General Practice 2022

5 possible causes of Alzheimer's (and diagnostic methods)

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5 possible causes of Alzheimer's (and diagnostic methods)
5 possible causes of Alzheimer's (and diagnostic methods)

Alzheimer's disease is a type of dementia syndrome that causes progressive degeneration of brain neurons and impairment of their cognitive functions, such as memory, attention, language, orientation, perception, reasoning and thinking. To understand what the symptoms are, see the warning signs for Alzheimer's disease.

There are some hypotheses that try to demonstrate what causes this disease, and that explain many of the symptoms that appear throughout its development, but it is known that Alzheimer's is related to the combination of several causes that include genetics and others risk factors such as aging, physical inactivity, head injuries and smoking, for example.

The main possible causes for Alzheimer's disease are:

1. Genetics

Alterations have been demonstrated in some genes that influence brain functioning, such as APP, apoE, PSEN1 and PSEN2 genes, for example, which seem to be related to neuron lesions that lead to Alzheimer's disease, but it is not yet known exactly what determines the changes.

Despite this, less than half of the cases of this disease are hereditary, that is, it is passed on by the person's parents or grandparents, which is familial Alzheimer's, which occurs in younger people, aged 40 to 50 years, having a very rapid worsening. People affected by this variant of Alzheimer's have a 50% chance of passing the disease on to their children.

The most common type, however, is sporadic Alzheimer's, which is unrelated to the family and occurs in people over 60, but it is still difficult to find the cause of this condition.

2. Accumulation of proteins in the brain

It has been observed that people with Alzheimer's disease have an abnormal accumulation of proteins, called Beta-amyloid protein and Tau protein, which cause inflammation, disorganization and destruction of neuronal cells, mainly in the regions of the brain called the hippocampus and cortex.

It is known that these alterations are influenced by the genes that were mentioned, however, it has not yet been discovered what exactly causes this accumulation, nor what to do to prevent it, and, therefore, the cure of Alzheimer's still not found.

3. Decreased neurotransmitter acetylcholine

Acetylcholine is an important neurotransmitter released by neurons, with a very important role in transmitting nerve impulses to the brain and allowing it to function properly.

It is known that, in Alzheimer's disease, acetylcholine is reduced and the neurons that produce it degenerate, but the cause is not yet known.Despite this, the current treatment that exists for this disease is the use of anticholinesterase drugs, such as Donepezil, Galantamine and Rivastigmine, which act to increase the amount of this substance, which, although not curing, slows the progression of dementia and improves the symptoms.

4. Environmental risks

Even though there are risks due to genetics, sporadic Alzheimer's also manifests itself due to conditions that are influenced by our habits, and that cause inflammation in the brain, such as:

  • Excess of free radicals, which accumulate in our body due to inadequate diet, rich in sugars, fats and industrialized foods, in addition to habits such as smoking, not practicing physical activity and live under stress;
  • High cholesterol increases the chances of having Alzheimer's, so it is important to control this disease with cholesterol medication, such as Simvastatin and Atorvastatin, in addition to being another reason to take care of the diet and regular physical activity;
  • Atherosclerosis, which is the accumulation of fat in the vessels caused by conditions such as high blood pressure, diabetes, high cholesterol and smoking, can decrease blood circulation to the brain and facilitate the development of the disease;
  • Age over 60 years is a great risk for the development of this disease, because, with aging, the body cannot repair the changes that can appear in the cells, which that increases the risk of disease;
  • Brain damage, which occurs after head trauma, in accidents or sports practice, for example, or by a stroke, increases the chances of destruction of neurons and development of Alzheimer's.
  • Exposure to heavy metals such as mercury and aluminum, as they are toxic substances that can accumulate and cause damage to various organs of the body, including the brain.

For these reasons, an important way to avoid Alzheimer's disease is to have he althy lifestyle habits, preferring a diet rich in vegetables, with few industrialized products, in addition to the practice of physical activity.

5. Herpes virus

Recent studies have indicated that another possible cause of Alzheimer's is the virus responsible for cold sores, HSV-1, which can enter the body during childhood and remain dormant in the nervous system, being reactivated only in periods of stress and weakening of the immune system.

Scientists indicate that people who carry the APOE4 gene and the HSV-1 virus are more likely to have Alzheimer's. In addition, with advancing age, there is a weakening of the immune system, which can favor the arrival of the virus to the brain, being activated in periods of stress or decrease of the immune system, and resulting in the accumulation of abnormal beta-amyloid proteins and tau, which are characteristic of Alzheimer's. It is worth noting that not all people who have the HSV-1 virus will necessarily develop Alzheimer's.

Due to the discovery of the possible relationship between the herpes virus and the development of Alzheimer's, researchers have been looking for treatment options that could help delay Alzheimer's symptoms or even cure the disease through the use of antiviral drugs, such as Acyclovir, for example.

Which doctor to consult

The most suitable physician to confirm the diagnosis of Alzheimer's and guide the treatment is the neurologist. However, it is also possible to schedule a first appointment with a general practitioner or a geriatrician, who will be able to refer you to the consultation with the neurology speci alty, if really necessary.

How the diagnosis is made

Alzheimer's is suspected when there are symptoms that demonstrate memory impairment, especially more recent memory, associated with other changes in reasoning and behavior, which worsen over time, such as:

  • Confusion;
  • Difficulty memorizing and learning new information;
  • Repeated speech;
  • Vocabulary decrease;
  • Irritability;
  • Aggressiveness;
  • Difficulties sleeping;
  • Loss of motor coordination;
  • Apathy;
  • Urinary and fecal incontinence;
  • Do not recognize acquaintances or family members;
  • Dependency for daily activities such as going to the bathroom, taking a shower, using the phone, or shopping.

For the diagnosis of Alzheimer's it is necessary to carry out reasoning tests such as the Mini Mental State Examination, Clock Drawing, Verbal Influence Test and other Neuropsychological tests, performed by the neurologist or geriatrician.

Exams such as magnetic resonance imaging of the brain may also be requested to detect brain changes, in addition to clinical and blood tests, which can rule out other diseases that cause memory changes, such as hypothyroidism, depression, vitamin B12 deficiency, hepatitis or HIV, for example.

Furthermore, the accumulation of beta-amyloid proteins and Tau protein can be verified by means of a cerebrospinal fluid collection test, but, because it is expensive, it is not always available.

Take a quick test now by answering the following questions that can help you identify your Alzheimer's risk (not a substitute for a doctor's assessment):

Evaluate your risk of developing Alzheimer's

Illustrative image of the questionnaire
  • I have a good memory, although there are small forgettings that do not interfere with my day-to-day.
  • Sometimes I forget things like the question I was asked, I forget appointments or where I left my keys.
  • I often forget what I was doing in the kitchen, living room, or bedroom and also what I was doing.
  • I can't remember simple, recent information like the name of someone I just met, even if I try very hard.
  • It's impossible to remember where I am and who the people around me are.
  • Yes! I also find it easy to recognize people and places.
  • I don't remember very well what day it is and I have a slight difficulty saving dates.
  • I'm not sure what month it is, but I can recognize familiar locations. However, I get a little confused in new places and can get lost.
  • I don't know. I also don't remember exactly who my family members are, where I live and I don't remember anything about my past.
  • All I know is my name, but sometimes I remember the names of my children, grandchildren or other relatives
  • I am fully capable of solving day-to-day problems and dealing well with personal and financial issues.
  • I have some difficulty understanding some abstract concepts (such as why a person is sad).
  • I'm feeling a little insecure and afraid to make decisions. That's why I prefer that others decide for me.
  • I don't feel capable of solving any problem and the only decision I make is what I want to eat.
  • I am unable to make any decisions and am totally dependent on other people for help.
  • Yes, I can work normally, I shop, I am involved with the community, church and other social groups.
  • Yes, but I'm starting to have some trouble driving. Still, I feel safe and know how to handle emergency or unplanned situations.
  • Yes, but I am unable to be alone in important situations and need someone to accompany me on social engagements.
  • No, I don't leave the house alone because I don't have the capacity and I always need help.
  • No, I am unable to leave the house alone and I am too sick for it.
  • Great. I still have chores around the house, I have hobbies and personal interests.
  • I no longer feel like doing anything indoors, but if you insist, I can try to do something.
  • I completely abandoned my activities, as well as more complex hobbies and interests.
  • All I know is showering alone, getting dressed and watching TV and I am not able to do any other chores around the house.
  • I can't do anything on my own and I need help with everything.
  • I am fully capable of taking care of myself, dressing, washing, showering and using the bathroom.
  • I'm starting to have some trouble taking care of my own personal hygiene.
  • I need others to remind me that I have to go to the bathroom, but I manage to relieve myself.
  • I need help dressing and cleaning and sometimes I pee on my clothes.
  • I can't do anything myself and I need someone else to take care of my personal hygiene.
  • I have normal social behavior and there are no changes in my personality.
  • I have small changes in my behavior, personality and emotional control.
  • My personality is slowly changing, before I was very nice and now I'm a little grumpy.
  • They say I've changed a lot and I'm not the same person anymore and I'm already shunned by my old friends, neighbors and distant relatives.
  • My behavior has changed a lot and I have become a difficult and unpleasant person.
  • I have no difficulty speaking or writing.
  • I'm starting to have some trouble finding the right words and it takes me longer to complete my reasoning.
  • It is getting harder and harder to find the right words and I have been having trouble naming objects and I notice that I have less vocabulary.
  • It's very difficult to communicate, I have difficulty with words, understanding what they say and I don't know how to read or write.
  • I just can't communicate, I don't say much, I don't write and I don't understand very well what they say to me.
  • Normal, I don't notice any change in my mood, interest or motivation.
  • Sometimes I get sad, nervous, anxious or depressed, but without major worries in life.
  • I get sad, nervous or anxious every day and this has become more and more frequent.
  • Every day I feel sad, nervous, anxious or depressed and have no interest or motivation to do any task.
  • Sadness, depression, anxiety and nervousness are my daily companions and I totally lost my interest in things and I have no motivation for anything anymore.
  • I have perfect attention, good concentration and great interaction with everything around me.
  • I'm starting to have trouble paying attention to something and get sleepy during the day.
  • I have some attention difficulties and poor concentration, so I can stare at a point or with my eyes closed for some time, even without sleeping.
  • I spend a good part of the day sleeping, I don't pay attention to anything and when I talk I say things without logic or that have no relation to the topic of conversation.
  • I can't pay attention to anything and I'm completely unfocused.

Alzheimer's Treatment

The treatment for Alzheimer's consists of reducing the symptoms of the disease, however this disease still has no cure. For treatment, the use of medications such as Donepezil, Galantamine, Rivastigmine or Memantine is suggested, in addition to stimuli with the practice of physiotherapy, occupational therapy and psychotherapy.

Learn more about how Alzheimer's is treated.

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