Senile Dementia: Can it be prevented?

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


It is estimated that in Spain there are currently between 600,000 and 1 million patients diagnosed with Alzheimer's disease, the main type of dementia after 65 years of age. Every year in our country are almost 100,000 new cases of the disease in what has been described almost as an epidemic, which so concerns society, experts and authorities.

Can we prevent dementia?

That is the question, in capital letters. This article will briefly review some important facts of dementia, later to focus on the disease prevention measures 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 relationship with a patient suffering from the disease increased 3 times the risk of contracting it. This relationship is especially true in cases where the disease appear early, ie in younger people. It was found that women at increased risk of Alzheimer's disease than men.

A low educational level is a known risk factor for developing Alzheimer's disease. The head trauma with loss of consciousness also increase the risk. Finally, there is evidence that atherosclerosis is a risk factor for both Alzheimer's disease to another type of dementia called vascular.

Parkinson's disease, such as common neurological disorder in the elderly and characterized among other signs and symptoms the appearance 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 it manifests?

Alzheimer's disease, the main type of dementia which is discussed mainly in this article, most often affects people over 65 years. Basically it is a serious disorder, progressive in nature, the functioning of the brain with impaired memory, thought process, speech and behavior. Its causes are not well known yet, although we know that there are significant structural and chemical changes in the brains of people who have it. These changes hamper the ability to process, store and retrieve information.

The clinical manifestations of the disease are highly variable and change as the condition progresses. At first common mood swings and personality. Later, see a recent memory impairment and difficulty finding the words you want. These changes may be subtle and unconsciously adapt the family can contribute to this decline in delayed recognition. Finally, affect other functional capabilities and problems arise, for example, driving a car, bring your own financial accounts, hygiene and meals, etc.. Displayed a gradual deterioration of language, disorientation in time and space, impaired ability to judge and difficulty recognizing even the members of his family. They often appear also psychiatric symptoms including paranoia, psychomotor agitation, irritability and frustration, anxiety , insomnia , inappropriate social behavior, hallucinations, etc..

Mild cognitive impairment

Mild cognitive impairment is a cognitive disorder located between the normal forgetfulness or physiological memory that occur with age and dementia. In this situation the patient, their family or doctor detect memory complaints, the patient remains normal daily activity (autonomy, ability to live alone), although there are difficulties in performing daily activities complex, there is an objective memory impairment, although global cognitive function is normal and is discarded by the different dementia clinical trials.

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

Preventive measures of dementia

in recent years and because they are not well known causes of Alzheimer's disease, has placed great emphasis on early diagnosis of the disease rather than preventive treatment or slow 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 decline. In particular, it was found that some drugs and lifestyles that protect the heart may also have their role in preventing this disease. Currently under investigation and measures many other drugs that briefly discussed below:

• Some epidemiological studies have suggested that NSAIDs protect against development of Alzheimer's disease, although no conclusive evidence. In addition, other studies have linked long-term use of these drugs with the preservation of cognitive function and prevention of early cognitive impairment and a decreased incidence of Parkinson's disease. Some researchers, until you provide more conclusive data, have proposed a low dose 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 treatment has not proven anything.
  
  
• Some studies have suggested that the use of a statin, a drug commonly used to reduce blood cholesterol, may prevent the development of dementia.
  
  
• It is proposed that antioxidants like vitamin E may be beneficial to delay disease progression in patients with established Alzheimer's disease. This substance could be delivered through the diet or supplements. Although no reliable data to suggest that taking vitamin prevent Alzheimer's disease, given their low risk, it could take 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.
  
  
• The high pressure 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 patients 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 may be important to reduce the risk of Alzheimer's disease.
  
  
• Although some preliminary epidemiological studies suggested that hormone replacement therapy could prevent prevent dementia, seems finally that it is not and may even increase it so now his administration is not recommended for prevention of dementia.
  
  
• The physical activity and exercise can help maintain cognitive function, as demonstrated by scientific studies.
  
  
• Likewise, 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, social activities and behaviors, and reducing stress are useful measures to keep the mind active and energetic.
  
  
• 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 may increase, although there is a clear and do a lot of controversy about .
  
  
• Data on alcohol use and risk of dementia are also confusing. While alcoholism is associated with cognitive dysfunction, there is abundant evidence to suggest that light to moderate consumption of alcohol may be protective.
  
  
• Research on animals have shown that vaccines derived from proteins found in the brains of animals suffering from this disease may be able to not only slow the progression of brain damage but even reverse it. In any case, these investigations are not available for human application until several years, although the findings are promising.
  
  

In conclusion, most data on dementia prevention comes from observational studies. Are currently being developed intervention prospective studies will clarify some of the questions raised so far. Meanwhile it has been proposed only for preventive administration of vitamin E and low dose of ibuprofen.