5/ Neurodegeneration

[ SPOTLIGHT / TORONTO ]

Dr. Howard Chertkow is a cognitive neurologist at Baycrest’s Rotman Research Institute and scientific director of the Canadian Consortium on Neurodegeneration in Aging.

“Many dementias can be prevented. It appears that if nine lifestyle factors were corrected, there would be about 30 per cent fewer people with dementia.

These are: low levels of education, mid-life hearing loss, physical inactivity, high blood pressure, Type 2 diabetes, obesity, smoking, depression and social isolation. The question is can people actually control these factors?

“There is no single brain abnormality and, therefore, no single cause behind most cases of dementia. This means effective therapies will need to be combinations of drugs. Targeting the brain’s ‘resistance’ to these dementias is important and should include managing medical conditions such as kidney disease and sleep apnea, which can affect brain health, regularly getting a good night’s sleep and keeping fit.

“While amyloid protein – the most common brain abnormality seen in Alzheimer’s disease – is no longer considered the sole cause, it plays a big role and anti-amyloid drugs should help, particularly early on in the disease. Up till now, however, anti-amyloid drugs have failed in large human trials. In December 2019, Biogen announced a drug, Aducanumab, had finally been found that slows progression of cognitive decline in people with very early Alzheimer’s disease by about 25 per cent. This is good news and suggests that we have turned the corner in the search for effective treatments.”

THE FUTURE

Researchers at Sweden’s Karolinksa Institutet have come up with a simple tool to show life expectancy after a dementia diagnosis, helping patients, caregivers and family to prepare.

The prognosis is based on various factors, including sex, age, cognitive ability and the category of dementia (Alzheimer’s disease, for example, doesn’t progress as fast as other dementias).