What Is The Most Common Cause Of Dementia In The Elderly – Dementia is a progressive impairment of two or more cognitive abilities (thinking skills) that affects daily life (see previous post for more information). It can be caused by various diseases. The simple answer is that Alzheimer’s disease is one of the diseases that causes dementia. Memory loss is often the first symptom, but it can then affect many other aspects of thinking and behavior. In some cases, people with Alzheimer’s disease have different early symptoms, such as difficulty with vision, language, decision-making, and social behavior.

Various diseases that cause dementia. Alzheimer’s disease is the most common. Alzheimer’s Association Dementia Information 2014 http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=2761

What Is The Most Common Cause Of Dementia In The Elderly

There’s also a slightly longer answer. Alzheimer’s disease has two slightly different meanings, and it’s hard to know exactly what people mean. This issue and how to treat terminology more carefully is discussed in the article by Bruno Dubois et al. (2010). I have summarized the thinking behind this below.

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The first meaning is related to symptoms and specific changes in the brain. When most people think of Alzheimer’s disease, they think of memory loss, but the word also describes changes in the brain that can be seen under a microscope. Abnormal accumulation of proteins in the brain (amyloid plaques and neurofibrillary tau tangles) and loss of brain cells, first described by Alois Alzheimer. The term “possible Alzheimer’s disease” is often used to reflect the fact that the person has symptoms that would be expected from changes in the brain, but doctors We cannot be sure that a specific protein construct is the cause. It’s causing the symptoms.

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His second use of the word is to simply refer to a change in the brain, a pathology that can be seen under a microscope (regardless of what symptoms it causes). The term here refers to the amyloid plaques, neurofibrillary tau tangles, and brain cell loss that are hallmarks of the disease. It has been suggested that this should be called “Alzheimer’s disease” because the term “Alzheimer’s disease” is associated with symptoms of memory loss, but all people with Alzheimer’s disease experience memory loss as the first or most prominent (Some people may have visual impairments in perception, language production, or decision-making; Murray et al, 2011).

To me, the confusion about this terminology stems from the fact that he uses one term to describe many different things, including symptoms, brain shrinkage, and microscopic brain changes (see image below). The use of the term Alzheimer’s disease often assumes that these things always occur together, but this is not the case. Instead, it may be clearer to explain them separately. For example, the hippocampus (a brain region important for memory) may shrink and memory loss may appear as an early symptom of Alzheimer’s disease. Or they may have difficulty interpreting visual information from their eyes, atrophy of the back of the brain, or early symptoms of Alzheimer’s disease. Although they have the same proteins that affect the brain, the early symptoms are very different because those proteins accumulate in different parts of the brain. Examples of these are shown in the figure below.

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Four different levels of explaining dementia – how cells are affected, where in the brain there is brain atrophy (atrophy), what the symptoms are, and what the diagnostic label is. .

Dubois B, Feldman HH, Jacoba C, Cummings JL, Dekosky ST, Barberger-Gateau P, et al. Revised definition of Alzheimer’s disease: New glossary. Lancet New Roll. 2010; 9: 1118–27. DOI: 10.1016/S1474-4422(10)70223-4

Murray ME, Graffford NR, Ross Oa, Petersen RC, Duala R, Dixon DW. Neuropathologically defined subtypes of Alzheimer’s disease with distinct clinical features: a retrospective study. Lancet New Roll. 2011; 10: 785–96. DOI: 10.1016/S1474-4422(11)70156-9 The word “dementia” is used to describe the symptoms people experience when their brain cells stop working properly due to disease. Memory problems may occur, such as frequently losing things or having trouble finding the right words in conversations. When most people hear the word dementia, they think of someone they know who has memory and thinking problems caused by Alzheimer’s disease. Alzheimer’s disease is the main cause of dementia, but vascular dementia affects 150,000 people in the UK and accounts for one in five of all dementia cases.

There is no single cause of vascular dementia, nor is there a single disease. This is caused by various conditions related to problems with blood supply to the brain.

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Without an adequate blood supply, brain cells do not receive enough oxygen and become damaged and die. Symptoms of this injury include slowed thinking and personality changes, as well as movement and stability issues.

Because the blood supply to our brain can be impaired in different ways, it is often said that there are different subtypes of vascular dementia.

Most cases of vascular dementia (approximately 30%) are caused by stroke. When you have a stroke, blood flow to the brain is cut off and brain cells are damaged.

This interruption can occur as a result of a rupture of a blood vessel (hemorrhagic stroke) or occlusion of a blood vessel by a blood clot (ischemic stroke). Ischemic stroke is the most common and is usually associated with vascular dementia.

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Ischemic stroke can cause single or multiple infarct dementia. The term infarction refers to an area of ​​dead tissue that occurs as a result of a lack of blood supply. Single-infarct dementia occurs when there is widespread damage to one part of the brain.

Multi-infarct dementia occurs after a series of strokes occur in different parts of the brain. When many areas of the brain are affected in this way, various symptoms appear that are related to the damaged area. For example, different strokes occur in different brain areas, which can affect speech and movement over time.

Another major cause of vascular dementia occurs when damaged cells are found in an area of ​​the brain called the white matter. This is sometimes called subcortical vascular dementia.

The brain is made up of white matter and gray matter, which are responsible for the color of brain tissue. Gray matter is located around the outer edges of the brain and contains synapses, the parts of brain cells that communicate with each other. White matter is deep in the brain and contains the parts of the brain cells that carry messages from one area of ​​the brain to another, allowing everything we normally do, such as eating, moving, and speaking. It becomes possible.

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When the white matter is deprived of blood supply, these cells die and connections throughout the brain are lost, causing typical dementia symptoms.

In dementia, cell damage in the white matter is often associated with small vessel disease, where small blood vessels become narrowed and blood cannot flow through them. This occurs naturally with age, but can be worsened by conditions such as high blood pressure or behaviors such as smoking.

There are many other diseases that can cause white matter damage and lead to vascular dementia. For example:

Yes, I can. This is called mixed dementia and occurs when someone has more than one type of dementia. Often this can be Alzheimer’s disease or vascular dementia.

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Thanks to amazing supporters like you, we are currently funding a variety of projects investigating the mechanisms in the brain that cause Alzheimer’s disease and vascular dementia at the same time. So far, these projects have shown that reduced blood flow in the brain can trigger disease processes associated with both types of dementia.

A Scottish research group is investigating how changes in the barrier between the blood supply and the brain contribute to the development of Alzheimer’s disease. Meanwhile, a group in London is investigating whether factors that damage the heart and blood vessels in childhood are linked to early changes in the brain that may influence how the brain works later in life. are doing.

Although many older people have both Alzheimer’s disease and vascular disorders, relatively few people are diagnosed with “mixed dementia.” Doctors can diagnose mixed dementia only when there are clear signs of both types of illness contributing directly to the symptoms of dementia.

The risk of developing dementia is a complex combination of factors such as age, genetics, and lifestyle. Although you can’t change your age or your genetic makeup, you can make positive lifestyle changes to reduce your overall risk of developing dementia, and it’s worth it.

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Taking care of your heart health can help reduce your risk of dementia, especially vascular dementia and Alzheimer’s disease. This includes lifestyle approaches such as quitting smoking, getting physical activity every day, eating a balanced diet, maintaining a healthy weight, and drinking alcohol in accordance with government instructions.

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