Dementia

Risk factors for dementia
We don't know why some people get dementia and others don't. But we do know that certain things make some people more likely to get it. These are called risk factors. Having a risk factor does not mean that you will definitely get dementia. It means only that your risk is somewhat higher than someone who does not have that risk factor.
The risk of getting dementia goes up with age, but age is not the only factor. There are millions of older people who don't
have dementia.
About 1 in 20 people over the age of 65 have some form of dementia. This figure rises to about 1 in 5 people who are 80 and
over.
1
Source:
Alzheimer's Society.
Facts about dementia.
Available at: http://www.alzheimers.org.uk (accessed on 27 September 2006).
Alzheimer's Society.
Facts about dementia.
Available at: http://www.alzheimers.org.uk (accessed on 27 September 2006).
Alzheimer's disease
People who have Alzheimer's disease slowly lose their memory and ability to think clearly. As the disease gets worse, they get more confused and start acting differently. Several changes happen in the brain that stop it working properly. Small lumps called amyloid plaques grow in the parts of the brain used for memory and thinking. And bundles of twisted threads called 'neurofibrillary tangles' form inside brain cells. These stop brain cells communicating with each other, and they can cause cells to die. Also, in Alzheimer's disease, the brain does not have enough chemical messengers (neurotransmitters), and holes or gaps appear where brain cells have died.
People who have Alzheimer's disease slowly lose their memory and ability to think clearly. As the disease gets worse, they get more confused and start acting differently. Several changes happen in the brain that stop it working properly. Small lumps called amyloid plaques grow in the parts of the brain used for memory and thinking. And bundles of twisted threads called 'neurofibrillary tangles' form inside brain cells. These stop brain cells communicating with each other, and they can cause cells to die. Also, in Alzheimer's disease, the brain does not have enough chemical messengers (neurotransmitters), and holes or gaps appear where brain cells have died.
Source:
Bird TD.
Alzheimer's disease and other primary dementias.
In: Braunwald E, Hauser SL, Fauci AS, et al (editors). Harrison's principles of internal medicine. 15th edition. McGraw Hill, New York, U.S.A.; 2001.
Bird TD.
Alzheimer's disease and other primary dementias.
In: Braunwald E, Hauser SL, Fauci AS, et al (editors). Harrison's principles of internal medicine. 15th edition. McGraw Hill, New York, U.S.A.; 2001.
Lewy body dementia
People with Lewy body dementia slowly lose their memory and ability to think clearly. Most people also get symptoms of Parkinson's disease. This means they may move more slowly and become rather stiff and rigid in the way they do things. People with this type of dementia get small, round clusters of proteins inside their brain cells. These are called Lewy bodies. They stop important chemicals in the brain from working normally. Lewy body dementia can also cause small lumps in the brain called amyloid plaques. They're made of protein and bits of dead cells. The lumps grow in the parts of the brain used for memory and thinking. They may stop messages from passing between brain cells.Lewy body dementia is the second most common cause of dementia after Alzheimer's disease.
People with Lewy body dementia slowly lose their memory and ability to think clearly. Most people also get symptoms of Parkinson's disease. This means they may move more slowly and become rather stiff and rigid in the way they do things. People with this type of dementia get small, round clusters of proteins inside their brain cells. These are called Lewy bodies. They stop important chemicals in the brain from working normally. Lewy body dementia can also cause small lumps in the brain called amyloid plaques. They're made of protein and bits of dead cells. The lumps grow in the parts of the brain used for memory and thinking. They may stop messages from passing between brain cells.Lewy body dementia is the second most common cause of dementia after Alzheimer's disease.
vascular dementia
This type of dementia happens when blood vessels near your brain get damaged, so your brain doesn't get enough blood. Some of the cells in your brain die, which causes symptoms such as confusion and memory problems. Vascular dementia can happen suddenly if you have a stroke. Or it can come on gradually if you have a series of little strokes (this is called multi-infarct dementia).
This type of dementia happens when blood vessels near your brain get damaged, so your brain doesn't get enough blood. Some of the cells in your brain die, which causes symptoms such as confusion and memory problems. Vascular dementia can happen suddenly if you have a stroke. Or it can come on gradually if you have a series of little strokes (this is called multi-infarct dementia).
high blood pressure
Your blood pressure is considered to be high when it is above the accepted normal range. The usual limit for normal blood pressure is 140/90. If either the first (systolic) number is above 140 or the lower (diastolic) number is above 90, a person is considered to have high blood pressure. Doctors sometimes call high blood pressure "hypertension."
Your blood pressure is considered to be high when it is above the accepted normal range. The usual limit for normal blood pressure is 140/90. If either the first (systolic) number is above 140 or the lower (diastolic) number is above 90, a person is considered to have high blood pressure. Doctors sometimes call high blood pressure "hypertension."
stroke
You have a stroke when the blood supply to a part of your brain is cut off. This damages your brain and can cause symptoms like weakness or numbness on one side of your body. You may also find it hard to speak if you've had a stroke.
You have a stroke when the blood supply to a part of your brain is cut off. This damages your brain and can cause symptoms like weakness or numbness on one side of your body. You may also find it hard to speak if you've had a stroke.
For women who have gone through
menopause, doctors used to think that taking
hormone replacement therapy (HRT) would lower their risk of getting Alzheimer's disease and other types of dementia.
2
3 But studies haven't shown this to be true. Also, there are risks linked with taking HRT. To learn more, see Hormone replacement therapy (HRT).
menopause
When a woman stops having periods, it is called menopause. This usually happens around the age of 50.
When a woman stops having periods, it is called menopause. This usually happens around the age of 50.
hormone replacement therapy
Hormone replacement therapy (also called HRT) is given to women after menopause to replace the estrogen (the main female hormone) that is no longer made by their ovaries. It can be given either as estrogen alone or as a combination of estrogen and progestin (another female hormone). It is useful to treat menopausal symptoms such as hot flushes, and to prevent brittle bone disease (osteoporosis). But there are concerns that it may increase the risk of breast cancer, heart attacks and strokes.
Hormone replacement therapy (also called HRT) is given to women after menopause to replace the estrogen (the main female hormone) that is no longer made by their ovaries. It can be given either as estrogen alone or as a combination of estrogen and progestin (another female hormone). It is useful to treat menopausal symptoms such as hot flushes, and to prevent brittle bone disease (osteoporosis). But there are concerns that it may increase the risk of breast cancer, heart attacks and strokes.
Source:
Bird TD.
Alzheimer's disease and other primary dementias.
In: Braunwald E, Hauser SL, Fauci AS, et al (editors). Harrison's principles of internal medicine. 15th edition. McGraw Hill, New York, U.S.A.; 2001.
Bird TD.
Alzheimer's disease and other primary dementias.
In: Braunwald E, Hauser SL, Fauci AS, et al (editors). Harrison's principles of internal medicine. 15th edition. McGraw Hill, New York, U.S.A.; 2001.
Source:
Hogervorst E, Williams J, Budge M, et al.
The nature of the effect of female gonadal hormone replacement therapy on cognitive function in post-menopausal women: a meta-analysis.
Neuroscience. 2000; 101: 485-512.
Hogervorst E, Williams J, Budge M, et al.
The nature of the effect of female gonadal hormone replacement therapy on cognitive function in post-menopausal women: a meta-analysis.
Neuroscience. 2000; 101: 485-512.
Of all the types of dementia, we know the most about the role of family history and
genes in Alzheimer's disease.
genes
Your genes are the parts of your cells that contain instructions for how your body works. Genes are housed on chromosomes, structures that sit in the nucleus at the middle of each of your cells. You have 23 pairs of chromosomes in your normal cells, each of which has thousands of genes. You get one set of chromosomes, and all of the genes that are on them, from each of your parents.
Your genes are the parts of your cells that contain instructions for how your body works. Genes are housed on chromosomes, structures that sit in the nucleus at the middle of each of your cells. You have 23 pairs of chromosomes in your normal cells, each of which has thousands of genes. You get one set of chromosomes, and all of the genes that are on them, from each of your parents.
If you have a close relative who has early-onset Alzheimer's disease, you have a greater chance of getting this condition. This is a rare type of Alzheimer's that starts before the age of 60.
4 About 1 in 10 people who have Alzheimer's have this type.
Source:
Carr DB, Goate A, Phil D, et al.
Current concepts in the pathogenesis of Alzheimer's disease.
American Journal of Medicine. 1997; 103 (supplement): S3-S10.
Carr DB, Goate A, Phil D, et al.
Current concepts in the pathogenesis of Alzheimer's disease.
American Journal of Medicine. 1997; 103 (supplement): S3-S10.
In general, the genes people inherit from their parents can make them more likely to get Alzheimer's disease. But the genes
don't directly cause the disease. Genes tell the cells of your body how to grow and work. If you have a faulty gene, it means
that cells affected by that gene won't work properly.
If you have certain genes from a group called ApoE, you're more likely to get Alzheimer's disease. But having these genes doesn't mean that you'll definitely get Alzheimer's.
You can have a blood test to see if you have one of these genes, but the test can't tell you if you'll get Alzheimer's. Most
specialists in the United States advise against genetic testing unless someone in your family had early-onset Alzheimer's.
5
Source:
Alzheimer's Disease Education and Referral (ADEAR) Centre
Alzheimer's Disease Genetics
Alzheimer's Disease Education and Referral (ADEAR) Centre
Alzheimer's Disease Genetics
Almost all people with
Down's syndrome develop brain changes similar to Alzheimer's disease by the time they reach middle age.
6 However, these brain changes don't lead to symptoms for everyone. One study found that around half of people with Down's
had symptoms of Alzheimer's by the time they reached their 60s.
7
Down syndrome
Down's syndrome affects some people from birth. It causes learning difficulties, and it also makes some physical problems more likely. It is caused by an extra chromosome. Chromosomes are found in all our cells, and contain genes, which tell cells how to grow and behave.
Down's syndrome affects some people from birth. It causes learning difficulties, and it also makes some physical problems more likely. It is caused by an extra chromosome. Chromosomes are found in all our cells, and contain genes, which tell cells how to grow and behave.
Source:
Prasher VP, Sajith SG, Rees SD, et al.
Significant effect of APOE epsilon 4 genotype on the risk of dementia in Alzheimer's disease and mortality in persons with Down syndrome.
International Journal of Geriatric Psychiatry. 2008; 23: 1134-1140.
Prasher VP, Sajith SG, Rees SD, et al.
Significant effect of APOE epsilon 4 genotype on the risk of dementia in Alzheimer's disease and mortality in persons with Down syndrome.
International Journal of Geriatric Psychiatry. 2008; 23: 1134-1140.
Source:
Alzheimer's Society.
Learning disabilities and dementia.
2008. Available at http://alzheimers.org.uk/site/scripts/documents_info.php?documentID=103 (accessed on 4 March 2009).
Alzheimer's Society.
Learning disabilities and dementia.
2008. Available at http://alzheimers.org.uk/site/scripts/documents_info.php?documentID=103 (accessed on 4 March 2009).
Scientists have noticed that some people with Alzheimer's disease have aluminum or zinc in their brains when they die. But
we don't know if having these substances in your body increases your chances of getting the disease.
8 There hasn't been enough research.
Source:
Blass JP, Poirer J.
Pathophysiology of Alzheimer's disease.
In: Gauthier S. Clinical diagnosis and management of Alzheimer's disease. Martin Dunitz, London, UK; 1999.
Blass JP, Poirer J.
Pathophysiology of Alzheimer's disease.
In: Gauthier S. Clinical diagnosis and management of Alzheimer's disease. Martin Dunitz, London, UK; 1999.
If you've had an injury to your head, you may be at risk of getting Alzheimer's disease earlier than most people.
8 This doesn't mean that head injuries cause Alzheimer's. But the injury may speed up the changes in the brain.
Source:
Blass JP, Poirer J.
Pathophysiology of Alzheimer's disease.
In: Gauthier S. Clinical diagnosis and management of Alzheimer's disease. Martin Dunitz, London, UK; 1999.
Blass JP, Poirer J.
Pathophysiology of Alzheimer's disease.
In: Gauthier S. Clinical diagnosis and management of Alzheimer's disease. Martin Dunitz, London, UK; 1999.
Having a stroke or lots of little strokes can damage brain cells and lead to vascular dementia. Risk factors for stroke include:
9
Source:
Tegos TJ, Kalodiki E, Daskalopoulou SS, et al.
Stroke: epidemiology, clinical picture, and risk factors (part I of III).
Angiology. 2000; 51: 793-808.
Tegos TJ, Kalodiki E, Daskalopoulou SS, et al.
Stroke: epidemiology, clinical picture, and risk factors (part I of III).
Angiology. 2000; 51: 793-808.
-
high blood pressure
Your blood pressure is considered to be high when it is above the accepted normal range. The usual limit for normal blood pressure is 140/90. If either the first (systolic) number is above 140 or the lower (diastolic) number is above 90, a person is considered to have high blood pressure. Doctors sometimes call high blood pressure "hypertension."High blood pressure -
high cholesterol
If you've been told that you have high cholesterol it usually means that your total cholesterol level is 240mg/dL or higher. But doctors also look at the amount of good (HDL) and bad (LDL) cholesterol you have in your blood. Having high levels of bad cholesterol can make it more likely that you'll get certain diseases in your heart and arteries.High cholesterol -
diabetes
Diabetes is a condition that causes too much sugar to circulate in your blood. It happens when your body stops making a hormone called insulin (type 1 diabetes) or when insulin stops working (type 2 diabetes).Diabetes - Smoking
- Being
obesity
If your body stores more energy than you need for daily functioning, this can make you overweight. The excess energy is stored in your fat cells. If your weight goes above a certain level, doctors call this obesity. Obesity is considered a medical condition. The excess weight can be a strain on your bones and joints. And if you are obese, you're more likely to get other diseases. Doctors have developed a scale for telling how much excess weight you have. This measure, called the body mass index (BMI), depends on your height.obese - Not getting much exercise
- Having an irregular heartbeat (such as
atrial fibrillation
Atrial fibrillation happens when your heart beats in an uneven or irregular way. Normally the beating of your heart is controlled by electrical signals. The signals make the upper parts of your heart (the atria) squeeze blood into the lower parts which then squeeze blood out into your blood vessels. If you have atrial fibrillation, the electrical signal doesn't work well, so the upper parts of the heart don't beat at the right time.atrial fibrillation).
Sources for the information on this page:
- Alzheimer's Society.Facts about dementia.Available at: http://www.alzheimers.org.uk (accessed on 27 September 2006).
- Bird TD.Alzheimer's disease and other primary dementias.In: Braunwald E, Hauser SL, Fauci AS, et al (editors). Harrison's principles of internal medicine. 15th edition. McGraw Hill, New York, U.S.A.; 2001.
- Hogervorst E, Williams J, Budge M, et al.The nature of the effect of female gonadal hormone replacement therapy on cognitive function in post-menopausal women: a meta-analysis.Neuroscience. 2000; 101: 485-512.
- Carr DB, Goate A, Phil D, et al.Current concepts in the pathogenesis of Alzheimer's disease.American Journal of Medicine. 1997; 103 (supplement): S3-S10.
- Alzheimer's Disease Education and Referral (ADEAR) CentreAlzheimer's Disease Genetics
- Prasher VP, Sajith SG, Rees SD, et al. Significant effect of APOE epsilon 4 genotype on the risk of dementia in Alzheimer's disease and mortality in persons with Down syndrome. International Journal of Geriatric Psychiatry. 2008; 23: 1134-1140.
- Alzheimer's Society.Learning disabilities and dementia. 2008. Available at http://alzheimers.org.uk/site/scripts/documents_info.php?documentID=103 (accessed on 4 March 2009).
- Blass JP, Poirer J.Pathophysiology of Alzheimer's disease.In: Gauthier S. Clinical diagnosis and management of Alzheimer's disease. Martin Dunitz, London, UK; 1999.
- Tegos TJ, Kalodiki E, Daskalopoulou SS, et al.Stroke: epidemiology, clinical picture, and risk factors (part I of III).Angiology. 2000; 51: 793-808.
This information was last updated on Mar 05, 2009
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© BMJ Publishing Group Limited 2009. All rights reserved.
© BMJ Publishing Group Limited 2009. All rights reserved.
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