For many people, senile dementia and Alzheimer's disease are synonymous, but in reality they are not. Understanding the differences between these pathological conditions contributes to early access to doctors, which allows preserving a person’s identity for a longer time.
The external signs of dementia and Alzheimer's disease are similar. In both cases, the first symptoms occur in old age, and both diseases affect higher nervous functions. The patient's level of intelligence decreases, memory deteriorates, and disorders develop in other areas.
But there is no point in equating these two pathological conditions. Dementia is a symptom of a number of diseases associated with brain disorders. Alzheimer's disease is a severe brain disease that leads to the development of dementia.
Etiology
Vascular dementia: Often caused by an acute, specific event, such as a stroke or transient ischemic attack, when the blood supply to the brain is disrupted. The disease can also develop gradually, over a long time, due to the presence of small blocks in the vascular bed (narrowing of the lumens of blood vessels caused by one reason or another) or chronically slow cerebral blood flow.
Alzheimer's Disease: While there are several ways to reduce the likelihood of developing Alzheimer's disease, such as physical activity and keeping your mind active, we still don't know what causes Alzheimer's disease. The prevailing view in medicine today is that there are many components that can contribute to the development of Alzheimer's disease - such as genetics, lifestyle, and various other factors.
Prevention of Alzheimer's disease
Unfortunately, since this is a progressive and incurable disease, prevention is ineffective and is aimed at increasing immunity and reducing the signs of the disease:
- Diet;
- Prevention of cardiovascular diseases;
- Intellectual loads;
- Getting enough vitamins;
- Fighting bad habits;
- Physical exercise;
- Fighting obesity.
Some foods should be included in the diet, as they have useful and necessary properties: fruits, vegetables, cereals, olive oil, red wine, grapes (namely seeds), cinnamon, coffee. Some of these foods have anti-amyloid properties, while others contain optimal amounts of essential nutrients and minerals.
Symptoms
Cognitive (cognitive) sphere
Vascular dementia: Cognitive abilities often decline suddenly due to a vascular accident in the brain - such as a stroke or transient ischemic attack - and then remain stable at the same reduced level. These cognitive changes are often described as “steps” because cognitive functioning between such rapid changes can be considered stable.
Alzheimer's disease: While cognitive abilities may change somewhat with the onset of the disease, a person's ability to think and use their memory does decline gradually over time. In Alzheimer's disease, as a rule, there is no history of sudden changes in the cognitive sphere (within one day).
Impaired memory and memory retrieval are typical in the early stages of Alzheimer's disease.
Walking and physical movements
Vascular dementia: Often accompanied by physical problems. For example, if your loved one suffered a stroke, they likely have limited mobility on one side of their body. Both cognitive and physical declines associated with vascular dementia usually develop at the same time, as they are often consequences of the same sudden illness, such as stroke.
Alzheimer's disease: The disease often begins with changes in mental abilities, usually represented by memory loss or decreased judgment. However, over time, when the disease enters the second stage, deterioration of physical abilities is also detected, such as the ability to maintain balance or gait.
Dementia, or acquired dementia
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IMPORTANT!
The information in this section cannot be used for self-diagnosis and self-treatment.
In case of pain or other exacerbation of the disease, diagnostic tests should be prescribed only by the attending physician. To make a diagnosis and properly prescribe treatment, you should contact your doctor. Dementia: causes, symptoms, diagnosis and treatment methods.
Definition
Dementia is a neuropsychiatric syndrome based on acquired, long-term (more than 6 months), progressive impairment of the cognitive functions of the brain - thinking, attention, memory, speech, perception of the surrounding reality, purposeful motor activity, orientation in space, recognition of time and places.
A significant decrease in cognitive functions leads to a deterioration in a person’s social, everyday and professional adaptation.
According to statistics, there are about 47 million people with dementia in the world, and by 2050 this number is predicted to increase significantly. Dementia is most common in low- and middle-income countries, where about two-thirds of people with this disorder live.
Causes of dementia
Dementia is most often diagnosed in people over 65 years of age. This syndrome can accompany many diseases and conditions: for example, dementia develops with Alzheimer's disease (AD) - 50-75% of cases, with vascular lesions of the brain - 20%, 5% each for dementia with Lewy bodies and frontotemporal dementia . In 10-15% of all cases, the patient’s dementia is caused by a combination of Alzheimer’s disease and vascular brain damage. The development of the syndrome can be caused by metabolic disorders, traumatic brain injuries, tumors of the brain and its membranes, brain metastases, autoimmune diseases (multiple sclerosis) and neuroinfections (neurosyphilis, neuroborreliosis, etc.).
Identifying the causes of dementia is important for choosing therapy that can slow down the progression of the disease, and in some cases even reverse the development of disorders.
Dementia in Alzheimer's disease
. Alzheimer's disease is a chronic neurodegenerative disease, the mechanism of development of which is not fully understood. Doctors believe that the disease occurs as a result of a combination of several factors, with genetic defects playing a leading role. Up to 10% of all cases of AD occur in familial forms, when pathological genes are inherited. There are currently three known pathological genes that can cause AD. One of the key links is a violation of the metabolism of the amyloid precursor protein. Normally, this protein is broken down into fragments that are not dangerous to the body. In AD, this process “breaks down”, and the fragments combine into the pathological protein β-amyloid, which is deposited in the brain substance and the walls of blood vessels, which leads to damage and death of brain cells.
Risk factors for the development of asthma are divided into correctable and non-correctable (those that cannot be influenced). In addition to genetic factors, uncorrectable factors include age, female gender, previous traumatic brain injuries, depression, lack of higher education, and low intellectual activity throughout life.
Correctable factors are arterial hypertension, atherosclerosis of large vessels of the head and neck, obesity, high cholesterol, high homocysteine, diabetes, and a sedentary lifestyle.
Dementia due to cerebrovascular diseases (vascular dementia). Vascular dementia can be caused by a stroke or chronic cerebral ischemia. The main risk factors are arterial hypertension, atherosclerosis, coronary heart disease, cardiac arrhythmias, diabetes mellitus, smoking, obesity, high cholesterol, high homocysteine levels, and less commonly, rheumatic vascular lesions, pathologies of the blood coagulation or anticoagulation system, and congenital vascular anomalies.
Classification of the disease
There are three main degrees of severity of dementia – mild, moderate and severe. Sometimes a preclinical stage is distinguished, when initial signs of an intellectual-mnestic disorder are noted - constant mild forgetfulness, difficulties in determining temporary relationships, while social and professional activity is preserved or slightly hampered, and everyday activity is not impaired.
At the stage of mild dementia, memory impairment (especially for current events) intensifies and becomes obvious to others, and difficulties arise in chronological and geographical orientation. Abstract thinking, the ability to generalize and compare suffers. Oral speech becomes poor, and written speech contains a large number of errors. Professional activities and social activity are limited, but still possible; patients cannot travel independently or resolve financial issues, but they retain independence in everyday life, can take care of themselves and live separately.
The stage of moderate dementia is characterized by severe memory impairment, making it difficult to acquire knowledge and remember current events, as well as reproduce past experiences and knowledge. Orientation in time and surroundings is severely impaired. The ability to read and write is lost, oral speech is difficult to understand. It is difficult for patients to use household appliances, carry out hygiene procedures, dress, and prepare food. Typically, at this stage of dementia, people can no longer live independently, but they can still be left alone for some time.
The severe stage is characterized by a complete loss of the possibility of independent existence and the formation of absolute dependence on others.
Patients lose awareness of time and surroundings, the ability to judge, make inferences and verbal communication.
Diagnosis of dementia
First of all, it is necessary to exclude a number of conditions that can either be an independent cause of cognitive disorders or contribute to their aggravation. Among them are anemia of various origins, hematological malignancies, infectious diseases, renal and liver failure, electrolyte disturbances, including those associated with taking medications, in particular hyponatremia, thyroid dysfunction, etc.
For this reason, differential diagnosis includes the following studies:
- general blood analysis;
Diagnostics
Vascular dementia: Some psychological tests can help assess your loved one's memory, judgment, communication and general cognitive abilities. In addition to these tests, MRI (magnetic resonance imaging) of the brain can clearly show the specific area of the brain that was damaged due to a stroke or transient ischemic attack.
Alzheimer's disease: Similar cognitive testing is used for Alzheimer's disease. Otherwise, this disease is diagnosed by excluding similar pathologies, since at present it is impossible to establish an accurate diagnosis by any instrumental or hardware research, for example, by scanning the brain. There is currently no reliable diagnostic test to diagnose Alzheimer's disease, so doctors rule out other, reversible causes of the disorder - such as vitamin B12 deficiency or hydrocephalus with normal intracranial pressure, as well as other types of dementia or delirium.
Dementia treatment
Despite numerous studies and increased attention from the scientific community to this disease, there is no cure for dementia yet. Medicines are at various stages of clinical trials. It is important to diagnose the disease as early as possible, take care of the patient’s physical health, and, for prevention, train one’s cognitive abilities.
For example, in dementia due to Alzheimer's disease, cholinesterase inhibitors and memantine are used to relieve cognitive symptoms. The patient may be prescribed medications to manage behavioral or psychotic symptoms.
Research shows that the risk of disease can be reduced by exercising regularly, giving up bad habits (smoking, alcohol), controlling your weight, eating right and monitoring your blood pressure, cholesterol and blood sugar levels. Other risk factors for developing this disease include depression, low education, social isolation and lack of cognitive activity.
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Forecast
Vascular dementia: Due to the huge variety of causes of damage and the varying severity of these damage in brain structures, it is difficult to predict life expectancy for patients with vascular dementia. The progression of vascular dementia depends on a number of factors, including the extent of damage to the brain.
Alzheimer's disease: The average life expectancy for people with Alzheimer's disease is 84.6 years, and the life expectancy after the first symptoms appear is 8.4 years.
Sources:
Alzheimer's Association. Risk Factors. Accessed July 31, 2012. https://www.alz.org/alzheimers_disease_causes_risk_factors.asp
Alzheimer's Association. Vascular Dementia. Accessed June 26, 2012. https://www.alz.org/dementia/vascular-dementia-symptoms.asp»>https://www.alz.org/dementia/vascular-dementia-symptoms.asp
Clin Interv Aging. 2006 September; 1(3): 229-235. Vascular dementia: prevention and treatment. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2695177/
Geriatrics and Aging. 2007;10(1):36-41. Vascular Dementia and Alzheimer's Disease: Diagnosis and Risk Factors. Accessed July 31, 2012. https://www.medscape.com/viewarticle/555220_1
https://alzheimers.about.com/
All materials on the site are presented for informational purposes only, approved by a certified physician, Mikhail Vasiliev, diploma series 064834, in accordance with license No. LO-77-005297 dated September 17, 2012, a certified specialist in the field of psychiatry , certificate number 0177241425770.
