Here, a neurologist discusses the landscape of dementia and Alzheimer’s disease, available treatments, genetic dementia and ways you can help strengthen your cognitive function.
Perhaps the greatest fear of aging is the loss of cognitive function, known as dementia. Cognitive function refers to memory, language, the ability to perform one’s usual daily activities, like dressing, bathing, using appliances, driving, and food shopping, as well as planning.
With no known cure and few therapies, coupled with an aging population, dementia and Alzheimer’s, its most common disease in the U.S., has a staggering effect on patients, their families, and the American healthcare system.
It is estimated that 5-8% percent of adults 65 and up will experience
dementia in their lifetime, with 10 million new cases worldwide every year. By 2030, experts predict 82 million cases, and a whopping 152 million by 2050.
Neurologist Jay Klazmer, DO, DAPN, treats patients with dementia. He explains that there are other diseases besides Alzheimer’s disease (AD) categorized as dementia. “Vascular dementia is a close number two to AD. It usually develops after a stroke,” says Dr. Klazmer. Frontotemporal Dementia and Lewy Body Dementia are two other forms of dementia.
Diagnosing dementia and treatment
According to Dr. Klazmer, these forms of dementia present differently. A blood test may be used to exclude a secondary, potentially treatable, medical cause for dementia. Additionally, a brain MRI can exclude other secondary and potentially treatable brain causes for dementia, such as a subdural hematoma, brain tumor and stroke(s).
Despite the advances in cancer and heart care, dementia has eluded researchers. “Currently available FDA-approved medications for Alzheimer’s disease have only mild symptomatic improvement early on without any effect on progression, says Dr. Klazmer, “but there is currently no cure for Alzheimer’s disease.”
Early in June, the FDA approved a new drug – the first in 18 years — called aducanumab (marketed as Aduhelm) which targets an abnormal protein in the brain and must be administered early in the disease process.
Aduhelm received an accelerated approval pathway by the FDA, with a mandated new clinical trial study required to help establish its benefit given the disagreement over the data and the different results reported from the two previous completed clinical trials.
How to discuss dementia with a family member
For those who suspect dementia in a loved one, having that conversation can be difficult but necessary. Dr. Klazmer recommends using diplomacy and kindness since many people do not have an awareness of their symptoms and are often in denial.
The first step medically is to make an appointment with their primary care provider. Sometimes cognitive problems are the result of medications or a treatable medical problem, which should be excluded prior to seeing a neurologist, advises Dr. Klazmer.
Genetic dementia and dementia prevention
If your parent has dementia, are you destined for the same fate? “Most people do not have genetic dementia,” says Dr. Klazmer, “and there is no way to tell for certain if one does. A small number will carry a genetic marker but that still does not mean you will definitely get it. The incidence of new cases of dementia with a positive family history in a parent or sibling increases from 2% (without a family history) to 2.6% per year.
What can adults do to proactively avoid dementia or Alzheimer’s disease? Dr. Klazmer recommends engaging in brain-stimulating activities, such as reading, puzzles, learning a new language, and playing Scrabble™.
“Get enough sleep, attend educational activities/classes/lectures, obtain regular aerobic exercise – 45-60 minutes a day four times a week – assuming no medical contraindication, take care of yourself medically, make social connections a priority and consider starting the Mediterranean Diet, which features plant-based food,” says Dr. Klazmer.
Environmental factors that may increase Alzheimer’s are cigarette smoking, pesticides and a Vitamin D deficiency.
Another potential way to ward off dementia is meditation and what is referred to as “spiritual fitness.” [Editor’s Note: Read more about spiritual fitness and how meditation can quite literally reverse cognitive decline here.]
“Whatever you can do to live a healthier lifestyle and keep your brain sharp as you age will bode well for you in the future,” says Dr. Klazmer. “Current and future research will lead to treatments that can delay the disease and improve lives.”