Alzheimer's is a disease defined from the end to the beginning

Alzheimer's is a disease defined from the end to the beginning

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Don't go to rural areas to retire early and grow tomatoes! Experts warn: This may increase the risk of Alzheimer's as a side factor through social isolation and brain stimulation. Emphasizing that Alzheimer's is not an aging-related disease, Prof. Dr. Oğuz Tanrıdağ draws attention to the fact that an introverted lifestyle, keeping oneself out of stimuli, and doing the usual routine things in daily life is objectionable in Alzheimer's.

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Prof. Dr. Oğuz Tanrıdağ, Head of the Department of Neurology at Üsküdar University Faculty of Medicine and Neurology Specialist at NPISTANBUL Hospital, shared important information about the early diagnosis of Alzheimer's disease.

Alzheimer's is a disease defined from the end to the beginning

Stating that Alzheimer's disease is a disease defined from the end to the beginning, Tanrıdağ said, "Like all diseases defined from the end to the beginning, there are difficult years in its solution. Alzheimer's was defined by autopsy method on a patient who died from this disease. A disease defined by the autopsy method inevitably brought autopsy to the forefront as a diagnostic method for the first time, and in classical books, including the years we grew up, there is still an understanding that 'the definitive diagnosis of Alzheimer's disease is made by obtaining pathological findings'. This is something that makes things difficult, maybe even impossible. In my opinion, some of the people we pass by, meet and talk to every day in our daily lives are different from others in terms of Alzheimer's risk."

Prevention should be taken before the disease occurs

"It is extremely important to recognize Alzheimer's risk groups, to understand the risks on ourselves and to take precautions based on the risks before the disease occurs," Tanrıdağ said, "If a normal effort is made that we will definitely find pathological findings in the brain in the last stage of the disease and we will obtain them, this can be a significant waste of time. From my point of view, Alzheimer's disease is a disease that is diagnosed quite late, and if there is such a thing as clinical early diagnosis, it is the diagnosis of the middle stages as a disease. In other words, there is no such thing as a clinical early diagnosis of Alzheimer's disease."

The first pathological findings of Alzheimer's disease: Forgetfulness, agitation and paranoia

Stating that the first patient diagnosed with Alzheimer's disease was a woman named Augusta Deter, who was diagnosed with the disease at the age of 51 and died 5 years later, Prof. Dr. Oğuz Tanrıdağ said that the pathological findings related to this patient were forgetfulness, agitation and paranoia, "Her doctor followed her patient for 5 years, when the news of her death came, he asked for the patient's brain and together with his laboratory colleagues working with him, he conducted a neuropathological study and found neuropathological findings. These three complaints revealed that the patient was not just a neurology patient. Before Alzheimer's disease was recognized, these patients were considered psychiatric patients. This clearly shows us that these patients are not only psychiatric patients but also neuropsychiatric patients."

Alzheimer's is not an aging-related disease

Stating that nothing was done about Alzheimer's disease, which was first defined in 1906, 113 years ago, for about 70 years in the world, Prof. Dr. Oğuz Tanrıdağ said: "Alzheimer's disease came to the agenda again after US President Ronald Reagan went on television and said 'Doctors diagnosed me with Alzheimer's' and also after the 10 years between 1990 and 2000, called the '10 Years of the Brain', were declared by Father Bush and the basis of today's studies was made after those years. In other words, a disease that was identified in the history of the 20th century was forgotten for 70 years. No attention was paid to the disease. When the disease was recognized, the patient's age was 51 and he died at the age of 56. So those who attribute Alzheimer's to aging or old age should focus on this data. Alzheimer's is a disease that is not in a one-to-one causal relationship with aging, is affected by aging at the level of influence, and when other risk factors are involved, aging becomes pathological. A disease that starts at the age of 51 has been shown to start even in the 30s with genetic factors in later years."

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Preclinical period should be investigated

Prof. Dr. Oğuz Tanrıdağ stated that there are neuropathological stages from a normal brain to a brain with advanced Alzheimer's and said, "There are pre-clinical stages and clinical stages from neuropathological stages. This means that early diagnosis will be made pre-clinically. The preclinical period will be investigated. When it moves to clinical stages, no matter how much we talk about early diagnosis, it will not be early diagnosis, time will have passed. Clinical early diagnosis is a delayed diagnosis in terms of the disease. Clinical early diagnosis corresponds to the period of moderate disease in the MCI stage and severe disease in the dementia stage. There is no clinical early diagnosis in real terms. There is an early early diagnosis."

Aging is not the cause of Alzheimer's disease

Drawing attention to the risk factors in Alzheimer's disease, Prof. Dr. Oğuz Tanrıdağ said, "The old understanding was that 'People get senile when they get old'. We excuse them because they had no diagnostic methods. There were cultural factors. The prolongation of human life, the improvement of socio-economic conditions, the improvement in the quality of life resulted in the prolongation of life. Therefore, the burden of the disease became more pronounced at older ages. Aging is not the cause of Alzheimer's disease. Aging is a factor, but it is a factor that emerges when combined with other factors. There are people who are 90 years old and do not even show the onset of Alzheimer's disease and today we call them super old people. We should focus on risk groups. We should start with our own family and relatives. Some people used to apply much more because they had Alzheimer's in their family and they wanted their risk to be investigated. Some people want to have genetic tests. This is possible. People's lifestyle is important. How they spend their lives is important. There are risk factors hidden in life."

Down Syndrome-Alzheimer's relationship

Stating that genetic research has found an important genetic partnership between Down Syndrome and Alzheimer's, Tanrıdağ said, "Those born with Down Syndrome get Alzheimer's early. Alzheimer's pathological findings appear in their brains between the ages of 30-40. Therefore, it is a factor that should be spread over a multidimensional period of time."

It is more common in women

Prof. Dr. Oğuz Tanrıdağ said, "Alzheimer's disease is not a women's disease, but it is a disease that is primarily seen in women, with a rate of 2 out of 3." Prof. Dr. Oğuz Tanrıdağ said, "There may be reasons for this, we can distinguish three reasons. One is that women live at least 10 years longer than men. The second reason; depression can be seen more frequently in women. Chronic depression is a risk factor that at least doubles the risk of Alzheimer's. Thirdly, the risk of Alzheimer's increases even more in the absence of ostrogen, which is a powerful stimulating hormone for the brain through ostrogen reduction and depression."

Brain check-up should be done

Pointing out the importance of brain check-up in early diagnosis, Prof. Dr. Oğuz Tanrıdağ said, "Brain check-up is routinely performed at NPISTANBUL Hospital. Its results reveal the concept of early diagnosis as early as possible. Diagnostic methods called PET CT are also used in early diagnosis. In other words, it is a metabolic examination that reveals changes that have not yet been structurally revealed in MRI or similar techniques. Therefore, if we are talking about a real brain check-up, we should include it. We need to do these researches. It can be done in a screening style not only for those who ask 'Am I sick?' but also for people who have gone beyond a certain age group."

Avoid an introverted lifestyle

Prof. Dr. Oğuz Tanrıdağ pointed out the importance of lifestyle in preventing Alzheimer's and said, "An introverted, closed-off lifestyle, keeping oneself out of stimuli, whether social or familial, keeping oneself out of stimuli, doing the usual routine things in one's daily life and aging come into play as risk factors. Therefore, chronic depression should be avoided and treated. One should not go to the countryside to 'retire early and grow tomatoes' as some people believe. This may increase the risk of Alzheimer's as a side factor through social isolation and brain stimulation. Head traumas and falls should be avoided. One should be careful about receiving recurrent general anesthesia over a certain age, and one should not receive general anesthesia after the age of 60, except in emergencies."

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CreatorNP Istanbul Hospital Editorial Board
Updated At05 March 2024
Created At23 December 2020
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