Parkzeit 2021-2 (EN)

PLAQUES consist of a nucleus, the amyloid
nucleus, pathologically altered nerve cell processes
and other cells, i.e. the supporting cells. In simplified
terms, one speaks of amyloids. In many Alzheimer's
patients, amyloids are found not only between nerve
cells but also in the smaller blood vessels of the brain.
That’s why about one in five Alzheimer's patients
suffers not only from Alzheimer-type dementia, but
also from vascular dementia at the same time. The
small blood vessels in the brain are constricted or
even blocked with amyloids, which can trigger
strokes.
STAGES OF ALZHEIMER'S DISEASE are
differentiated in medicine into mild (early-stage
Alzheimer's disease), moderate (progressive
Alzheimer's dementia) and severe (advanced
Alzheimer's dementia). Doctors use tests, such as
the MMST (the Mini-Mental Status Test), an
interview with nine task components, to determine
patient’s current stage.
15 %
15 %
5 % Alzheimer's disease
65 %
Vascular dementias
Mixed Dementias
Other
DISEASE PROGRESSION
In Alzheimer's disease, the short-term memory
is affected first. The long-term memory is affected
later. In the beginning, those affected forget
situations that have just happened as if they have
been erased, and some names for the most banal
everyday things, such as shoes, no longer spring to
mind. As the disease progresses, memories
disappear, as do everyday skills such as how to
handle eating utensils or personal hygiene activities.
DURATION OF THE ILLNESS
On average, Alzheimer's disease lasts about
eight years after diagnosis, though this varies from
patient to patient, especially since the disease is
often detected or diagnosed late. There are patients
who live with their disease for 20 years. Nevertheless,
Alzheimer's generally leads to death in its final stages.
The reason that the condition becomes fatal is
that the immune system of those affected continues
to weaken, so that infections become more
frequent. For instance, patients are more likely to
contract pneumonia and other infections. Since
patients in the final stage are usually already of an
advanced age, many also suffer from other physical
diseases which can also lead to death.
ALZHEIMER RISK FACTORS
Even though the causes of Alzheimer's disease
remain largely unclear, there are definitely some
risk factors that promote the onset of Alzheimer's
dementia. These include obesity, high blood
pressure, high cholesterol, high blood sugar, lack of
exercise and poor nutrition, as well as alcohol
abuse, type 2 diabetes mellitus or permanent stress
(see WHO recommendations).
obesity
high cholesterol
lack of exercise
poor nutrition
type 2 diabetes mellitus
high blood pressure
high blood sugar
alcohol abuse
permanent stress
WOMEN are statistically more likely to develop
Alzheimer's disease. This may be because men
don't live to be that old on average, and for that
reason alone, their risk is simply lower. However, it
is a fact that the number of new cases is higher in
women than in men.
VASCULAR DEMENTIAS refer to forms of
dementia caused by disturbances in the blood
supply to the brain. For various reasons such as
deposits, constriction or clotting, the blood vessels
are no longer able to adequately fulfil their task of
transporting blood. What are the consequences?
Nerve cells become damaged or even die. High
blood pressure is often the underlying cause,
although obesity or smoking can also promote
vascular dementia. Vascular dementia accounts for
about 15 percent of all dementia cases and is the
most common form of dementia after Alzheimer's
disease. Although vascular dementia cannot be
cured, there is a good chance that its cause, i.e.
circulatory problems, can be treated. It is important
that vascular dementia is detected and treated as
early as possible.
BINSWANGER'S DISEASE is amongst the
most common classifications of vascular dementia
cases. The cause is a thickening of the walls in small
blood vessels of the brain (arteriosclerosis). This
subcortical arteriosclerotic encephalopathy (SAE
disease) is called Binswanger's disease after the
German neurologist Otto Ludwig Binswanger.
Sometimes, the terms 'subcortical dementia' or
'subcortical vascular dementia' are also used. Those
who have suffered from high blood pressure or
other vascular diseases for many years are often
affected by this condition.
MULTI-INFARCT DEMENTIA is a form of
dementia in which small cerebral infarctions occur
due to repeated vascular occlusions. They slowly
destroy the brain in many small steps. Sometimes, a
single, severe stroke is responsible, but often there
are several multi-strokes.
SYMPTOMS OF VASCULAR DEMENTIA,
unlike Alzheimer's, can occur quite suddenly –
depending on where a blood vessel has clotted in
the brain. Multi-infarct dementia, in particular,
progresses almost inconspicuously over long
phases. At times, the affected person is clearly
impaired, for example, cannot find words or has
difficulty remembering, then suddenly he or she is
lucid once again. Typical symptoms include
memory, speech, thinking and movement disorders,
problems with orientation or mood swings.
1 + 1 = ?
thinking
?
orientation
mood
?
memory
distancing
RISK FACTORS FOR VASCULAR DEMENTIA
include high blood pressure, smoking, diabetes
mellitus, high LDL cholesterol levels, heart failure
and cardiac arrhythmias. These risk factors all have
one thing in common: They can lead to damage of
the blood vessels, deposits (arteriosclerosis), poor
blood circulation and strokes. If none of the risk
factors apply, family history may also promote the
development of vascular dementia. There is an
increased risk of vascular dementia if ancestors,
parents or close relatives have suffered strokes
more frequently and if family members are prone to
high blood pressure.
high blood pressure
diabetes mellitus
heart failure
family history
smoking
high LDL cholesterol levels
DEMENTIA PREVENTION
A study published in Nature in 2009 impressively
illustrated that modified fasting with a thirty percent
calorie reduction over a period of just three months
could significantly improve memory performance
in the fasting group.
ADDITIONAL INFORMATION ON DEMENTIA
Dementia is an enormous burden for those
affected and for their relatives. You can find more
information on this topic here:
A Austrian Alzheimer Society
D German Alzheimer’s Society
UK Alzheimer's Society
Sources:
Alzheimer Forschung Initiative e.V., www.pflege.de
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SPECIAL TOPIC: DEMENTIA
SPECIAL TOPIC: DEMENTIA 19