Dementia beyond Alzheimer’s disease – 06/19/2022

Not so long ago, the diagnosis of dementia was understood to be a natural result of aging, provided by the hardening of arterial blood vessels and compromised oxygenation and nutrition to the brain. Thus, an elderly person who gradually evolves with forgetfulness and difficulty articulating ideas would be diagnosed with senile dementia.

Although physician Alois Alzheimer in 1906 described microscopic brain changes in and around neurons in the brain of a patient who died at the age of 56 with dementia, it was only three decades since we understood that it was the most common cause of dementia.

However, it didn’t take long for us to start making a new conceptual error, as any deficit in memory and thought conjugation would begin to be diagnosed with Alzheimer’s disease.

The fact is that Alzheimer’s disease is responsible for about two-thirds of dementias and unfortunately there is not much that can be done to reverse its course, while the rest have vascular, depositional, toxic causes. , traumatic, as well as other degenerative diseases.

Vascular involvement is the second most common cause of dementia, ranging from microvascular damage promoted by smoking, diabetes, dyslipidemia (high cholesterol and triglyceride levels) and hypertension, to ischemic and hemorrhagic strokes resulting from the same disorders noted above.

The third most common cause of dementia results from changes in the structure of synuclein, a protein found in neurons involved in cognition, promoting rounded deposits called Levy bodies. The gradual accumulation of Levy bodies will cause these nerve cells to completely malfunction, however, as with Alzheimer’s disease, there is little that can be done other than supportive measures.

Nerve tissue toxicity caused by excessive and chronic consumption of alcohol (and other drugs), frequent head trauma, as seen in some sports, including boxing (and derivatives) and other specific diseases, represent the remaining causes of dementia.

At least for vascular causes, there is a lot we can do to prevent these outcomes, as they come from treatable conditions, however, many studies suggest that care with diet, exercise, sleep and not smoking, the gold standard of vascular protection, protect us. also develop Alzheimer’s disease.

At a time when smoking is declining dramatically, while the use of other drugs and hormones of all kinds has proportionally increased many times over, it is hard to imagine what future old age will be like.

Be that as it may, aging is a privilege, which will only reach its full potential for a few. I take this opportunity to quote Millôr Fernandes: “Any idiot can be young. It takes a lot of talent to grow old.

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