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7 Stages of Alzheimer’s Disease

Petra Boh Blog, Stages March 11, 2021October 16, 2021alzheimer's disease, dementia stages

People with Alzheimer’s disease (AD) experience the illness differently but research shows that affected individuals tend to go through similar stages of Alzheimer’s from the beginning to the end.

The categorization of the illness is useful when it comes to understanding what to expect to plan for appropriate care and treatment through each stage.

What Are the 7 Stages of Alzheimer’s Disease?

Some professionals use a simple 3-phrase model (early, moderate, and end) while others will use a more comprehensive breakdown that explains the progression of the disease.

The most common system breaks down the progression of Alzheimer’s into 7 stages.

It was developed by Dr, Barry Reisberg from New York University.

Below we will incorporate both systems discussing the three main stages of the disease and its seven sub-stages.

Pre-diagnosis

Also known as preclinical Alzheimer’s, these are the stages of Alzheimer’s that a person goes through before there is an “official” diagnosis of the progressive illness.

Note that changes in the brain usually start years before an individual can showcase any warning signs of the illness.

In the beginning, most people will not have a clue that they have the disease because the symptoms they may experience are usually associated with growing older.

People will continue to function independently at this stage.

There is currently no treatment for the pre-clinical stage of Alzheimer’s.

Experts are, however, hoping that in the future, there will be a medication that can halt the progression before people start showcasing symptoms to prevent the illness.

Let’s take a closer look at what affected persons may experience during the three pre-diagnosis stages.

Stage1: No Cognitive Decline

In the early stage of the progressive illness, most people will not showcase any subjective or objective cognition symptoms or functional decline.

They are also free from any mood or behavioral changes and have what is considered to be normal outward behavior.

Individuals at this stage can be referred to as mentally healthy persons. Alzheimer’s disease at this stage cannot be detected.

Stage 2: Basic Cognitive Decline

The 2nd Alzheimer’s stage is primarily characteristic of forgetfulness that occurs with normal aging.

A majority of people who are over 65 years will experience typical forgetfulness.

Alzheimer’s usually affects people who are above the age of 65. Elderly persons may no longer recall names as they would when they were younger.

Some may forget where they had placed their purse, keys, glasses, or other things around the house.

Many people in this stage will perform well on memory tests be able to go on working, drive, and be social.

The symptoms are normally not noticed by the individual, their family, or physicians.

Stage 3: Mild Cognitive Decline

Certain symptoms are common in the 3rd stages of Alzheimer’s.

For instance, a person with mild cognitive decline may find it hard to concentrate or focus on something.

Most people will also experience increased forgetfulness. If an individual is working, their performance at the workplace may be compromised.

People who stay at home may experience decreased performance in household chores like cleaning or even staying updated with paying bills.

Learning a new skill at this point becomes difficult. People may get lost in familiar places and they can find it challenging to find the correct words to speak when having a conversation.

Someone with stage 3 Alzheimer’s may frequently lose their possessions including prized items.

In this stage, a person’s family may begin to notice the changes that are happening in their loved one’s life.

The affected person may not do too well on memory tests and doctors can detect impaired cognitive function.

This stage can last up to seven years and the symptoms may start to be clearer in 2-4 years.

A person may need professional counseling at this stage especially if they have been conducting complex job responsibilities.

Most people will experience mild to moderate denial and anxiety during the 3rd stage of AD.

It is best to consult a physician during this point so that they can come up with care planning and treatment options that will keep the symptoms at bay.

Early-Stage Alzheimer’s

Also known as early-onset AD, this is one of the stages of Alzheimer’s where physicians can diagnose the disease.

The professionals use a combination of medical and neurological exams as well as imaging tests to help in the diagnosis process.

A team of different doctors like neurologists, geriatricians, psychiatrists, and psychologists among others can work together to help diagnose AD.

Stage 4: Moderate Cognitive Decline

Individuals at this stage will start to have more challenges with daily tasks. Denial of symptoms is usually more evident in this stage.

Some people will also have socialization issues where they withdraw from their relatives and friends.

This is mostly because they begin to be aware of the changes happening.

Other warning signs prominent in this stage include:

Having poor short-term memory
Decreasing awareness of recent or current events
Having challenges with simple arithmetic
Forgetting details about life history
Having difficulties paying bills and managing finances
Decreased emotional response
Having challenges cooking or even ordering from a menu
Forgetting about the season or month
Vision loss can also happen in some individuals. It can be as simple as having a hard time reading
Personality and mood changes may also occur some of the most noticeable ones being depression, confusion, fearfulness, and anxiety
Some individuals may also become increasingly irritated when something out of the norm happens.

This stage lasts about 2 years.

Individuals at this stage may need assistance from caregivers. Carers can lend a hand with day-to-day chores and making sure affected persons are well-fed and safe.

This includes looking out for them to ensure no one takes advantage of them financially because many affected individuals can become victims of financial scams.

Some affected adults may not be fit to drive and caregivers should ensure they do not get behind the wheel and endanger their lives and those of others.

Middle-Stage Alzheimer’s

Middle stage (mid-stage) AD consists of the fifth and sixth stages of Alzheimer’s that we will discuss below.

Stage 5: Moderate/Severe Cognitive Decline

In the 5th stage, most people with AD will have significant memory impairment.

Memory loss can either be moderate or severe.

It is usual for some people to forget major bits of details that affect their day-to-day lives such as phone numbers or home addresses.

Many people are unable to tell what time it is or where they are. It is one of the reasons many people in the 5th stage will get lost even after visiting a place they were once familiar with.

Affected individuals might require help with daily living activities like preparing meals, eating, bathing, and grooming.

Most people at this point will also have a hard time dressing.

It is common for a person to pick the wrong clothing for the season. For instance, an individual can insist on wearing summer clothes during winter.

Some individuals will start to wear the same outfit day in day out unless someone reminds them to change.

Caregivers can help out with dressing by laying out clothes for the day on a person’s bed. Depending on the level of independence, carers may have to dress up the person so that the individual with Alzheimer’s is always in proper attire.

A decline in personal hygiene habits may become more noticeable. For instance, a person may not brush their teeth or practice bathroom hygiene.

This stage can last an average of one and a half years.

Stage 6: Severe Cognitive Decline

The 6th stage of AD marks the point of the illness where many affected people will require more help with their daily tasks.

Taking a bath becomes challenging where persons cannot adjust the temperature of bathwater or handle other aspects of bathing.

Persons in this stage normally have limited memory of past and recent events.

Most will not remember the name of the school they went to or life events like their first job and the place where they were born.

Some retain details about their names but they may begin to confuse the names of people they are close to.

For example, a person may call their spouse the name of a deceased parent or use a different name to address someone they know. Most people in stage six might also start to experience incontinence of the bladder or bowel.

Speech ability may also start to diminish.

At this stage, personality changes become more pronounced. Individuals may experience different AD symptoms such as:

Anxiety
Delusions
Agitation
Paranoia
Fidgeting
Fear of being alone
Frustrations
Suspicions
Shame

The ability to calculate becomes challenging where even a well-educated person may not be able to count backward from 10 to 0.

Some people may start to wander at night and sleep more during the day.

The stage can last for around two and a half years.

Caregivers at this stage can offer help with personal care from hygiene to daily tasks.

Late-Stage Alzheimer’s

After going through the middle stages of Alzheimer’s persons with the disease will go through the final and last stage of the illness.

This is the 7th stage which is also known as late-stage AD. Read on to find out what affected persons can expect from this stage.

Stage7: Severest Cognitive Decline

At this stage, most people with AD lose their ability to communicate. Research shows that for most individuals, speech is limited to 6 words or fewer.

After sometime speech will decline to a single recognizable word before it is lost.

For survival, they usually require help with most daily activities including bathing, toileting, eating, and other activities around the clock.

Stage 7 is also associated with loss of psychomotor capabilities implying individuals at this stage may require help with ambulation and some might not be able to walk at all.

Affected individuals normally lose their ability to smile and instead they only have grimacing facial movements.

After a while, individuals may also lose their ability to hold their heads without support and others are not able to swallow.

Body movements tend to become more rigid which can cause severe pain to the affected persons.

Healthline reports that at least 40% of persons with AD form contractures, or hardening and shortening of tendons, muscles, and other tissues.

It is also common for adults to develop infantile reflexes such as sucking.

As cognitive and memory skills continue to become worse, individuals may require extensive care.

At some point, caregivers may have to consider support services like hospice care that will offer dignity and comfort at the end of life.

Although engagement is minimal during the end stages of Alzheimer’s persons with the disease can still benefit from interactions like a gentle reassuring touch or listening to relaxing music. This final stage normally lasts for about 2 and a half years.

Most people with AD will succumb during this stage.

Persons in this stage are usually vulnerable to developing other medical conditions that can lead to their death such as pneumonia, cancer, heart disease, or stroke.

Some individuals survive for years in this stage with proper care and life support.

Stages of Alzheimer’s Closing Remarks

It is important to learn how Alzheimer’s unfolds through various stages of Alzheimer’s.

While these stages do not always fall into neat little boxes and the symptoms may vary from one person to the next, they can be beneficial in taking care of a person with the illness.

It helps in preparing for the challenges that come next by getting the necessary medical supplies and aids like wheelchairs.

It also helps to identify care facilities like assisted living when an affected person can no longer live on their own safely.

AD is a progressive disease that gradually becomes worse over 4-20 years. However, a majority of affected persons will live for about four to eight years after diagnosis.

It is challenging for people with the disease and their loved ones to go through the stages of the illness. Knowing what to expect during these stages can help ease stress and unpredictability.

Corticobasal Syndrome (CBS) – Symptoms, Causes & Treatment

Petra Boh Blog, Types March 9, 2021October 16, 2021corticobasal degeneration, corticobasal syndrome

A rare progressive neurological disorder, corticobasal syndrome (CBS) is a condition that causes changes in language skills, movement, or both.

What is Corticobasal Syndrome?

It is one of the illnesses that has caught the attention of behavioral neurologists and movement disorder specialists.

Also known as CBD (corticobasal degeneration) it may start with issues such as stiff muscles on one side of the body involving a leg, arm, or both.

Such motor abnormalities include apraxia which is the inability to perform voluntary or purposeful movements and muscle rigidity.

Persons with this condition often complain about having trouble controlling their arms or legs.

Historically, CBD was recognized as a neurological condition that was mostly associated with movement disorders.

However, in recent years, research has revealed that behavioral and cognitive abnormalities occur more often than what was believed.

In some cases, dementia warning signs may precede the development of motor symptoms.

The initial cognitive symptoms may include impairments in executive function, progressive aphasia, and loss of intellectual abilities.

CBS was first described in 1968 by Rebeiz and colleagues. Most people will this condition will start showcasing symptoms around the age of 60 but some will have the warning signs earlier.

What Causes Corticobasal Syndrome

Scientists are yet to identify the exact cause of CBS.

Experts, however, know that in some individuals with the condition, there is usually a large build-up of tau.

This is a type of protein that usually occurs in the brain, but it is not clear why it at times builds-up in large amounts.

The function of tau within the nerve cells is quite complex and experts do not fully understand it.

It is, however, thought that tau is essential for the normal functioning of brain cells.

The abnormal tau levels in various brain cells result in their deterioration. The specific role that tau plays in the development of corticobasal syndrome is not yet clear.

Tau abnormalities are observed in numerous neurodegenerative brain disorders like Pick’s disease, Alzheimer’s disease, frontotemporal dementia with parkinsonism linked to chromosome 17 (FTDP-17), Niemann-Pick disease type C, and progressive supranuclear palsy.

Collectively, these disorders are known as “tauopathies.”

Large build-up of amyloid plaques

Some people with CBS also have a large build-up of amyloid plaques which are similar to those present in individuals who have Alzheimer’s disease (AD).

The excessive accumulation of these proteins in the nerve cells is quite dangerous because it results in brain cells losing their ability to function normally, and they die off eventually.

As a result, the affected sections of the brain will start to shrink.

Researchers believe that several factors contribute to the development of CBD.

These include a combination of multiple environmental, genetic, and factors that relate to aging.

A person develops corticobasal degeneration symptoms due to the progressive deterioration of tissue in various areas of the brain.

The loss of nerve cells happens in specific areas resulting in shrinkage or atrophy in specific brain lobes.

The type and severity of symptoms that a person will get will depend on the section of the brain that has been affected by the condition.

Moreover, the 2 areas of the brain that are mostly affected include basal ganglia and cerebral cortex, but some other areas may also be affected.

The cerebral cortex is mostly involved with higher functions of the brain including learning, memory, voluntary movement, and sensory information coordination.

The basal ganglia can be described as a cluster of nerve cells that is responsible for learning and motor functions.

Symptoms of Corticobasal Syndrome

Trouble with movement is normally the first warning sign of CBS.

It may include poor coordination or trouble accomplishing simple goal-oriented activities like buttoning a shirt, gesturing with hands, or combing hair amongst others.

This symptom may start with one leg, arm, or hand. The limbs might shake and feel stiff.

Persons with this condition may experience movement that is slower than usual, go through changes in the feelings of the limbs or have a hard time making their limbs move.

As time goes by, moving around becomes harder.

In most cases, the symptoms will start on one side of the body and slowly move to the other side.

Other symptoms

Additional symptoms might include a slight tremor when a person is in a particular position or while performing a certain task.

Limb dystonia may also occur sometimes.

Dystonia describes a group of neurological conditions that are characterized by involuntary muscle contractions.

These put certain parts of the body into abnormal and sometimes painful positions and movements.

Affected persons may also experience contractures which is a condition where a joint becomes permanently fixed in an extended or bent position.

This can partially or completely restrict the movement of the joint that has been affected.

Alien limb phenomenon is also common in persons with CBS where a limb will carry out actions or assume certain positions without the awareness of the affected person.

Some individuals will also go through jerky or lightning-like movements.

Communication can become difficult

Language problems may also start to develop as the disease progresses.

Individuals may have challenges naming people and objects, finding the right words to speak, or just getting the words out mostly because of the problems with the muscles that help with speech.

After some time, people with malady may not be in a position to communicate effectively. Reading skills may start to diminish while writing can become harder especially if the movement symptoms have affected the hands.

Some people with CBD may also suffer problems with swallowing, uncoordinated walk, or inability to control eyelid blinking.

Others with CBS may also experience visuospatial difficulties or challenges seeing things and understanding their right place in space.

Persons with these challenges will have a difficult time locating things in space, grasping complex visual arrays like a cupboard, and judging distances while driving.

Individuals with the condition may also have a hard time with number knowledge and calculations.

It is also common for persons with CBS to develop memory problems where they keep repeating questions or misplace objects.

Later in the course of the illness, persons may experience personality changes.

This is where persons may exhibit disinhibition, reduced attention span, irritability, apathy, and obsessive-compulsive behaviors.

Some even get into the habit of saying inappropriate things. Others will experience difficulties when trying to move or open their eyes.

Eventually, persons with CBS might become bed-ridden and they may be susceptible to life-threatening complications like bacterial infections, pneumonia, blood infections, or blockage of one or more main arteries to the lungs primarily because of blood clots.

Keep in mind that the progression, severity, presentation, and symptoms of this disease vary greatly from one person to another.

Diagnosis

A positive diagnosis for corticobasal degeneration is suspected when characteristic neurologic warning signs occur progressively in the absence of a structural lesion like a tumor or stroke.

It is normally challenging to distinguish corticobasal degeneration from other related neurodegenerative disorders.

Currently, there are no tests for CBS.

A clinical diagnosis is done based on the pattern of symptoms and extensive neurological exam involving multiple specialized tests and these include:

An EEG (electroencephalogram)

This is a test that measures the brain’s electrical activity.

Imaging Techniques

CT (computerized tomography) and MRI ( magnetic resonance imaging) are helpful when it comes to ruling out other medical conditions. They also come in handy when the doctor wants to view brain tissue degeneration within the basal ganglia and cerebral cortex.

DaTscan

This technique measure the amount of dopamine which is a chemical that the brain makes.

Neuropsychological testing

It is where professionals conduct various memory tests with pictures and words. These are exclusive to evaluate the extent of a person’s symptoms and the impact they have on mental abilities.

The tests look into multiple abilities like concentration, numbers, counting, memory, understanding language, and how a person processes vital details such as words and pictures.

Diagnosis is also done to rule out other medical conditions that can cause similar symptoms like Alzheimer’s disease, motor neuron disease, and Parkinson’s disease.

It is important that a consultant with expertise in corticobasal degeneration confirms the diagnosis.

Most of the time, this will be a neurologist who is an expert in conditions that affect the nerves and brain.

In the majority of cases, the confirmation of the diagnosis is only possible once professionals conduct autopsy examinations of the brain.

This shows “ballooned” protein, neurons aggregations, and other characteristic abnormalities that are as a result of an abnormal build-up of tau protein.

Treatment Options

There is still no approved cure for the corticobasal syndrome. Nonetheless, there are several treatments that can benefit persons with the disease, and these include:

Medications

Doctors can prescribe medication that can help manage the symptoms. Examples of these drugs include cholinesterase inhibitors which are helpful if a person with CBS is having memory problems.

The most common medicines that persons take include rivastigmine, donepezil, and galantamine.

For the movement symptoms, an individual may be treated with drugs that are used for persons with Parkinson’s disease.

These include carbidopa or levodopa but the effects of the drugs are subject to research.

Physicians may also recommend drugs to help deal with other issues like incontinence and bladder problems, sleeping problems, anxiety, pain, and bone strength.

It is also important for physicians to treat any existing conditions that affect the brain.

These include high cholesterol, high blood pressure, and diabetes.

Eating Right and Working Out

Research indicates that getting physically active helps to improve brain health, general fitness, and mood.

Getting enough sleep, eating a balanced diet, and limiting alcohol intake also helps to promote good health.

Alternative Therapies

Several therapies can help people with CBS and these include:

Speech and Language Therapy

It can help enhance communication between people with the condition and others. The experts can also help manage swallowing problems.

Physical Therapy

This in addition to stretching exercises can help ease movement challenges by maintaining the range of motion and mobility of rigid stiffened joints as well as preventing the development of contractures.

Occupational Therapy

It may be useful in assessing the safety of an affected individual’s home as well as determining the adaptive medical equipment that may boost a person’s independence. That’s when occupational therapy comes into play. Affected people may need to use devices like a walker or a crane to assist in walking.

Cognitive Stimulation

This comes in handy for persons with CBS but is showcasing dementia symptoms. This type of therapy involves engaging in exercises and activities that aim to enhance language ability, problem-solving skills, and memory.

Palliative Care and Advanced Care Planning

Palliative care is normally offered to relieve pain as well as other distressing symptoms a person may be facing while offering spiritual, social, and psychological support.

This can be beneficial at any stage of CBD alongside other treatments. An individual can receive this type of care at home, in a hospital, or at a hospice.

Advanced care planning is where persons with the corticobasal syndrome will make plans for the future highlighting their wishes in regards to medical care and other important decisions.

Affected individuals share the plans with their family members and health professionals who are taking care of them.

Seeing that this is quite a rare condition, clinical trials may at times not be available for persons seeking them.

CBS Prognosis

Corticobasal degeneration is a condition that changes over time and is believed to affect females and males equally.

An individual with the disease can live for years after a positive diagnosis. Symptoms of the conditions tend to worsen over 3-8 years and often cause great disability.

Research suggests that a majority of affected individuals live for about 6-8 years on average although this varies from one person to the next.

Closing Thoughts

Even though currently there are no therapies or treatments that can reverse or slow down the progression of corticobasal syndrome, there is still hope.

Scientists reckon that the biology of CBS may be similar to that of other neurodegenerative diseases.

It is possible that therapies that are useful for these conditions can be helpful to persons with corticobasal degeneration.

Stroke-Related Dementia: What Is It?

Petra Boh Blog, Types March 8, 2021October 16, 2021stroke, stroke-related dementia

When learning about the various types of dementia, it is important to talk about stroke-related dementia.

This is dementia that develops after the brain has been damaged by a stroke.

What is stroke-related dementia?

Strokes happen when there is an interruption of blood flow to the brain causing blood vessels to burst.

Worth noting is that not everyone who experiences a stroke will end up with dementia.

Strokes are normally associated with vascular dementia which is the second most common type of dementia.

In short, dementia is a general term describing problems with memory, planning, judgment, reasoning, and other thought processes.

Symptoms of Stroke-Related Dementia

The symptoms of this kind of dementia can appear suddenly, after a few days, weeks, or months in a gradual or stepwise manner.

The symptoms that a person will get depend on the kind of stroke they experienced as well as the section of the brain that has been damaged.

Cognitive decline normally happens within three months of a recognized stroke.

Examples of some warning signs of vascular dementia include:

Loss of memory especially with remembering recent events
Problems following instruction, inattention, and poor concentration
Poor judgment
Confusion
Getting lost in familiar places
Challenges with problem-solving, reasoning, and calculations
Depression
Mood and behavior changes
Crying or laughing inappropriately
Psychosis: loss of contact with reality, aggression, hallucinations, agitation, delusions, and inability to appropriately relate with other people and surroundings

The Diagnosis Process

It is not easy for medics to diagnose stroke-related dementia.

This is because several medical conditions can cause an individual to experience dementia-like symptoms.

Doctors have to identify the cause of the symptoms to determine whether or not a person has dementia.

It is important because there are some causes of dementia that are reversible with treatment.

The diagnosis process is not an easy one.

Health care providers will gather details from different sources to come up with the proper diagnosis.

They usually start with a medical interview where the doctor will ask questions like:

When the symptoms appeared
Past and recent medical problems
Medications a person is taking or was taking in the past
Lifestyles and habits

Physicians also conduct physical examinations to look for physical disabilities as well as signs of underlying conditions like previous strokes, high blood pressure, or heart and blood vessel diseases.

Doctors will also include mental status examinations to check memory, orientation, language, and attention.

Some professional practitioners will as well conduct neuropsychological testing which is a detailed cognitive assessment that helps them pinpoint and document an individual’s cognitive strengths and problems.

A doctor may also recommend laboratory tests such as blood tests to rule out blood disorders, infections, hormonal disorders, chemical abnormalities, and kidney or liver problems.

The lab tests are also important for identifying other health issues like diabetes and various vascular disorders that might underlie dementia.

Imaging studies can also be done to help detect stroke and rule out other conditions that can cause dementia.

Treatment Options for Stroke-Related Dementia

Sadly, treatments currently available cannot reverse brain damage that is caused by strokes if the injury has lasted for a few hours.

Treatment aims at enhancing vascular health in a bid to prevent the occurrence of new strokes and slow down the progression of cognitive decline and other related symptoms.

Treatment options include surgery, medication, and behavioral interventions.

High Blood Pressure and Alzheimer’s Risk

Petra Boh Blog, Causes March 4, 2021October 16, 2021alzheimer's disease, blood pressure, high blood pressure

New research suggests there may be a link between hypertension or high blood pressure and Alzheimer’s disease (AD).

High blood pressure occurs when the force of blood pushing against blood vessels becomes too high.

This can cause harm because it stresses not only the blood vessels but the heart as well.

The blood vessels cease to function properly because they have to work harder than normal.

Over time, the arteries will become narrower which can result in problems such as stroke, kidney failure, or heart disease.

Damaged small blood vessels can also negatively affect the sections of the brain responsible for memory and thinking.

Blood Pressure and Alzheimer’s Risk

Persons with higher blood pressure are also more likely to have brain lesions. These are the areas of dead tissues that develop because of low blood supply.

AHA statistics report that about 46% of America’s adult population has blood pressure. Not to mention, 16% do not even know they have the condition.

Alzheimer’s disease is the most common cause of dementia.

Dementia is a general term for the progressive loss of memory and other cognitive abilities that can seriously interfere with a person’s day-to-day life.

High blood pressure can affect the brain

Scientists believe that hypertension can also affect a person’s brain to the extent of developing some of the main markers for AD.

A study published in Neurology states that seniors who have higher average blood pressure compared to their age-mates are more likely to develop plaques and tangles in the brain which are both markers for Alzheimer’s.

The study had 1,288 participants who were 65 years and older. The researchers conducted annual cognitive testing and blood pressure checks on the subjects.

Moreover, experts also kept track of the medications the participants took and their medical histories. They also agreed to go through a brain autopsy after death to look for signs of brain aging like plaques and tangles.

Researchers discovered that persons who had higher than average blood pressure had more dead tissues resulting from strokes (blocked blood flow) as well as tangles and plaques.

Dr. Claudia Padilla, a neurologist, explained that plaques and tangles happen when proteins that the body produces break down into toxic forms which significantly affect neurons in the brain.

Director of global science initiatives at Alzheimer’s Association, James Hendrix, Ph.D. notes that damage that the toxic proteins cause is only part of the problem.

He said that lack of sufficient blood flow affects how the brain works around damaged tissue which can worsen symptoms of brain tissue damage.

Hypertension may not be the warning sign of AD

Padilla also stated that because this was an observational study on the relationship between blood pressure and Alzheimer’s disease, the results do not prove that hypertension causes warning signs of AD.

The study did not determine how higher average late-life blood pressure ends up increasing plaques and tangles in the brain.

However, she added that the study found a clear association between higher blood pressure in late life and the presence of protein plaques and tangles which are symptoms of Alzheimer’s disease.

Based on the findings of the study, Padilla considers it important to control blood pressure as a strategy for preventing cognitive decline.

In another interesting study on the relationship between blood pressure and Alzheimer’s, a Johns Hopkins analysis of formerly gathered data revealed that individuals who took prescribed blood pressure medication were half as likely to develop AD than those who did not.

The report established earlier work from researchers at Johns Hopkins who found that using potassium-sparing diuretics reduced the risk of Alzheimer’s by about 75%.

The risk was reduced by a third for persons who used any kind of antihypertensive drugs. Director of Johns Hopkins Memory and Alzheimer’s Treatment Constantine Lyketsos, M.D said that they found that if a person did not have Alzheimer’s and they were taking blood pressure medication, they were less likely to develop dementia.

He continues to say that if a person developed dementia from AD and was taking certain antihypertensive, the illness was less likely to progress.

They were not sure if this connection arises from better management of blood pressure or there are specific drugs that end up interfering with processes that relate to AD. Lyketsos suspected that both play a role.

Controlling your levels of blood pressure is important

An in-depth examination of long-term data from 4 countries by a team of global scientists also supported the idea that controlling high blood pressure can reduce the risk of Alzheimer’s.

The experts cross-referenced data from 6 large longitudinal studies. They observed the heath of more than 31,000 adults who were 55 years and above.

The scientists analyzed data from community-based comprehensive health studies conducted between 1987 and 2008 in France, United States, Netherlands, and Iceland.

They looked into 5 primary types of blood pressure drugs diuretics, ACE inhibitors, calcium channel blockers, beta-blockers, and angiotensin II receptor blockers.

The data was divided into 2 groups; 15, 553 people with normal blood pressure, and 15,537 people with high blood pressure.

In all, there were 1,741 Alzheimer’s disease diagnoses over time.

The results showed that treating hypertension reduced the risk of developing Alzheimer’s by 16% regardless of the type of antihypertensive medication a person was on.

In other words, it is important to take the link between lowering blood pressure and Alzheimer’s risk seriously.

High blood pressure medication can boost blood flow to the brain

A small clinical trial also revealed that using blood pressure medication for treatment can enhance blood flow to key brain regions in persons with Alzheimer’s disease.

The research was part of a larger trial that was looking into whether nilvadipine could improve thinking and memory skills with persons with Alzheimer’s.

It involved a trial of 44 participants who had mild to moderate AD. The average age of the participants was 77 years.

They were randomly assigned to either use blood pressure medication nilvadipine or inactive placebo pills for 6 months. At the end of the trial, specialized MRI scans showed the persons on the drugs recorded a 20% increase in blood flow to the hippocampus.

This is the structure of the brain that is involved in learning and memory.

These are the first areas that Alzheimer’s damages.

Persons on the real drug also indicated that their blood pressure dropped by eleven points when compared to the group that was on the placebo.

Experts, however, acknowledged that the size of the study was too small and short.

Unfortunately, it is impossible to conclusively indicate whether enhanced blood flow could have effects on the symptoms.

The lead author Dr. Jurgen Claassen hoped that future research could give a better answer to the query and it should mostly focus on persons with early Alzheimer’s.

He, however, explained that persons with early-stage AD showed benefits.

Closing Remarks

Even though several studies have linked high blood pressure to Alzheimer’s symptoms more research is still required.

The findings of the studies affirm that what’s good for the heart is also good for the brain.

We can reduce hypertension through various lifestyle changes like physical exercise, eating a healthy diet, and reducing sodium. Some medications can also help lower blood pressure.

Do Concussions Cause Alzheimer’s Disease?

Petra Boh Blog, Causes March 4, 2021October 16, 2021alzheimer's, alzheimer's disease, concussion

There has been a lot of concern as to whether concussions cause Alzheimer’s disease (AD) in the medical field.

This is mostly because the immediate effects of a head injury can include symptoms that are seen in the disease. These would be memory loss, confusion, and changes in speech, personality, and vision.

Can Concussions Increase Risk for Alzheimer’s

These symptoms can quickly vanish, last for some time, or become permanent depending on the severity of the injury.

Also, the symptoms that develop after an injury in most cases will not become worse over time something synonymous with AD.

This said some kinds of head injuries increase the risk of a person developing Alzheimer’s later in life.

Concussions can stimulate cognitive decline

Research reveals that concussions can accelerate the development of cognitive decline and brain atrophy.

These relate to Alzheimer’s in people who are at the genetic risk of this progressive illness.

This is especially true for people who carry one form of the APOE (apolipoprotein) gene. This gene has the potential to increase the risk of AD.

These findings are documented in the journal Brain and they show promise of identifying the influence that concussions have on neurodegeneration.

One of the environmental risk factors of developing neurodegenerative illnesses such as late-onset Alzheimer’s is a moderate-to-severe traumatic brain injury.

It is still not yet clear whether concussion or mild traumatic brain injury also contribute to increasing the risk.

Several studies have been conducted to try and establish the link between Alzheimer’s disease and concussions. Check out details of a few of these studies below.

Researchers from BUSM (Boston University School of Medicine), observed 160 war veterans from Afghanistan and Iraq.

The group comprised some people who had never suffered a concussion and others who had suffered one or more concussions.

The researchers measured the thickness of the participant’s cerebral cortex using MRI imaging in 7 regions. These are usually the first to indicate atrophy in AD and 7 control regions.

The experts stated that they found that lower cortical thickness in some of the regions of the brain caused by a concussion was first to be affected in AD.

Assistant professor of psychiatry at BUSM and research psychologist at the National Centre for PTSD Jasmeet Hayes, Ph.D. and corresponding author of the study explained that the results suggested that concussions when combined with genetic factors may be associated with accelerated memory decline and cortical thickness in areas that are relevant to Alzheimer’s.

Concussions have an impact on the young brain, too

The researchers noted that the brain abnormalities appeared in a relatively young group. The average age of the participants was 32 years.

The researchers translated this to imply that the influence of concussions on neurodegeneration can be detected early in a person’s lifetime.

They, therefore, advised that after suffering a concussion, it is important to document as much as possible.

But at least when it happened and the symptoms that a person showcased. This is because when concussions combine with other factors like genetics, they can cause long-term health consequences.

The experts were hopeful that other researchers will build on their findings to give a clear answer when asked if concussions cause Alzheimer’s disease.

Head injuries can cause AD twice as likely

Another study revealed that young adults who suffer from moderate or severe head injury are two times likely to develop AD later in life.

This was after Dr. Brenda Plassman and her colleagues from Duke University Medical Centre in Durham, North Carolina conducted research trying to find the link between Alzheimer’s and head injury in over 7000 US marine and Navy veterans from World War II.

The subjects of the study included 548 veterans who had experienced a head injury and 1228 who did not have any head injuries.

The experts discovered that people with a history of head injury were more than double the risk of developing AD.

Moderate head injury was associated with a 2.3 times increase in risk.

In addition to that, severe head injury was associated with more than 4 times the risk.

Severe head injury, in this case, was one where a person remained unconscious and was admitted to a hospital.

Moderate injury referred to bouts of amnesia or loss of consciousness that lasts for less than 30 minutes after the injury.

Do genes have a role?

The experts also went ahead to test for the presence of the apolipoprotein E gene. Participants who had this gene were 14 times more likely to develop Alzheimer’s.

Because there was no apparent relationship with a head injury and APOE gene, the researchers suggested that more work is necessary.

This will allow us to understand the effects of the gene and a head injury better. Potentially, more research will also give a better understanding of the causes of AD.

Yet another study reported that brain scans of elderly persons with a prior head injury and poor memory have more build-up of plaque associated with AD which supports that concussions may cause Alzheimer’s disease.

In this study associate professor of neurology and epidemiology at Mayo Clinic Rochester and her team evaluated 448 residents of Olmsted County who did not have any signs of memory problems.

They also studied 141 residents who had mild cognitive impairment (thinking and memory problems).

All the participants of this study were 70 years and above.

Before the study, they all reported whether they had experienced a brain injury that caused the loss of memory or consciousness.

The researchers conducted brain scans on all the subjects.

The results revealed that persons who had cognitive impairment and concussion history had amyloid plaques levels that were 18% higher than those who did not have a history of head trauma but had cognitive impairment.

They concluded that the link between concussions and AD is quite complex. This is because the results showed an association but not a cause and effect link.

Risk Factors for Developing Alzheimer’s After a Concussion

Scientific research supports the idea that suffering concussions may increase the chances of a person developing AD.

Some factors also seem to affect the risk of concussions causing Alzheimer’s disease and these include:

Age

The age when a person suffers from a concussion may have an impact on whether they end up developing AD.

Several studies suggest that suffering concussions at a young age increases the risk of developing Alzheimer’s disease. This applies to when a person is older.

The severity of the Injury

The risk of concussions causing Alzheimer’s disease increases with the severity of the injury.

Repeated mild injuries may also increase an individual’s risk for future problems with reasoning and thinking.

Conclusion

Keep in mind, although concussions can increase the risk of developing AD, other factors also play a role.

Not everyone who suffers a severe head injury will end up developing the disease.

More research is still necessary to understand the link between Alzheimer’s disease and concussions.

What is the Average Age for Alzheimer’s Disease?

Petra Boh Blog, Signs March 4, 2021October 16, 2021age, alzheimer's, alzheimer's disease

Alzheimer’s disease (AD) is one of the most common causes of dementia among seniors which leads to the question of what is the average age for Alzheimer’s.

What is the typical age for Alzheimer’s?

There are two categories of Alzheimer’s disease, which we further investigate below.

Late-Onset Alzheimer’s Disease

Late-onset AD normally affects people who are 60 years and above when Alzheimer’s symptoms become more apparent.

National Institute on Aging reports that the number of individuals who have AD doubles after 5 years for persons who are above 65 years.

Around 3% of women and men who are between the ages of 65-74 have the illness.

Almost half of those who are 85 years and older are diagnosed with AD.

A study performed in East Boston, Massachusetts observing 32,000 non-institutionalized persons aged 65 and above revealed that the prevalence of AD was 10% for seniors who were 65 years and over and 47% for those who are older than 85.

Pharmaceutical Technology reports that the prevalence of AD increases as a person grows older.

However, the greatest burden of the progressive disease exists in persons between the ages of 80-89 years.

Keep in mind that although increasing age is one of the risk factors for AD, old age does not make a person develop Alzheimer’s.

Many people live well into their 90s without developing AD.

Researchers have not pin-pointed the exact gene that causes late-onset Alzheimer’s.

Nonetheless, there is a single genetic risk factor that involves having one allele or form of APOE (apolipoprotein E) gene on chromosome 19 which is known to increase an individual’s risk.

Early-Onset Alzheimer’s

Although Alzheimer’s is common in older adults, this is not always the case.

It is important to note that the average age for Alzheimer’s is not limited to people who are above 60.

It can also affect younger individuals who are in their 30s and 40s.

This, however, is a rare occurrence that accounts for about 5% of people who have Alzheimer’s disease.

When this happens, we call it younger-onset or early-onset Alzheimer’s disease.

Research shows that an inherited change in one of the three genes causes some of the cases.

Still, other generic components can cause the rest of the cases. Experts are working to identify other genetic risk variants for young-onset AD.

Experts believe that the age a person is diagnosed with Alzheimer’s usually has a huge impact on their life expectancy.

Researchers at Johns Hopkins School of Public Health revealed that a person can live longer after an earlier diagnosis.

They discovered that the average survival rate for individuals who get AD diagnosis at the age of 65 is about 8 years.

This is different for people who get their diagnosis at 90 years because their average life expectancy is around 3 years.

Reasons Rate of Alzheimer’s Disease Increases with Age

When talking about the average age for Alzheimer’s, it is important to discuss the reasons the illness increases with age.

Healthy brains clear out amyloid-beta (proteins that cause AD) regularly. This ability tends to slow down as people grow older.

A study from The Washington University School of Medicine shows that for people in their 30’s a healthy brain will clear amyloid-beta every 4 hours.

When a person is 80 the brain may take at least 10 hours to complete the job. This may explain the relationship between Alzheimer’s and age.

Obesity and Alzheimer’s Disease – Risk?

Petra Boh Blog, Causes March 3, 2021October 16, 2021alzheimer's disease, obesity

When looking into the risk factors of Alzheimer’s disease (AD), researchers have been paying close attention to the relationship between obesity and Alzheimer’s.

Alzheimer’s Association reports that over 5 million people in the US are living with AD. Unfortunately, we expect this number to rise to almost 14 million by 2050.

Does Obesity Increase Alzheimer’s Risk?

Alzheimer’s is a progressive brain disorder that results in loss of memory, cognitive skills, and also causes changes in behavior.

The increasing rate of this progressive illness means that it is important to identify the biomarkers that tell when a person is at high risk of developing AD.

Early diagnosis can lead to the development of treatment and prevention strategies with a positive impact.

What is obesity?

We can describe obesity as a complex condition that involves too much body fat according to Mayo Clinic.

This increases the risk of a person suffering other health problems like diabetes, heart diseases, certain cancers, and high blood pressure.

Experts also state that obesity is one of the risk factors for developing AD.

This is because obesity often leads to insulin resistance. Data suggests that in middle age, insulin resistance can increase the risk of Alzheimer’s disease through numerous pathways.

These include dysfunctional brain insulin and decreased brain glucose metabolism which can result in increased amyloid deposition as well as reduced brain volume.

Results from human and animal studies show that subjects with AD have increased brain insulin resistance.

Worth noting is that excessive insulin in a person’s bloodstream ends up interfering with the energy supply in the brain. This is primarily because it lowers the amount of glucose or fuel that reaches the brain.

Obesity can contribute to Alzheimer’s

Over the years, research has revealed that obesity and related comorbidities as potential contributors to Alzheimer’s disease pathophysiology.

This suggests that conditions like poor-quality diet, diabetes, and a sedentary lifestyle may be part of AD’s modifiable risk factors.

A study published in Obesity Reviews examined possible mechanisms in the relationship between AD and obesity.

This also included recommended treatment strategies that may play a role in the development as well as the progression of Alzheimer’s.

Reports from numerous animal and human studies suggest that there is a link between obesity and Alzheimer’s.

Obesity and higher body mass index (BMI) have been linked to reduced white matter, brain atrophy, cognitive decline, the integrity of the blood-brain barrier, and an increased risk for late-onset Alzheimer’s.

The calculated effect size of obesity for the neurodegenerative disease was 1.54 according to various results from longitudinal epidemiological studies.

Strong evidence points to midlife obesity as a risk factor for Alzheimer’s.

A cross-sectional study that was published in Obesity revealed that there is an inverse relationship between cognitive function and BMI among healthy middle-aged adults.

Several observational studies have also reported that obesity in mid-life increases the risk of dementia later in life.

Weight loss can occur later in life due to the disease

Even though there seems to be a connection between obesity and Alzheimer’s, this association tends to shift later in life.

According to the statistics about 20%-45% of patients with Alzheimer’s tend to experience weight loss as the illness progresses.

There may be a possibility that a decline in BMI that goes before AD diagnosis may be related to the neurodegeneration sections of the brain that are responsible for homeostatic weight regulation.

Several factors can contribute to weight loss including decreased motivation for self-care, https://readementia.com/why-do-dementia-patients-stop-eating/, paying less attention to mealtime, social withdrawal, and altered metabolism amongst others.

At times, genetic factors might also come into play.

For instance, there have been reports on a connection between increased weight loss in AD and the presence of the APOE gene.

Inappropriate diet has a degenerating impact on the body and mind

Another study on the association between obesity and Alzheimer’s suggests that when HFS (high-sugar and high-fat) diet linked to obesity is paired with normal aging, it can lead to the development of AD.

You can find the details of this study in Physiological Reports. The study was conducted by researchers from Brock University in Ontario, Canada.

They chose to look at the effects of an obesity-inducing diet on insulin signaling which is the process that lets the body know how to use sugar as well as markers of cellular stress, and inflammation.

These are some of the factors that play a role in the progression of Alzheimer’s during the aging process in mice.

There were two groups of mice one on a normal diet and the other on HSF.

The researchers measured the animals’ stress and inflammation levels in the prefrontal cortex and hippocampus areas of the brain after 13 weeks of the allocated diets.

The prefrontal cortex oversees complex cognitive, behavioral, and emotional functions. The hippocampus deals with long-term memory.

Obesity affects aging and brain functioning

After comparing the two groups of mice, the experts found that the HFS had higher markers for insulin resistance, inflammation, and cellular stress in the hippocampus region.

This is thought to play a role in the progression of Alzheimer’s disease. Their prefrontal cortex region also showed more signs of insulin resistance.

On the other hand, there were no alterations in cellular stress and inflammation markers.

The researchers concluded that the region-specific differences between the hippocampus and prefrontal cortex in regards to aging with an HFS diet shows that the pathology of the disease is not uniform in all section of the brain.

When compared to baseline readings, the control group also recorded an increase in inflammation levels.

The results according to this study indicate that although age plays a role in the progression of AD, obesity also worsens the effects of aging on the function of the brain.

The research team acknowledged that their study offers fresh details to the mechanistic link between obesity and Alzheimer’s.

This is regarding the pathways that lead to the early progression of AD and the negative effects that the HFS diet has on the hippocampal and prefrontal cortex regions of the brain.

Obesity and Alzheimer’s Conclusion

After talking about the link between obesity and Alzheimer’s, it is important for people to manage their weight well especially during mid-life or better yet earlier to reap the benefits later in life.

A healthy diet and proper exercise are key to reducing the risk of a myriad of health problems including Alzheimer’s disease.

Multi-Infarct Dementia: What Is It?

Petra Boh Blog, Types March 3, 2021October 16, 2021dementia, multi-infarct dementia, stroke, vascular dementia

A kind of dementia, multi-Infarct dementia (MID) is a type of vascular dementia that is caused by multiple strokes.

It is also considered to be the second-most common cause of dementia after Alzheimer’s disease.

The strokes interrupt blood flow to the brain, which ends up affecting how the organ functions.

A brain infarct or stroke happens due to the block or interruption of blood flow to any part of the brain.

Everything You Need To Know About Multi-Infarct Dementia

Blood transports oxygen and other essential nutrients to the brain. When the brain lacks oxygen, it causes the death of brain tissues.

Multi-Infract imply that multiple areas in the brain have been injured because of lack of blood from a series of small strokes.

There are times when blockages of the brain cause an infarction (stroke) without any stroke symptoms.

These are known as “silent” strokes which are known to increase an individual’s risk of getting vascular dementia.

If someone experiences a series of small strokes over time, they may end up developing infarct dementia.

Symptoms of Multi-Infarct Dementia

The type of symptoms a person gets often depends on the area of the brain that the stroke has damaged.

At times the symptoms appear suddenly after a stroke or they may appear slowly over time.

We can categorize MID warning signs into two major sections as seen below.

Early Dementia Symptoms

Loss of executive function
Getting lost in familiar places or wandering
Short-term memory loss or confusion
Losing bowel or bladder control
Walking with shuffling rapid steps
Crying or laughing inappropriately
Challenges performing routine tasks like paying bills
Personality changes
Losing interest in activities or things that were previously enjoyed

Late-Stage Symptoms

As the disease progresses, a person may also experience other symptoms such as:

Hallucinations/delusions
Problems with simple tasks like meal preparation and dressing
Changes in sleep patterns
Memory loss
Social withdrawal
Poor judgment
Depression

Some individuals may go through periods where they seem to improve and then decline after experiencing small strokes.

MID Risk Factors

Some of the risk factors that increase a person’s risk of getting this disease include:

Medical Conditions

Diabetes, heart failure, previous strokes, atrial fibrillation, high blood pressure, cognitive decline prior to the stroke, and hardening of the arteries are some of the medical conditions that increase the risk of MID.

Age

Increasing age is a common risk factor for all types of dementia including MID.

The disease mostly affects persons who are between the ages of 60-75. In some rare cases, some people get the illness before they celebrate their 60th birthday.

Research also shows that men are slightly more likely to develop the disease than women.

Lifestyle Risk Factors

These include alcohol consumption, smoking, little to no physical activity, poor diet, and low level of education.

Diagnosing Multi-Infarct Dementia

There is no single test that can determine whether a person has MID or not. Worth noting is that each MID case is not the same.

One person may experience severe memory impairment while another individual may only experience mild memory loss.

Diagnosis can also be difficult because it is possible for a person to have both Alzheimer’s disease and MID making it challenging for a doctor to diagnose either of the diseases.

Medics base diagnosis on a number of factors such as:

History of stepwise mental decline
Blood pressure reading
Neurological exam
Blood tests
Physical Exams: this is where the doctor will ask questions pertaining to diet, sleep patterns, medications, past strokes, personal habits, stressful events, recent illness, and other medical issues.
Ruling out other causes of dementia like depression, diabetes, anemia, high cholesterol, brain tumors, carotid stenosis, chronic infections, thyroid disease, drug intoxication, vitamin deficiency, and high blood pressure.
Radiological imaging tests such as X-rays, CT & MRI scans that detail tiny areas of tissue that died from lack of adequate blood supply, electroencephalograms that measure the electrical activity of the brain, and transcranial doppler that is used to measure the velocity of blood flow through the blood vessels in the brain

MID Treatment Options

Currently, there is no treatment for multi-infarct dementia.

Experts have not yet discovered how to reverse brain damage that occurs after a stroke. Treatment options mainly focus on preventing strokes from reoccurring in the future.

This is done by putting in place measures to avoid or control the medical conditions and diseases that put individuals at risk of experiencing strokes.

Stroke risk factors include diabetes, high blood pressure, cardiovascular disease, and high cholesterol.

Treatment is also tailored to a person’s individual and most of them will include:

Medications

Doctors may prescribe certain medications to help improve symptoms such as:

Folic acid
Memantine
Hydergine
Nimodipine
Angiotensin: these help to lower blood pressure by converting enzyme inhibitors
Calcium channel blockers that help with short-term cognitive function
Some serotonin reuptake inhibitors that are antidepressants which may help neurons grow in a bid to re-establish connections in the brain

Healthy Lifestyle Habits

Practicing healthy habits is also key when it comes to MID treatment and some of them include:

Maintaining a healthy weight
Not smoking
Moderately using alcohol
Exercising
Eating a healthy diet

Alternative Therapies

Herbal supplements are also common when it comes to treating MID. However, more studies are still necessary to prove their efficiency.

Some of the herbal supplements that are being studied for use in MID treatment are:

Lemon Balm: A great alternative to restore memory
Wormwood: It enhances cognitive function
Water Hyssop: Used to improve intellectual function and memory

It is important to consult a doctor before taking any supplements to be on the safe side.

Other treatment options include rehabilitation therapy for mobility problems and cognitive training to help regain mental function.

Caregiver Support

Relatives and friends of persons with MID can help them cope with their physical and mental problems.

This can be done by encouraging regular physical and social activities as well as daily routines to help reinforce mental abilities.

Alarm clocks, calendars, and lists are useful when it comes to reminding the affected persons of important events and times.

MID Prognosis

The prognosis for persons with multi-infarct dementia is not clear.

This is mostly because the symptoms of the disease can appear all over sudden after each small stroke mostly in a step-wise pattern.

Some individuals with the disorder can appear to improve after some time and then decline after experiencing silent strokes.

The disease will spiral downwards with intermittent periods of fast deterioration. Some people may die after a MID diagnosis while others will survive many years.

Death may also occur from heart disease, stroke, pneumonia, or other infections.

Is Normal Pressure Hydrocephalus Reversible?

Petra Boh Blog, Prevention, Signs March 2, 2021October 16, 2021dementia, normal pressure hydrocephalus, nph

One of the questions that often comes up when looking into the reversible causes of dementia has got to be “is normal pressure hydrocephalus reversible?”

Before answering this query, it is important to discuss what normal pressure hydrocephalus (NHP) is.

What is Normal Pressure Hydrocephalus

The brain has chambers that are known as ventricles. These ventricles usually contain a fluid called cerebrospinal fluid (CSF) which protects and cushions the spinal cord and the brain.

It is also responsible for supplying them with nutrients and eliminating some waste products. The body typically makes enough CSF that it absorbs daily.

However, there are times when too much of the fluid builds up in the ventricles leading to NPH.

This can result in brain damage because the extra fluid can cause expansion of the ventricles which puts pressure on the brain tissues.

NPH mostly affects the parts of the brain that control the bladder, legs, and mental cognitive processes like reasoning, memory, speaking, and problem-solving.

Even though NPH can affect anyone, it is common among seniors who are in their 60s and 70s.

Appropriately 700,000 Americans are living with NPH according to Hydrocephalus Association. It is also known as “treatable dementia.”

This is because it is one of the dementia causes that can be reversed or controlled with treatment.

Causes of Normal Pressure Hydrocephalus

Several factors contribute to excess fluid build-up in the brain ventricles and these may include:

Brain surgery
Infection
Head injuries
Bleeding around the brain
Brain tumors
Stroke
Worth noting is that some people will develop NPH even in the absence of the factors above

Symptoms of Normal Pressure Hydrocephalus

Examples of NPH warning signs include:

Confusion
Mood Changes
Apathy
Loss of bladder or bowel control
Difficulties thinking
Depression
Challenges with responding to questions
Speech problems
Nausea
Headache
Problems with vision
Mild dementia that may involve loss in interest in day to day activities, challenges completing routine tasks as well as short-term memory loss and forgetfulness
Having trouble walking, falling, changes in the way a person walks, poor balance, and getting stuck or freezing when a person wants to walk

Diagnosing NPH

It is usually challenging to diagnose normal pressure hydrocephalus because its symptoms are similar to those of other diseases such as Parkinson’s disease, Alzheimer’s disease, and Creutzfeldt-Jakob disease.

Many cases go unnoticed because the disorder is usually misdiagnosed.

This means that it often goes untreated. Doctors may use several tests to rule out other conditions and diagnose NPH such as:

Brain scans (MRI or CT)
Cisternography: this is a test that highlights the absorption of CSF
Intracranial pressure monitoring: this is a diagnostic test that helps medics determine if there is low or high CSF pressure causing symptoms.
A Lumbar catheter or spinal tap: this is a procedure that measures CSF pressure. Doctors also use this to remove some of the fluid located close to the spinal cord for analysis to help them spot any abnormalities that may direct them to the problem
Medical interviews where doctors ask a person about the symptoms they are experiencing, past and current mental and medical problems, medications a person is taking, family medical problems, habits and lifestyle as well as travel and work experiences.
Detailed physical exams that may include testing mental status, neuropsychological tests, and lab tests that help to rule out other medical conditions with similar symptoms.

Treating NPH

You will be happy to learn that normal pressure hydrocephalus is reversible.

In most cases persons will NPH will go through surgery so that medics can place a shunt or tube in the brain to drain off any surplus fluid.

Medics will insert the shunt into a ventricle and then pass it under the skin from a person’s head to their abdomen through the neck and chest.

This way, the excess fluid will flow from the brain into the abdomen where the body will absorb it.

At this point, the ventricles in the brain can go back to their original size.

The shunt can remain in position as long as the brain has too much CSF.

Regular follow-ups by a professional physician are essential because it helps to identify if there are any subtle changes that can show if there is a problem with the shunt.

When implanted properly, the shunt is usually not obvious to other persons and it remains in place for an indefinite period.

Most people will enjoy full recovery after treatment and continue to enjoy a good, quality life.

However, not everyone will benefit from implanting a shunt because the method does not work for a small percentage of individuals.

Although normal pressure hydrocephalus is reversible, its symptoms will become worse when it is left untreated.

It is advisable to get an early diagnosis and prompt treatment because this may increase the chances of good results.

Currently, no other medical treatment or drug has been known to help reverse normal pressure hydrocephalus.

Behavioral Variant Frontotemporal Dementia

Petra Boh Blog, Types March 2, 2021October 16, 2021behavioral variant frontotemporal dementia, bvftd, pick’s disease

Behavioral variant frontotemporal dementia (BvFTD) is one of the most common types of dementia that is called FTD (frontotemporal dementia).

It accounts for around half of the cases of this disease.

What is BvFTD

Brain condition called FTLD (frontotemporal lobar degeneration) causes FTD. BvFTD is a kind of frontotemporal dementia because it affects the temporal and frontal lobes of the brain.

Another name for the disease is also Pick’s disease. Some doctors also use terms frontotemporal disorder or frontal lobe disorder.

The brain’s frontal lobe controls essential facets of daily life such as emotional control, judgment, behavior, planning, multitasking, inhibition, and executive function.

The temporal lobe, on the other hand, primarily affects language, behavior, and emotional response.

Symptoms of Behavioral Variant Frontotemporal Dementia

The symptoms of BvFTD start mildly and progressively become worse over time.

The rate of progression, however, varies from one person to another. A person may experience various emotional and behavioral issues like:

Withdrawal from social interaction
Poor personal hygiene
Abrupt mood changes
Difficulty keeping a job
Disinterest in previously enjoyable activities
Inappropriate or compulsive behavior
Apathy
Hoarding
Repetitiveness

An individual with BvFTD may also experience neurological and language changes such as:

Shrinking vocabulary
Reduced reading and writing skills
Accelerated memory loss
Trouble understanding speech or problems with speaking
Physical weakness
Changes in diet or eating habits
Pacing
Delusions
Repeating or echoing what other people say

The symptoms of this type of dementia usually start showing for people who are between 40-60 years.

In some cases, they can be seen in persons who are as young as 20 years.

Most people with frontotemporal dementia are between ages 45-64.

Persons with Pick’s disease rarely recognize when they change their behaviors or the effect this has on others around them.

Causes of BvFTD

Frontotemporal dementia is normally caused by abnormal amounts of tau which is a kind of nerve cell protein.

These proteins exist in all nerve cells.

If a person has Pick’s disease, the proteins will accumulate into clumps in the brain’s temporal and frontal lobe which can result in the death of cells.

After the cells die, the brain tissue will start to shrink which will result in dementia symptoms.

It is not yet clear what causes the formation of these abnormal proteins in the nerve cells.

Some studies indicate that genetics play a role in the development of this kind of dementia.

This is because about 40% of people with behavioral variant frontotemporal dementia usually have a family history of at least one relative who has been diagnosed with a neurodegenerative disease.

For the rest of the people, the development of this type of dementia is known to be sporadic. It does not relate to genetics, as none of their relatives has FTD.

Stages of Behavioral Variant Frontotemporal Dementia

BvFTD usually occurs in three main stages as explained below.

Early Stage BvFTD

The early stages of FTD usually have some unique features. At this stage, memory loss is usually not prevalent.

A person may, however, experience changes in social and personal behavior. Most individuals will start to disregard social boundaries or start engaging in activities that may be deemed inappropriate.

They can end up behaving carelessly, impulsively, and in some cases criminally.

The ability to handle money may deteriorate and the concern for other peoples’ feelings may start to diminish.

Misdiagnosis also occurs often during this initial stage. This is because a specialist can easily misdiagnose or overlook it as a psychiatric condition.

Middle Stage BvFTD

In the middle stage, the symptoms of BvFTD become more similar to those of frontotemporal dementia.

They may even resemble those of other types of dementia such as Alzheimer’s disease.

At this point, people with progressive disease may require some assistance with day to day activities like bathing, dressing, and grooming.

Disturbances of behavior became more consistent.

Most people will also start developing language problems.

Late-Stage BvFTD

The final stage of the illness is usually the most challenging. Language and behavior problems become worse and memory deterioration also happens fast.

For most people, it may be necessary to have round-the-clock care to ensure adequate safety and care.

BvFTD Diagnosis

Diagnosis for Pick’s disease (or BvFTD) is usually not an easy task, especially in the early stages.

Many times, medics can misdiagnose it for other conditions like depression, Alzheimer’s disease, Parkinson’s disease, vascular dementia, drug or alcohol dependence, or other psychiatric disorders.

The symptoms a person showcases and the results of neurological examinations are key to behavioral variant frontotemporal dementia diagnosis.

Glucose positron emission scans and brain scans like MRIs (magnetic resonance imaging) are also helpful in the diagnosis process.

These must, nonetheless, be interpreted in the context of an individual’s neurological exam and medical history.

Treatment Options

Currently, the FDA has not approved any medication that can be used to treat BvFTD.

In a majority of the cases, it may not be possible to slow down the progression of symptoms.

Environmental and behavioral interventions are considered some of the most effective options for managing symptoms.

Experts advocate for the use of distracting and reassuring tactics instead of challenging disruptive behaviors that can lead to more agitation.

Some doctors can also recommend pharmacological measures to help relieve distressing symptoms. The role of medication in frontotemporal dementia intervention is still not clear.

Selective SSRIs (serotonin reuptake inhibitors) are used to treat challenging behaviors.

Antipsychotics like olanzapine have been used on individuals suffering from prominent psychosis and agitation.

Studies are, however, on-going to try and introduce an effective treatment option for BvFTD.

Behavioral Variant Frontotemporal Dementia Prognosis

Years after positive BvFTD diagnosis, affected persons usually start to showcase problems with coordination and muscle weakness.

This can leave a person bedbound or needing a wheelchair.

The problems can result in difficulties with chewing, swallowing – eating in general – controlling bladder/bowels, and moving.

In the long run, persons with frontotemporal degenerations die because of physical changes that cause lung, skin, or urinary tract infections.

From the onset of symptoms, the average life expectancy is approximately 8-9 years. Some people may live up to 20 years or more with this progressive disease.