Dementia Alzheimer
Causes
There are several causes of dementia, depending on the location and severity of brain damage.
- Alzheimer’s disease: Most common, caused by the accumulation of abnormal proteins in the brain.
- Cerebrovascular disease: Caused by inadequate blood supply to the brain.
- Parkinson’s disease: Degeneration of nerve cells in the central brain
- Lewy body dementia: Caused by the accumulation of abnormal Lewy body proteins in the brain.
- Other forms of dementia: Such as Huntington’s disease, Pick’s disease.
- Other causes: Such as nutritional deficiencies, infections, head injuries.
Risk factors
- Increasing age, with higher risk in people aged 65 and older.
- Genetics Several genes are associated with dementia, especially Alzheimer’s disease, such as APP involved in amyloid protein production, GRN related to nerve cell growth and function, TREM2 associated with the brain’s immune system.
- Chronic diseases, such as heart disease, high blood pressure, diabetes, high cholesterol, kidney disease, obesity.
- Smoking
- Lack of physical exercise
- Depression
- Brain injuries, such as falls from heights, head trauma, stroke or ruptured brain blood vessels.
- Chemicals in daily life
- Heavy metals like lead (in paint, batteries, contaminated water), pesticides, aluminum.
- Insecticides
- Tinners, gasoline
- Carbon monoxide gas from exhaust fumes
- PM 2.5 dust
Symptoms
- Memory loss, forgetting recent events, missing appointments.
- Difficulty speaking or communicating, difficulty finding words.
- Confusion, disorientation, problems with analysis and planning.
- Getting lost, losing track of places.
- Mood swings, irritability, easily getting upset, depression.
- Loss of daily living skills.
Diagnosis
Diagnosing dementia often requires the collaboration of multiple specialists. Generally, doctors will:
- Take a medical history:
- Ask about symptoms such as memory loss, difficulty speaking, getting lost, mood swings.
- Inquire about chronic diseases, medication use, various risk factors like genetics, smoking.
- Ask about social history, family, and work.
- Physical examination:
- Measure blood pressure, general vital signs.
- Examine the nervous system, such as posture, walking, response to stimuli.
- Cognitive Assessment:
– Short-term and long-term memory tests
– Analytical thinking and problem-solving assessment
– Language usage and communication evaluation
– Screening tools for dementia such as MMSE (Mini-Mental State Examination)
– Cognitive ability tests such as MoCA (Montreal Cognitive Assessment)
– Further Evaluation:
– Blood tests to identify other potential causes such as thyroid disorders, vitamin deficiencies
– Brain imaging with CT or MRI to detect structural abnormalities
– PET scan or SPECT scan to assess brain function
Treatment of Dementia with Medication:
Currently, there is no cure for dementia, but medication plays a crucial role in delaying symptoms and alleviating disease severity. Medications used to treat dementia include:
1. Cholinesterase Inhibitors:
These drugs help increase the neurotransmitter acetylcholine in the brain.
Suitable for patients with early to moderate stages of Alzheimer’s disease.
Examples: Donepezil (Aricept), Rivastigmine (Exelon), Galantamine (Reminyl)
2. Memantine:
This drug helps protect brain cells from damage.
Suitable for patients with moderate to severe stages of Alzheimer’s disease.
Example: Memantine (Namenda)
3. Other Medications:
Antidepressants: Help alleviate symptoms of depression that may occur alongside dementia.
Mood stabilizers: Help control mood swings and behavior.
Sleep aids: Help improve sleep quality.
Other Treatment Approaches:
– Cognitive training such as card games or chess
– Rehabilitation activities like singing therapy, art therapy, group activities
– Physical therapy to improve blood circulation
– Exercise to increase blood flow
– Meditation
– Nutritional care
– Mental health care
– Brain stimulation with magnetic waves and low-energy pulse waves (Transcranial Magnetic Stimulation and Transcranial Pulsed stimulation)
