Dementia Medical Myths 4-6

 4. Dementia only affects older adults

Age is a risk factor for dementia, but dementia can affect younger adults in rare cases. Some scientists estimate that, in people aged 30–64 years, 38–260 people in 100,000 — equivalent to 0.038–0.26% — develop early-onset dementia.

In the 55–64 age bracket, this increases to close to 420 people in 100,000 or 0.4%.

5. Using aluminum pans causes Alzheimer’s

In the 1960s, scientists injected rabbits with high levels of aluminum. They found that the animals developed neurological lesions similar to those that form in the brains of people with Alzheimer’s.

Additionally, some studies have identified aluminum within the plaques associated with Alzheimer’s. However, aluminum also appears in the healthy brain, and researchers have not established a causal link between this element and the disease.

Following on from these studies, myths still circulate that drinking from aluminum cans or cooking with aluminum pots increases the risk of Alzheimer’s.

However, since those early experiments, scientists have not found a clear association between Alzheimer’s and using aluminum pots and pans.

Although researchers will, eventually, establish the precise relationship between aluminum and Alzheimer’s, consuming aluminum through the diet is unlikely to play a major role.

As the Alzheimer’s Society explain: “Aluminum in food and drink is in a form that is not easily absorbed into the body. Hence, the amount taken up is less than 1% of the amount present in food and drink. Most of the aluminum taken into the body is cleaned out by the kidneys.”

However, they also write that some research has found “a potential role for high dose aluminum in drinking water in progressing Alzheimer’s disease for people who already have the disease.”

6. Dementia signals the end of a meaningful life

Thankfully, this is not the case. Many people with a dementia diagnosis lead active, meaningful lives. Some people fear that if a doctor diagnoses them with dementia, they will no longer be able to go for a walk alone and will have to stop driving their vehicle immediately.

It is true that these adjustments may come in time as the condition progresses, but in mild cases of dementia, no changes may be necessary. As dementia worsens, changes to the way an individual leads their life are likely, but that does not mean that the person cannot lead a fulfilling life.

“Too many people are in the dark about dementia — many feel that a dementia diagnosis means someone is immediately incapable of living a normal life, while myths and misunderstandings continue to contribute to the stigma and isolation that many people will feel. The research shows that life doesn’t end when dementia begins.”

Dementia Medical Myths 1 -3

 Medical myths: All about dementia written by Tim Newman on September 21, 2020 — Fact checked by Zia Sherrell, MPH

In our Medical Myths series, we approach medical misinformation head-on. Using expert insight and peer-reviewed research to wrestle fact from fiction, MNT brings clarity to the myth-riddled world of health journalism.

Dementia is not a normal part of aging.

Today, an estimated 5.8 million people aged 65 years or older in the United States have dementia.

Due to the fact that the average lifespan of people in the U.S. has increased over recent decades, some experts project that by 2050, the number of older adults with dementia could reach 13.8 million.

Figures of this stature spark justifiable fear, and, as we have found in previous Medical Myths articles, fear tends to breed misconceptions.

In this article, we aim to dispel 11 of these myths.

1. Dementia is inevitable with age

This statement is not true. Dementia is not a normal part of aging. According to a report that the Alzheimer’s Association published, Alzheimer’s disease, which is the most common form of dementia, affects 3% of people aged 65–74 years in the U.S. As a result of the risk increasing as we age, 17% of people aged 75–84 years and 32% of people aged 85 years and older have a dementia diagnosis.

2. Dementia and Alzheimer’s disease are the same things

This is not quite correct. Alzheimer’s is a type of dementia, accounting for 60–80% of all dementia cases. Other types of dementia include frontotemporal dementia (FTD), vascular dementia, mixed dementia, and Lewy body dementia.

The National Institute on Aging defines dementia as “the loss of cognitive functioning — thinking, remembering, and reasoning — and behavioural abilities to such an extent that it interferes with a person’s daily life and activities.”

Although dementias share certain characteristics, each type has a distinct underlying pathology. Alzheimer’s disease is associated with a buildup of so-called plaques and tangles in the brain. These structures interfere with brain cells, eventually killing them. In contrast, brain cell death in vascular dementia occurs due to a lack of oxygen, which can result from a stroke, for instance.

3. A family member has dementia, so I will get it

A common myth is that dementia is purely genetic. In other words, if a person’s family member has a dementia diagnosis, they are guaranteed to develop dementia later in life. This is not true.

Although there is a genetic component to some forms of dementia, the majority of cases do not have a strong genetic link. As we learned above, rather than genetic factors, the most significant risk factor for dementia is age. However, if a parent or grandparent developed Alzheimer’s when they were younger than 65 years, the chance of it passing on genetically is higher.

Early-onset Alzheimer’s is relatively uncommon, though. It occurs in about 5.5% of all Alzheimer’s cases.

As the majority of dementia cases are Alzheimer’s disease, this means that most dementia cases are not hereditary. But if a parent or grandparent develops the condition, it does not mean that children or grandchildren are guaranteed to develop it.

Dementia risk factors

 Study identifies 10 factors linked to Alzheimer’s risk written by James Kingsland on March 1, 2022 — Fact checked by Hannah Flynn

A new study appearing in The Lancet Digital Health finds links between health conditions and Alzheimer’s risk. The study was an observational study that highlighted 10 medical conditions associated with a diagnosis of Alzheimer’s disease up to 10 years later.

The conditions include known risk factors for the disease, such as depression and hearing loss, and conditions with no links to the disease, such as constipation.

People with dementia experience a progressive loss of their ability to remember, think, and communicate effectively.

However, the changes in the brain that are responsible for dementia may begin decades before its effects on cognition and behaviour become apparent.

The World Health Organization (WHO) indicates that of the 55 million people worldwide living with dementia, 60–70% have Alzheimer’s disease.

Attempts to develop an effective treatment for Alzheimer’s have met with little success. Researchers are increasingly turning their attention to detecting the disease early.

The key to this strategy is to identify early, “modifiable” risk factors that doctors can target with drugs or other interventions.

Researchers at the Paris Brain Institute in France have now found statistical associations between 10 health conditions and a diagnosis of Alzheimer’s disease up to 10 years later. Major depression was the earliest condition to be associated with a subsequent diagnosis of Alzheimer’s, appearing at least 9 years in advance.

Other conditions that the study linked to a later diagnosis of Alzheimer’s included:

·        anxiety

·        constipation

·        abnormal weight loss

·        a type of arthritis called cervical spondylosis

·        reaction to severe stress

·        hearing loss

·        sleep disorders

·        They also showed that falls and fatigue had links to Alzheimer’s risk.

The next step will be to determine whether these conditions help cause the disease or whether they are early signs of changes in the brain that are already happening.

Some of the conditions, such as depression, hearing loss, and sleep disorders, are already known risk factors for Alzheimer’s. However, this study was the first to identify constipation as a possible risk factor. The link between the two conditions became apparent 7 years before the diagnosis of Alzheimer’s.

Interestingly, constipation is also associated with depression and is an established early sign of other brain diseases, such as Lewy-body dementia and Parkinson’s disease.

Another recent study also found an association between mental health conditions and dementia. In 2020, the Lancet Commission on dementia added three new modifiable risk factors: excessive alcohol consumption, head injury, and air pollution to its existing list, which includes:

·        hypertension

·        smoking

·        obesity

·        depression

·        physical inactivity

·        diabetes

The report concluded that modifying all the risk factors that researchers have identified could prevent or delay dementia in up to 40% of people.

Dementia Tests

 Cognitive dementia tests

Experts established the dementia tests that doctors currently use in the 1970s. A doctor may ask questions such as:

·        What is your age?

·        What is the time, to the nearest hour?

·        What is your address?

·        What is the year?

·        What is your date of birth?

The doctor may also consider observations by family members and caregivers.

If the results suggest memory loss, the doctor may carry out blood tests and a CT brain scan to investigate further and rule out other possible causes.

Another test, called the mini-mental state examination — which has also been in use since the 1970s — measures:

·        orientation to time and place

·        word recall

·        language abilities

·        attention and calculation

·        visuospatial skills

It can help diagnose dementia due to Alzheimer’s disease. It can also rate its severity and assess whether or not drug treatment is appropriate.

Mini-Cog test

The doctor may also carry out a test known as the Mini-Cog test. This involves the following steps:

 

·        The doctor will take three words from a specific set, “banana, sunrise, chair,” and ask the person to repeat them. The person can have three attempts at this.

·        If the person cannot do this, the doctor will ask them to draw a clock face, fill in the numbers, and set the hands to a specific time. The person should do this within 3 minutes.

·        If the individual cannot complete the clock task in time, the doctor will ask them to recall and repeat the three words from the first task.

There will be a maximum of 10 points. If the person scores fewer than 3–4 points, the doctor will consider dementia as a possible diagnosis.

Dementia treatment

There is currently no cure for most types of dementia, as it is not yet possible to reverse brain cell death. However, treatment may help manage symptoms.

Some medications may help reduce the symptoms of Alzheimer’s disease. Three drugs known as cholinesterase inhibitors, have approval for use in the United States. They are:

·        donepezil (Aricept)

·        galantamine (Reminyl)

·        rivastigmine (Exelon)

·        Cholinesterase inhibitors can also help manage behavioral symptoms of Parkinson’s disease.

A person may also use memantine (Namenda), which is an NMDA receptor antagonist, either alone or with a cholinesterase inhibitor.

 

If the symptoms result from an injury, medication use, or a vitamin deficiency, it may be possible to prevent further damage.

Other forms of care

Some lifestyle strategies that may help manage dementia include making sure the person:

·        follows a healthy diet

·        gets regular exercise

·        attends all medical appointments

·        takes their medication as prescribed

·        has regular sleep habits

·        has a safe living space

·        has support from family members and caregivers, as needed

Preventing dementia

In most cases, it is not possible to prevent dementia. However, the WHO suggests that the following habits may lower the risk:

·        exercising regularly

·        avoiding smoking

·        limiting alcohol consumption

·        maintaining a moderate weight

·        eating a healthy diet

·        seeking treatment for conditions such as high blood pressure, high cholesterol levels, and high blood sugar levels

·        Wearing protective headgear during contact sports may also lower the risk of sustaining repeated head injuries, which could be a risk factor for dementia.