Here’s what you need to know about Alzheimer’s, the most common dementia

Alzheimer’s is the most common neurodegenerative disease in the world. According to the World Health Organization (WHO), it is estimated that 35.6 million people have the condition, a number that tends to double by 2030 and triple by 2050. According to the Ministry of Health, about 1.2 million of people suffered from the disease in 2021 in Brazil and 100,000 new cases are diagnosed each year.

Dementia is characterized by the loss of cognitive functions such as memory, orientation, attention and language, and is caused by the death of brain cells. According to neurosurgeon Marcelo Valadares, a physician at Hospital Israelita Albert Einstein and a researcher at Unicamp, people with Alzheimer’s have an accumulation of two proteins, called beta-amyloid and Tau.

In excess, substances cause inflammation, disorganization and destruction of cells, especially in brain regions such as the hippocampus and cortex. The affected areas are mainly responsible for the formation, order and storage of new memories.

However, there is no consensus. In an article published on the Science Alert website, Canadian scientists suggest that dementia is not even a disease of the brain, but an autoimmune condition that attacks the cells of the organ.

O metropolises talked to two doctors to list the main information that is already confirmed about Alzheimer’s. Check out:

1. What are the causes of Alzheimer’s?

Despite being a much studied area, the cause of Alzheimer’s is still unknown. Valadares comments that, for the time being, it is believed that genetic aspects influence the development of the disease, increasing the risk, but they are not decisive. Recent studies show that comorbidities and the patient’s social situation can also influence the degeneration of brain cells.

“The most important risk factors are low education, high blood pressure, obesity, hearing loss, depression, diabetes, physical inactivity, smoking and social isolation. It is a combination of these factors”, points out geriatrician Jean Pierre de Alencar, vice president of the Brazilian Association of Alzheimer’s Regional São Paulo (ABRAz-SP).

2. Is it possible to prevent?

According to Alencar, several studies show that controlling risk factors, such as cholesterol and hypertension, for example, can prevent the development of dementia.

“Doing physical activity, at least 150 minutes a week, is recommended. We also encourage the Mediterranean diet, which cuts down on foods with saturated fat and a high glycemic index, associating food with the consumption of nuts, olive oil, fish and lean meats, whole grape juice or a glass of wine, and colorful fruits and vegetables” , teaches the doctor.

He reminds us that, in addition, it is essential to keep the brain working. Therefore, engaging in activities that stimulate cognitive function — such as crosswords, puzzles, learning a new language, playing a different instrument, and studying — is important for increasing neural connections and preventing neurodegeneration.

Valadares adds that the disease has no cure and, although early diagnosis is desirable, it is not enough to guarantee that symptoms will not progress. As there are still no tools or drugs capable of resolving or blocking the evolution of the disease, identifying it as early as possible only allows care to be implemented more quickly, guaranteeing a better quality of life for the patient.

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3. How is the evolution of the disease?

The evolution of Alzheimer’s and the response to treatment vary from case to case. In some patients, symptoms may improve with specific medications; in others they remain stable. But the neuroscientist says that there are also patients who do not respond to therapies. In these cases, the medication can be adjusted or changed.

The disease is classified into three stages:

  • Initial phase: the patient has mild symptoms and, for this reason, the diagnosis is often not made. “Alterations such as loss of recent memory, difficulty in finding words, exemption in time and space and difficulty in making decisions can be observed”, explains Alencar;
  • Second (or intermediate) phase: the absence of memory already exists and is stronger. At this stage, there are simpler behavior changes, such as forgetting the name of close people, aggressiveness, irritability, inability to cook and take care of the house, hallucinations and distrust;
  • Third phase: there is impairment of social functions in a more aggressive way. “In the last stage, the patient often has difficulty controlling urine, swallowing food, and is often confined to bed,” says Valadares.

4. Do all people have Alzheimer’s or dementia as they age?

According to the neurosurgeon, no. Despite being a disease commonly diagnosed with aging, not every elderly patient will necessarily have Alzheimer’s or other dementias. He states that the disease usually appears after the age of 65 and, when it affects people below this age, it is called early Alzheimer’s.

5. Is Alzheimer’s more common in women?

Yup. According to Valadares, about 70% of patients diagnosed with Alzheimer’s are female. In July 2022, research carried out by American scientists identified the presence of a gene that appears to increase the risks of neurodegeneration in women, which may help to explain why females are the most affected by the disease.

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