SARAH’S SURGERY
DEMENTIA: WHAT YOU NEED TO KNOW
‘The focus of research is on detecting early brain changes’
Are you, or a loved one, forgetting names, faces and places? Dr Sarah Brewer explains the risk factors for Alzheimer’s and what we can do to protect ourselves
Dementia is an umbrella term used to describe a progressive loss of cognition, with Alzheimer’s disease accounting for up to 75% of cases. Worldwide, around 50m people have dementia and numbers are steadily increasing. It has been estimated that as many as one in three of those born in the UK today will develop it during their lifetime.
The average adult brain contains around 86bn nerve cells (neurons) that are connected via synapses. In Alzheimer’s disease, connections are lost due to a build-up of abnormal tau protein tangles inside brain cells and amyloid protein (plaques) outside cells, which causes their demise.
This month, Dementia Action
Week (17 to 23 May) aims to raise awareness of the condition and improve the lives of those affected.
WHAT ARE THE SYMPTOMS?
The first sign is usually mild forgetfulness when trying to remember recent events or the names of people or familiar things, while long-term memories may be unaffected. Solving simple sums or finding the right words may become difficult. Although these symptoms are normal in older people, and in those who are over-worked or stressed, in someone with Alzheimer’s disease they become noticeably worse with time, leading to confusion and problems with self-care and daily activities. This can lead to anxiety, mood swings and sometimes aggressiveness. Persuading someone they need help isn’t always easy, says the Alzheimer’s
Society. If a loved one is reluctant, try suggesting they go for a general medical check-up; it is often easier for you both.
Abnormal tau and amyloid protein can be detected in the brains of people who will go on to develop Alzheimer’s disease as much as 20 years before symptoms start, according to Dr Emer Macsweeney, CEO and medical director at Re:cognition Health (recognitionhealth.com). The focus of research is on detecting these early changes and finding new treatments that can slow or even stop the disease progressing.
Current drug treatments are not that effective as they only help dying brain cells to work more efficiently. But, says Dr Macsweeney, there is reason to be cautiously optimistic, as several new drugs are in development that may help to stop brain cells from dying in the first place. These include monoclonal antibodies that increase the removal of amyloid protein from the brain or dissolve abnormal tau protein as it spreads from one cell to another. Other approaches include drugs with antiviral or anti-inflammatory actions, and one that neutralises a bacterial toxin implicated in the development of Alzheimer’s disease.
DID YOU KNOW? Detector dogs have been trained to ‘sniff out’ Alzheimer’s by smelling odour changes in urine samples.
DOES ALZHEIMER’S RUN IN FAMILIES?
More than 20 gene variants have been identified that increase the risk of Alzheimer’s. These are involved in regulating inflammation, immunity and fat processing but inheriting one of these doesn’t usually mean you will be affected, as many other factors are also involved.
Alzheimer’s can be familial if a particular mutation in a single gene occurs. In these rare cases, symptoms of the disease tend to develop early in life, presenting in people during their 30s, 40s or 50s.
To support dementia action week (17 to 23 May 2021) and for more information and advice, visit alzheimers.org.uk/daw