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What Are The Comorbidities That Are Ruled Out Because of Alzheimer’s?

What Are The Comorbidities That Are Ruled Out Because of Alzheimer’s?
What Are The Comorbidities That Are Ruled Out Because of Alzheimer’s?

We spoke to Dr. Raj Agarbattiwala, Consultant Neurosurgeon, Masina Hospital, Mumbai, on the topic. Here's what the doctor wants you to know.

Written by Satata Karmakar |Published : September 22, 2021 1:34 PM IST

Alzheimer's disease is the most common form of dementia characterized by progressive degeneration of cognitive abilities. Its symptoms range from forgetfulness in its early stages to loss of speech and immobility in its late stages. However, Alzheimer's differs from other geriatric diseases in that its early symptoms are often confused with that of old age and its onset is often missed. According to the Dementia India Report 2010 by the Alzheimer's and Related Disorders Society of India (ARDSI), there were around 3.7 million Indians with dementia in 2010 with the number projected to rise to 7.6 million by 2030. General awareness about Alzheimer's disease remains low throughout the country and even lower in rural and underdeveloped areas. There is an urgent need to increase awareness about dementia in general, and about the early symptoms of Alzheimer's disease in particular. Family members and primary care physicians are best placed to recognize these early symptoms and hence, a national awareness campaign targeted towards them is likely to have the most effect. TheHealthSite.com spoke to Dr. Raj Agarbattiwala, Consultant Neurosurgeon, Masina Hospital, Mumbai, on the topic. Here's what the doctor wants you to know.

The Onset of Alzheimer's and the precautions to take:

World Health Organization (WHO) strongly recommends physical activity, quitting smoking, and managing hypertension and diabetes to reduce the risk of cognitive decline and dementia. Many factors that increase the risk of cardiovascular disease are also associated with a higher risk of dementia. These factors include smoking and diabetes. Midlife obesity, hypertension, prehypertension (systolic blood pressure from 120 to 139 mm Hg or a diastolic pressure from 80 to 89 mm Hg), and high cholesterol are associated with an increased risk of dementia. Intensive medical treatment to reduce blood pressure may safely decrease the occurrence of mild cognitive impairment and dementia in older adults who have hypertension. A heart-healthy diet, which emphasizes fruits, vegetables, whole grains, fish, chicken, nuts, and legumes while limiting saturated fats, red meat, and sugar, is associated with a reduced risk of dementia.

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How does Alzheimer's disease impact the nervous system?

People with more years of formal education are at lower risk for Alzheimer's and other dementias than those with fewer years of formal education. Researchers believe that having more years of education builds "cognitive reserve." Cognitive reserve refers to the brain's ability to make flexible and efficient use of cognitive networks (networks of neuron-to-neuron connections) to enable a person to continue to carry out cognitive tasks despite brain changes. Individuals with the APOE-e4 risk gene had a decreased risk of developing dementia if they had more years of early life education, had mentally challenging work in midlife, participated in leisure activities in late life, and/or had strong social networks in late life.

The Comorbidities associated with Alzheimer's disease:

Traumatic brain injury (TBI) increases the risk of dementia. The risk of dementia increases with the number of TBIs sustained. Even those who experience mild TBI are at increased risk of dementia compared with those who have not had a TBI. Mild TBI is associated with a two-fold increase in the risk of dementia diagnosis. People with a history of TBI who develop Alzheimer's do so at a younger age than those without a history of TBI. Remaining socially and mentally active throughout life may support brain health and possibly reduce the risk of Alzheimer's and other dementias.

Remaining socially and mentally active might help build cognitive reserve, but the exact mechanism by which this may occur is unknown.

It is important to note that "reducing risk" of cognitive decline and dementia is not synonymous with preventing cognitive decline and dementia. Individuals who take measures to reduce risk may still develop dementia, but may be less likely to develop it, or may develop it later in life than they would have if they had not taken steps to reduce their risk. Current and projected future shortages in specialist care geriatricians, neurologists, geriatric psychiatrists, and neuropsychologists place the burden on the vast majority of patient care. The severity of these needs requires solutions that develop the specialty workforce while also improving capacity in primary care.