been affected. Macroscopic features of the brain are usually not necessarily related to Alzheimer disease. To have a definitive diagnoses of Alzheimer disease, there will be a microscopic exam done. Doctors will examine multiple regions while using the staining method. Using the staining method will make it easier to detect the neuropathologic change seen in Alzheimer disease.
More common causes of dementia are Lewy body disease, vascular disease, down syndrome, and having a traumatic brain injury. Lewy body disease is caused by abnormal deposits of protein in the brain, which is what causes the dementia. Vascular dementia is caused from having bad blood flow. Most down syndrome patients have an Alzheimer type of pathology, that can begin between the age of 40 and 50 and actually have dementia by the age of 65. There are many cases that also develop due to a brain injury. Having the genotype APOE4 allele puts people at a higher risk for Lewy body, traumatic brain injury, vascular and down syndrome dementia.
Some uncommon causes of dementia are familial Alzheimers and early onset dementia. Familial Alzheimers is genetically passed down and can show up as early as 20 years of age. Familial Alzheimers is only seen in about one percent of dementia cases. Signs of the disease begin around 46. Familial Alzheimers must be passed on by a family member thats in the first generation. Early onset dementia can happen more frequently than familial dementia but not by much. Early onset dementia only happens in less than 5 percent of dementia cases and affected at or before 65. Having a genotype known as APOE4 polymorphism and having a single copy of it can also put someone at a higher risk to develop dementia.
There have been studies done that suggest alcohol use could play a pretty big role in the development of early-onset dementia. This is usually something that happens to people that are 64 years old and younger. A lot of these dementia cases were classified as alcohol-related or seen in people that had prior alcohol abuse problems. A prior diagnosis of an alcohol disease was known to have a high significance associated with dementia in all ages.
Chronic alcohol use, can result in thiamine deficiency, also known as a b1 vitamin deficiency. This will cause the gastrointestinal tract to not be able to absorb the thiamine. This will cause thiamine utilization in the cells, causing a syndrome known as Wernicke-Korsakoff syndrome. If caught early enough there is a treatment with so many doses of thiamine, that will reverse many Wernicke-Korsakoff syndrome symptoms, although some people are not lucky enough to get help in time and some of the damage is irreversible. Heavy use of alcohol is somewhat associated with vascular dementia from the associations of cardiovascular diseases such as high blood pressure, cardiomyopathy, heart disease, and stroke caused by alcohol.
When it comes to the care of someone with Dementia, there should be some sort of training program whether its in a facility or at home. There is a lot of information that is necessary to know when taking care of someone with dementia. According to the School of health and Communities Studies the training program was effective in producing a significant positive change on all three outcome measures following intermediate training compared to baseline (Surr 2016). Dementia is steadily increasing as years go by. Its expected to increase in people around the world, due to epidemiological transition of the world’s population with having older individuals and is even higher in countries that have lower to middle income.
Following a representative Spanish sample, the overall prevalence of mild cognitive impairment was 9.6%, with higher rates in older people and women than in younger people and men (Kim 2019). Dementia costs a lot of money. One trillion is about how much dementia cost annually. This means it is up to pre-clinical diagnosis and treatments to catch the disease progression before onset symptoms occur. Having the knowledge of what puts people higher risk for dementia, should either prevent or help with finding a cure to the disease for some cases.