Dementia, Alzheimer's & Brain Injury

Dementia or Senile Dementia or Alzheimer; no matter what we call it, it is on the increase. In general, it describes a condition of decline and loss in mental ability serious enough to interfere with normal daily life. Questions that beg to be asked are:

  1. Is it normal that as one gets older, the mind starts to go?
  2. Is there any way to prevent it or slow it down?

In short, the answer to the first one is “No”. Secondly, there are now new treatments to control and manage dementia, Alzheimer and Traumatic Brain Injury (TBI). When we talk about dementia, TBI and related conditions, we talk about the following problems:

Memory

Progressive loss of short term memory. Trouble keeping track of personal stuffs such as purse, appointment, bills and money affairs, names or recent events.

Communication and language

Asking the same question or mentioning event repeatedly. Sentences become disjoined and out of context. Loss of words to describe things.

Ability to focus and pay attention

Lost interest quickly and shift from doing one thing to another before completion. Appears to be perplexed or confused over ordinary situation or events. Become agitated easily or unable to carry on normal conversation.

Mobility

Loss of balance or unable to use one or more limbs. Loss of sense of direction or unaware of their current location.

Reasoning and judgment

The best way to describe this stage is- They start acting weird. Common sense is gone and behaviour becomes ‘One track minded’. Sometimes start to imagine things that are unreal. As the condition deteriorates, there will be tremor, speech and language difficulty, depression, restlessness, anxiety, aimless wandering or even trouble eating or swallowing.

Alzheimer's disease is an advanced form of the condition that accounts for up to 50% to 70% of cases of dementia[1] which now affects over 36 million people globally and resulted in 1.7 million deaths.[2] From an economic point of view, dementia costed $845 billion (Cdn. D.) last year in treatment, supports and lost production.

Clinical Diagnosis

Although CT scan or magnetic resonance imaging (MRI scan) is often done on dementia patients, it is not that useful in diagnosis except for vascular type of dementia. SPECT and PET[3] scans are more useful in detecting cognitive dysfunction. The most recent research found the PIB-PET scan using carbon-11 Pittsburgh Compound B gives a more accurate diagnosis of dementia.[4] Currently no medication is known to have any lasting effects on all types of dementia. Side effects can be more harmful than benefits in a number of cases.

Latest Advances in Treatment & Management

In the past 20 years, the concept of Neuroplasticity started to gain attention in the brain research arenas. This is in contrast to previous thinking that the brain’s functions are divided into fixed locations.

The new finding is that many functions of the brain can be changed to work in a different location if the original site is damaged. Clinical study has shown that neurogenesis (birth of new brain cells) occurs in the adult, mammalian brain regardless of age.[5] More evidence is coming forth that these transformations and re-routing as a result of new brain cells can happen in multiple areas within the brain.[6]

The latest advancement of Low Intensity Medical Laser technology have shown that under proper supervision and treatment protocols, it can give birth to new brain cells, nerve tissues and blood vessels. This opens up a promising development where brain damages, injury and dementia can now be better managed and treated.

Given the proper laser treatment, it could lead to recovery of traumatic brain injuries and concussion as well as reversal of some of the most troublesome dementia symptoms. This is more than just a ray of hope for the dementia and brain injury patients. It means a return to normal and healthy living for these patients and less burden on the families and society.

References

  1. Burns, A; Iliffe, S (5 February 2009). "Dementia.". BMJ (Clinical research ed.). 338: b75.
  2. GBD 2013 Mortality and Causes of Death, Collaborators (17 December 2014). "Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013.". Lancet. 385 (9963): 117–71.
  3. Bonte, F.J.; Harris, T.S.; Hynan, L.S.; Bigio, E.H.; White, III, C.L. (2006). "Tc-99m HMPAO SPECT in the differential diagnosis of the dementias with histopathologic confirmation". Clinical Nuclear Medicine. 31 (7): 376–8.
  4. Abella HA (June 16, 2009). "Report from SNM: PET imaging of brain chemistry bolsters characterization of dementias"
  5. Rakic, P. (January 2002). "Neurogenesis in adult primate neocortex: an evaluation of the evidence". Nature Reviews Neuroscience. 3 (1): 65–71.
  6. Ponti, Giovanna; Peretto, Paolo; Bonfanti, Luca; Reh, Thomas A. (2008). Reh, Thomas A., ed. "Genesis of Neuronal and Glial Progenitors in the Cerebellar Cortex of Peripuberal and Adult Rabbits"