To learn more about this condition, we approached Dr. Janfreisy Carbonell, neurologist and internist at the Medical Center for Diabetes, Obesity and Specialties (CEMDOE).
—Sometimes this disease is difficult to diagnose, what is the difference between senile dementia and Alzheimer’s?
Before differentiating these concepts, we must previously know what dementia really means.
The World Organization for Health (WHO) defines dementia as “a syndrome – usually chronic or progressive in nature – characterized by deterioration in cognitive function (i.e., the ability to process thought) beyond what might be considered a consequence of normal aging. It affects memory, thinking, orientation, comprehension, calculation, learning ability, language and judgment.
Senile dementia is not really a specific disease, which belongs to the group of dementias that generally affects older adults. According to Alzheimer’s‘s Association, this dementia represents a set of symptoms that includes impaired memory and other reasoning abilities. These symptoms are severe enough to interfere with daily life. That is, senile dementia can refer to any type of dementia, such as Alzheimer’s disease, vascular dementia, or some other disease of the central nervous system that causes cognitive impairment.
Alzheimer’s is the most common form of dementia, responsible for 60-80% of cases worldwide (of senile dementia), a general term applied to a chronic and irreversible progressive neurodegenerative disorder of memory loss and other cognitive skills that interfere with daily life
What percentage of the population in the country suffers from it?
According to statistics from the Ministry of Health Public, through the Department of Health Mental reported that in the Dominican Republic approximately 8% of the population over 60 years of age lives with dementia, equivalent to about 90,000 cases.
—What is the advantage of detecting Alzheimer’s in its early stages, when the person still has no symptoms?
The answer is a bit complex, but I understand that the advantage of detecting this type of dementia, even when its clinical stages have not yet manifested, means trying to intervene or modify certain risk factors that contribute to the accelerated process of neurodegeneration (previous cardiovascular and cerebrovascular risks, such as poor diet and sedentary lifestyle, etc.) of populations that could have some predisposition to its development, for example those in which the predisposition (who previously had a close relative with Alzheimer’s disease), such as the gene that codes for apolipoprotein E-e4, or APOE-e4, which is the first risk gene identified and continues to be the one with the greatest impact. Other common forms of the APOE gene are APOE-e2 and APOE-e3.
—What is metabolic syndrome and what role does it play in this disease?
Metabolic syndrome is a clinical condition that includes a set of cardiometabolic abnormalities, such as arterial hypertension, central obesity, insulin resistance, and atherogenic dyslipidemia. The prevalence of metabolic syndrome has increased in recent years in the world, representing a problem of Health because it directly increases the risk of cardiovascular/cerebrovascular diseases and type 2 diabetes mellitus by two to six times.
Lifestyle changes can reverse the components of the metabolic syndrome, but pharmacological intervention is sometimes necessary for tighter control of risk factors. According to recent studies, it has been determined that this syndrome could contribute to accelerating the progression of neuronal degeneration of cognitive impairment in Alzheimer’s disease.
Can we prevent Alzheimer’s?
Currently there is no effective prevention or etiopathogenic treatment to cure or stop Alzheimer’s disease. Modestly effective symptomatic treatments are now available to improve cognition and behavioral disturbances in order to maintain function. There are two main groups of drugs for symptomatic treatment whose use has been authorized by the FDA for some years: Anticholinesterases or acetylcholinesterase inhibitors for mild to moderate deterioration; and Modulators of glutamatergic transmission or antagonists of N-receptors for moderate to severe impairment.