About the Disease
How common is dementia in China?
According to Wang Haidong, director of the Department of Aging of the National Health Commission in September 2022, Alzheimer's disease is the most important type of Alzheimer's disease. There are about 15 million dementia patients in China among the elderly aged 60 and above, 10 million of whom have Alzheimer's disease.
In recent years, the National Health Commission has carried out a lot of work on social prevention and education of "Alzheimer's disease", such as strengthening knowledge publicity, organizing preventive intervention, and carrying out early screening. Among them, regarding the organization of preventive intervention, Wang Haidong specifically talked about organizing 15 provinces to carry out pilot work on the prevention and intervention of disability (dementia) in the elderly. Psychological care projects for the elderly have been launched in 1,672 urban and rural communities across the country, providing psychological and cognitive status assessments for 580,000 elderly people, and carrying out classified intervention and referral services. Guide the implementation of the yellow bracelet charity campaign to prevent the elderly from getting lost.
What is Alzheimer's disease?
Dementia is a general term that refers to impairment of memory, thinking, or decision-making abilities that affects daily activities. Although dementia primarily affects older adults, it is not a normal part of aging. Alzheimer's disease is the most common form of dementia and is a progressive disease. This neurodegenerative disease mainly affects the cognitive, memory and language centers of the brain, and patients' ability to perform daily activities is significantly reduced. Patients will have progressively worsening cognitive dysfunction. In comparison, Alzheimer's disease is more serious because in addition to cognitive impairment, patients may also develop personality disorders.
Here, we will focus on the symptoms, principles, and causative factors of Alzheimer’s disease, the most common form of dementia. We will also present the causes and treatments of several other types of dementia. We have also attached several websites so that you can follow the latest scientific research progress in this field at any time.
Alzheimer's disease
1. What is Alzheimer’s disease?
The most common type of dementia, it is a progressive disease that initially manifests as mild memory loss but, over time, affects the patient's ability to interact and adapt to their surroundings. This neurodegenerative disease typically affects the cognitive, memory and language centers of the brain. As the condition worsens, the patient's ability to perform daily activities decreases significantly.
2. 10 early warnings
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Memory loss that affects daily life: forgetting recently learned information, important dates, or events; relying on memory aids or others to handle tasks you once performed independently.
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Difficulty planning and problem-solving: Difficulty making and following plans, crunching numbers, and completing familiar tasks such as cooking or managing bills.
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Difficulty completing familiar tasks: Having difficulty with everyday tasks, such as driving to a familiar location, organizing a shopping list, or remembering the rules of a favorite game.
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Confusion of time or place: Loss of track of dates, seasons, and passage of time; disorientation or forgetfulness of where one is.
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Difficulty understanding visual images and spatial relationships: Changes in vision leading to balance problems, difficulty reading, problems judging distances, or determining color and contrast.
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New problems with speaking or writing: difficulty following or participating in conversations, finding the right words, using wrong names for familiar objects.
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Misplacement of items and loss of traceability: placing items in unusual places, losing items, and being unable to recall steps to find them; accusing others of theft.
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Diminished or worse judgment: Changes in decision-making and judgment, such as making poor financial choices or neglecting personal discipline.
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Withdrawal from work or social activities: Difficulty holding and following conversations, leading to withdrawal from hobbies, social activities, or favorite activities.
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Mood and personality changes: Mood swings, confusion, suspicion, depression, fear, anxiety, and a tendency to become irritable or irritable when routines are disrupted.
3. Symptoms and Characteristics
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Memory problems: One of the classic hallmarks of Alzheimer's disease is the inability to retain and recall new knowledge. Sufferers may put objects in unexpected places, say the same words and questions repeatedly, and forget details of conversations, appointments, and activities.
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Difficulties with thinking and reasoning: Alzheimer’s disease can affect thinking and reasoning abilities. Concentration and abstract thinking (such as work with numbers) will gradually become more difficult. Sufferers may find it difficult to multitask and manage their finances, and may struggle to make informed decisions in everyday situations.
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Difficulty with judgment and decision-making (daily tasks): Planning and performing daily tasks, such as cooking or playing games, may gradually become more difficult. Patients may have difficulty planning and performing tasks in sequence. Even simple daily activities, such as dressing and bathing, may eventually be forgotten.
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Behavioral and personality changes: Alzheimer’s disease can cause significant changes in mood, behavior, and social relationships. Patients may experience symptoms such as depression, loss of interest in activities, social isolation, mood swings, distrust of others, anger, violent behavior, changes in sleep patterns, wandering, loss of inhibition, and delusions.
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Preserved skills and characteristics: Despite the effects of Alzheimer's disease on memory and cognitive abilities, patients may retain some skills for a long time. These skills include reading, listening to music, engaging in artistic activities such as crafting or sketching, and sharing memories, and are often controlled by areas of the brain that are damaged later in the development of the disease.
4. Stage of onset
Stage 1: Preclinical Alzheimer’s disease
During this stage, brain changes associated with Alzheimer's disease begin to occur, but there are no obvious symptoms. This is often called the "preclinical" phase and can last 10 to 15 years. Currently, there are no treatments available for this stage, but researchers hope to develop drugs in the future that can prevent the disease before symptoms appear.
Stage 2: Mild forgetfulness
During this stage, individuals may occasionally forget things, such as forgetting names or misplacing items. These forgetfulness are often attributed to normal aging. Individuals can still carry out daily activities, work and socialize. However, the frequency of forgetfulness may increase, and loved ones may notice the changes before the individual does. Early treatment can help slow the progression of the disease.
Stage 3: Mild cognitive impairment/early confusion
During this stage, marked changes in cognitive abilities become more apparent. Memory difficulties go beyond simple forgetfulness and may include difficulty remembering recent information, difficulty organizing tasks, and challenges socially or at work. This stage often leads to diagnosis because it disrupts the individual's daily life. Seeking medical advice and exploring treatment options becomes critical at this stage.
Stage 4: Moderate Cognitive Decline/Moderate Alzheimer’s Disease
During this stage, memory loss becomes more severe and other aspects of cognition are affected. Individuals may experience difficulties with language, organization, and calculation. They may have difficulty recalling important details from their lives, including recent events and conversations. Daily tasks, like dressing appropriately or knowing the day and location, become increasingly challenging. Personality changes, increased confusion, and sleep disturbances may also be observed.
Stage 5: Moderate to Severe Cognitive Decline/Mid-to-Advanced Alzheimer’s Disease
During this stage, the individual's independence decreases significantly. The individual may have difficulty recognizing close family members and have difficulty learning new things. They may need help with basic tasks such as dressing. Mood changes, hallucinations, delusions, and paranoia may occur during this stage. Communication becomes more difficult, although some words and phrases can still be used. Symptoms can be managed with medications and behavioral strategies.
Stage 6: Severe Cognitive Decline/Advanced Alzheimer's Disease
During this stage, the individual is highly dependent on others for care. They may have difficulty reacting to their environment and have difficulty communicating. Personality changes, increased anxiety, hallucinations, delusions, and paranoia may still be seen. Physical and mental impairments worsen, requiring round-the-clock care.
Stage 7: Very Severe Cognitive Decline/End-stage Alzheimer’s Disease
In this final stage, the individual loses the ability to communicate effectively and control body movements. The physical and mental damage was severe and extensive care was required. Basic functions such as walking, sitting, and swallowing become increasingly difficult. Due to reduced exercise capacity, the risk of infection (such as pneumonia) is increased. Take supportive measures to ensure comfort and prevent complications.
5. Causative factors
Factors that increase the risk of Alzheimer's disease include:
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age
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family history
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down syndrome
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head injury
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Cardiovascular diseases
Lifestyle and other issues related to Alzheimer's disease risk include:
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smoking
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overweight
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have diabetes
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have high blood pressure
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have high cholesterol
6. Prevention methods
The following activities may reduce your risk of Alzheimer's disease and other forms of dementia:
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read
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learn foreign language
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Musical instrument
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Participate in community contribution
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Play a team sport
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Explore new interests
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Maintain a rich social life
Other dementia
1. Other types of dementia
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Vascular Dementia is dementia caused by problems with the blood supply to the brain, usually as a series of mild strokes, leading to progressive cognitive decline. This term refers to a syndrome consisting of a complex interaction of cerebrovascular disease and risk factors that lead to structural changes in the brain caused by stroke and injury and lead to cognitive changes. The temporal relationship between stroke and cognitive deficits warrants diagnosis.
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Lewy body disease, Lewy body (Lewy body) is a characteristic marker in the brain of patients with Lewy body disease represented by Parkinson's disease. Under the microscope, it is a round pink homogeneous structure.
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Frontotemporal dementia is a group of dementia syndromes characterized by frontotemporal lobe atrophy, including Pick disease and Pick syndrome with similar clinical manifestations, which in turn includes frontal lobe dementia and primary progressive aphasia. Clinically, it is characterized by significant personality, behavioral changes, and cognitive impairment.
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Huntington’s disease (HD) is a rare autosomal dominant genetic disease. Patients typically present in middle age and experience motor, cognitive, and psychiatric symptoms. The clinical symptoms of Huntington's disease are complex and changeable, and patients' condition worsens progressively, and patients usually die 15 to 20 years after the onset of disease. The disease has an insidious onset, slow progression, dance-like movements accompanied by progressive cognition, mental dysfunction and eventually dementia. The cause is the misexpression of polynucleotide repeats on the huntingtin gene, which affects different molecular pathways and ultimately leads to neurological dysfunction and degeneration.
The Mini-Mental State Examination (MMSE) is one of the most influential cognitive impairment screening tools compiled by Folsten in 1975. When evaluating, the subjects should be asked directly. If you are conducting an investigation in the community, be careful not to allow other people to interfere with the inspection. The elderly may easily become discouraged or give up, so you need to be encouraged. An inspection takes 5-10 minutes.
The test has high sensitivity and specificity for diagnosing dementia, but is not sensitive enough for identifying mild cognitive impairment (MCI). Moreover, there are also many highly educated mild patients who do not feel well about the questions in the MMSE. The MMSE can be used for follow-up of AD. Its total score decreases by an average of 2 to 4 points every year, and the full score is 30 points.
2. Treatment methods
There is no cure for dementia, but there are treatments that can help relieve dementia symptoms.
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medical treatement:
Acetylcholinesterase inhibitors (donepezil, ritazol, galantamine): These drugs block the breakdown of acetylcholine in the brain and improve communication between nerve cells. They are commonly used to treat mild to moderate Alzheimer's disease and may also be effective in Lewy body disease and Parkinson's disease dementia.
Memantine (also known as antigravir): This drug blocks excessive levels of glutamate in the brain and is used to treat moderate to severe Alzheimer's disease and Lewy body disease dementia.
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Treatment related diseases:
Conditions such as stroke, heart problems, diabetes, high blood pressure, high cholesterol, chronic kidney disease, and depression can affect the symptoms of dementia, especially vascular dementia. It is important to treat these underlying conditions.
In the later stages of dementia, behavioral and psychological symptoms may occur, including restlessness, anxiety, aggression, delusions, and hallucinations. Coping strategies should be used first, but if these strategies don't work, doctors may prescribe antipsychotic medications (such as risperidone or haloperidol) to manage ongoing aggression or extreme distress. If depression is suspected as a potential cause of anxiety, antidepressant medication may be considered.
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Alternative treatments:
Adjuvant therapies such as ginkgo leaf extract, curcumin, and coconut oil are sometimes used, but there is currently insufficient evidence to support their effectiveness. Consult your doctor before trying any alternative treatments as they may interact with medications you are already taking and are not intended to be used as replacements.
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Non-drug treatments:
Cognitive Stimulation Therapy (CST): Group activities and exercises designed to improve memory, problem-solving and language skills.
Cognitive Rehabilitation: Work with professionals to achieve personal goals and improve daily functioning.
Memories and Life Story Work: Discuss past events and create a chronicle of memory through photos, notes and keepsakes. These methods improve mood, well-being, and focus on individual skills and achievements.
Research progress
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Alzheimer's Disease Research Institute
The Alzheimer's Disease Research Institute is based on Xuanwu Hospital of Capital Medical University as its main supporting unit. The Department of Neurology at Xuanwu Hospital of Capital Medical University is one of the earliest and largest neurology departments in China.