June is the month of Alzheimer’s and brain awareness, and according to the Alzheimer’s Association, 50 million people worldwide are living with Alzheimer’s disease and other types of dementia. In the United States alone, more than six million people have the disease, which kills more people each year than breast cancer and prostate cancer combined.
Thomas C. Hammond, MD, neurologist at Marcus Neuroscientific Institute who specializes in Parkinson’s disease and other brain disorders, says dementia is actually an umbrella term for a group of symptoms. These include memory loss that disrupts daily life, difficulty planning or solving problems, and difficulty completing familiar tasks.
Not all memory loss is a sign of dementia, notes Dr. Hammond notes, and the disorder may develop with symptoms that are subtle and easy to write off. “With all forms of dementia, you lose nerve cells, and the symptoms can be similar to Alzheimer’s,” he says. “However, Alzheimer’s is a degenerative brain disease and the most common form of dementia. It accounts for up to 80 percent of all dementia cases. “
In the last 15 to 20 years, knowledge about Alzheimer’s has grown significantly, says Dr. Hammond. “We believe the disease is linked to the production of certain abnormal proteins – tau proteins in the nerve cells and amyloid clumps that surround the nerve cells.” These proteins, he says, build up over the course of time Time and can become plaques (amyloid) and balls (tau), which impair the function and lead to the death of nerve cells and thus lead to decreased brain function. “The disease often has a genetic component,” he adds.
The earliest symptoms of neurocognitive disorder or mild dementia are known to be known as Dr. Hammond often confuses it with normal aging, depression, or anxiety, which is why he says early and accurate diagnosis is important. Other symptoms to look out for include personality shifts, mood swings, and language changes. “These symptoms of early cognitive decline can be subtle and easily overlooked,” he says. “Family members often attribute such changes to the person being depressed, anxious, or stressed.”
The Marcus Neuroscience Institute has three neurologists including Dr. Hammond, who are specially trained in neuroimaging to better assess the neuroanatomy of neurocognitive disorders.
It’s one of only a few facilities in South Florida that has advanced NeuroQuant imaging capabilities, he says – sophisticated software that analyzes MRIs of the brain and helps detect and assess neurodegeneration in its earliest stages.
“People with Alzheimer’s have a loss of cortical tissue – especially in the hippocampal lobe, which controls memory, but also in the parietal and frontal lobes,” he notes. “The NeuroQuant protocol that we are using here enables us to precisely measure the thickness of the cortical tissue and determine whether there has been any tissue loss.”
In addition to helping diagnose Alzheimer’s and dementia, the NeuroQuant protocol is also used to Improving early detection and treatment of traumatic brain injuries, multiple sclerosis, and epilepsy, says Dr. Hammond.
Often times, an Alzheimer’s diagnosis begins with your GP, who is trained to identify signs of cognitive decline and dementia. Jose Vazquez, MD, a family doctor with Baptist Health Primary Care, specializes in the prevention, diagnosis, and treatment of a wide variety of health problems. He often sees patients with symptoms of Alzheimer’s disease and dementia.
“We are often the first to see it,” says Dr. Vazquez on the role of general practitioners in diagnosing Alzheimer’s disease. “A lot of patients come to me for something else – an illness, a routine check-up, laboratory work or medication maybe – but as an internist I treat the whole person and am trained to recognize the early warning signs of dementia.” Looking out at the patient and also evaluating their cognitive health.
How can Alzheimer’s disease be distinguished from other forms of dementia? Dr. Vazquez says that while symptoms are very similar for both, other forms of dementia usually have a known cause, such as multiple head trauma or multiple strokes, while Alzheimer’s is more global and usually occurs in older patients. “A clinical diagnosis can rule out all other conditions,” he adds.
Knowing when to refer the patient to a neurologist is also important, says Dr. Vazquez, who sends patients to see Baptist Health neurologists if he suspects they have Alzheimer’s or dementia.
Treatment of Alzheimer’s
While there is still no cure for Alzheimer’s, newer therapies have come a long way to help patients manage their symptoms, says Dr. Hammond. “For the past 15 to 20 years we’ve been using cholinergic drugs like Aricept, Exelon, and Razadyne along with healthy lifestyle recommendations to treat Alzheimer’s and dementia.” Namenda is another drug that has been used with good results, he says. “While it’s not a cure for Alzheimer’s, it appears to be slowing the progression of the disease.”
Dr. Hammond says that a healthy lifestyle can help minimize the symptoms of Alzheimer’s. That includes not smoking, no more than one or two drinks a day of alcohol, keeping a body mass index below 25, eating healthy, and exercising for at least 30 minutes a day five days a week, he says . “Regular aerobic exercise has both neuroprotective and potentially neuro-regenerative benefits in patients with memory and cognitive disorders.”
As an internist, Dr. Vazquez on the importance of prevention. In addition to the physical benefits, a healthy lifestyle can also help prevent or at least delay the onset of the cognitive decline associated with Alzheimer’s and other forms of dementia. “Dieting, exercising, keeping your daily brain active – all of these are important for the health of your brain,” he says.
Some people believe that anti-inflammatory and hormonal drugs can help prevent Alzheimer’s, adds Dr. Vazquez added. “They don’t,” he says. Others believe they can stave off cognitive decline with a diet composed of vitamins and supplements. Dr. Vazquez says that while it is perfectly safe to take gingko biloba or vitamins B6, B12 and D, “there is still no solid evidence that they work”.
What Dr. As for Hammond, he recommends staying cognitively engaged in midlife by reading, writing, solving puzzles, and engaging in social activities with others. “One study showed that mid-life cognitive activity could reduce amyloid deposition in the brain and prevent cognitive decline in old age,” he says.