The Alzheimer’s is the most common form of dementia (accounts for at least 60% of cases), as well as the main cause of cognitive impairment in the world. Is a neurodegenerative disease linked to ageing. Age is the most important risk factor. Every year some 40,000 new cases of this pathology are diagnosed in Spain, of which more than 90% correspond to people over 65 years of age.
“Although age is the main risk factor for developing Alzheimer’s disease, it is important to note that this disease and its symptoms not part of normal brain aging. There is a tendency to think that it is normal for a person, over the years, to lose memory and cognitive abilities. But this is a misconception that only contributes to Alzheimer’s being underdiagnosed. At the SEN we estimate that more than 50% of the cases that are still mild are still undiagnosed“, says Dr. Juan Fortea, coordinator of the Behavior and Dementia Study Group of the Spanish Society of Neurology (SEN).
In addition, although the evolution of the disease follows a more or less predictable pattern, “it is different in each person and depends a lot on the age at which Alzheimer’s manifests itself, as well as genetics, lifestyle habits and many other factors such as the clinical history of each patient”, adds the expert.
Although the cause of the disease is not known exactly, everything indicates that it has a origen multifactorial in which it seems that different processes are involved such as the accumulation of certain brain proteins, neuroinflammation, immunity, vascular changes, genetics… that predispose certain people to develop it. Hereditary cases, however, are rare and only account for 1% of all cases.
There’s also risk factors linked to lifestyle and modifying them is in our hands. “There are a series of measures that could significantly reduce the number of Alzheimer’s cases. In this sense, several modifiable risk factors have been identified that would allow prevent at least 30% of cases of dementia in the world. However, according to our studies, less than 50% of the Spanish population knows what the modifiable risk factors for the disease are”, highlights Dr. Fortea.
These are the protective measures that can delay and, therefore, prevent the onset of the disease:
-Stay intellectually active.
-Promote a good mood.
-Maintain personal contact with friends and family.
– Give up the consumption of alcohol and tobacco.
-Perform physical exercise.
-Have a healthy weight.
-Follow a proper diet.
-Control diabetes.
-Control high blood pressure.
-Correct hearing loss.
-Avoid brain injuries.
-Avoid exposure to environmental pollution.
“Carrying out these measures would make it possible to significantly reduce the impact that this disease has on an individual, family and social level. We are talking about a disease that entails a very high social and health cost, since it is estimated that the annual direct costs for each patient are around 40,000 euros, and that affects not only the patient, but the entire family nucleus, due to the need for care that people with this disease require. We must not forget that in 80% of cases the main caregiver of patients with Alzheimer’s is a family member who will also need medical and social support”, concludes Dr. Juan Fortea.
For the expert, it is also important to identify and early diagnosis of all patients. This makes it possible to start pharmacological and non-pharmacological therapies aimed at improving symptoms, increasing quality of life and increasing the number of patients who can participate in research studies or clinical trials of new drugs, “something that is very necessary”.
Having a punctual forgetfulness due to lack of attention is not alarming. The characteristic memory loss of Alzheimer’s disease is that of episodic memory (that which refers to the memory of moments, places, emotions and details of the context of life episodes that can be evoked very clearly). Other warning signs that should lead us to consult, whether it happens to us or to a family member, are the difficulty in remembering important events or appointments and the loss of objects. Sometimes it is the patient himself who realizes this memory loss early, but on other occasions there may be a lack of awareness of the disease and it is someone close to him who suspects it. That is why the doctor evaluates taking into account what the patient tells him, what the family tells him and what he himself sees in consultation.
Los advances in the treatment of Alzheimer’s disease They’re slow. Since 2003 no new drug has been approved in Spain that allows symptomatic improvement of the disease, but the SEN is hopeful that perhaps we are on the verge of a paradigm shift in the treatment of the disease. At the end of 2022 and in 2023, the results of two new treatments will be known, based on the use of monoclonal antibodies, which may make it possible to modify the key pathophysiological processes of the disease.