The timing and pattern of the onset of diseases can sometimes lead to conflicting views about their causes, the factors that contribute to their occurrence, their diagnosis and their treatment. One of the most important of these contradictions is to look at the symptoms of diseases that occur suddenly or in a very short period of time and assume that these symptoms really occur suddenly or in a short period of time. In neurology, stroke, epilepsy and headache are examples of such diseases. Neurological diseases such as stroke, epilepsy and headache can often present with sudden or short-lived symptoms. However, there are long processes that prepare for the onset of symptoms and to which risk factors contribute. For example, no matter how sudden the onset of a stroke, a family history of stroke, previously diagnosed hypertension, diabetes and high cholesterol are among the risk factors that contribute to the development of stroke over many years.
Epilepsy and headache follow similar processes with different risk factors. In short, a sudden (acute) onset does not mean that the disease appeared at that hour or at that moment. On the contrary, the potential for recurrence over time indicates that these are not really sudden conditions.
For Alzheimer's disease, the opposite misconception is true. Although this disease, like the above-mentioned diseases, is a disease that matures over time in the presence of certain risk factors, no one talks about the disease itself and its development until the final stage of the disease, dementia, is reached. This is also the stage at which the possibility of any kind of treatment is almost nil. What is true is that Alzheimer's is a disease before it leads to dementia. This way of looking at it - that Alzheimer's is just another brain disease - reminds us that there are factors that weaken and strengthen our hand in the fight against it.
What are the factors that weaken our hand in Alzheimer's?
The most important factor that weakens our hand in Alzheimer's disease is meeting or being introduced to it too late and in a form that eventually leads to dementia. In other words, late diagnosis. Amnestic Syndrome is the final stage of the disease, which is reached at the end of five or ten years representing the past course of the disease, and the patient has mental deficiencies, behavioral abnormalities and inadequacies in daily life activities that go far beyond forgetfulness. At this stage, there is no treatment other than behavioral abnormalities.
Another factor that weakens our hand is the lack of new drugs with therapeutic (stopping or slowing down) effects on the symptoms of the disease in the last thirty years. Many drug trials have been carried out during this time, many of which have not been completed due to side effects, and the remaining ones have been found to be partially effective in the early stages and ineffective later on.
Another factor that weakens our grip on the disease is Early Onset Alzheimer's, a genetically inherited disease with onset in the 40s. Of the four chromosomes (1, 14, 19 and 21) involved in Alzheimer's disease, three (1, 14, 21) are responsible for early-onset disease. Chromosome 19, which is involved in late-onset Alzheimer's disease, is actually a vascular disease chromosome and its role is limited.
There are other factors that weaken our hand against the disease. These factors include low educational attainment, narrow social environment and lifestyle, and the impact of other diseases. Many studies have shown that a low level of education is a risk factor for the disease. The same can be said for an introverted and isolated lifestyle. Those with a history of chronic depression have at least three times the risk of the disease. The presence of risk factors for vascular diseases, especially hypertension and diabetes, are known to increase the risk of both vascular dementia per se and Alzheimer's disease.
To summarize, it can be said that the factors that weaken our hand in Alzheimer's disease are late diagnosis, lack of treatment, genetic transmission, low level of education, narrow-restricted lifestyle and the effect of other diseases. The fact that the factors other than genetics and lack of treatment become factors that strengthen our hand is entirely up to our approach.
What are the factors that strengthen our hand in Alzheimer's?
One of the factors that strengthen our hand in Alzheimer's disease is early diagnosis of the disease whenever possible. Early diagnosis of the disease is the diagnosis made before the symptoms of dementia appear. The early diagnosis of the disease without dementia can be made without any behavioral and daily life-occupational abnormalities, and mentally only by showing the presence of near-term forgetfulness that tends to recur.
This stage, called Mild Cognitive Impairment (MCI), is by no means dementia and it is not clear whether it will evolve into dementia. Studies have shown that when diagnosed at this stage, i.e. only at the stage of recurrent near-term forgetfulness, regular test follow-ups show that 60% of these people develop Alzheimer's disease and 40% do not.
In those who were diagnosed early and for whom medication was recommended, there is an impression that the use of existing medications at the early diagnosis stage has a slowing effect. Therefore, the use of medication in the early diagnosis group can be considered as a factor that slows down the potential for conversion to dementia.
There is a great similarity between major depression and Alzheimer's onset symptoms. Among these similarities, forgetfulness and attention deficit are noteworthy. In this respect, there is a link between successful treatment of depression and a reduced risk of Alzheimer's in later years.
Similarly, it can be said that the effective fight against vascular risk factors and the implementation of the so-called Mediterranean Diet, which is a requirement of this fight, are among the factors that indirectly strengthen our hand.
To summarize, among the factors that weaken our hand in Alzheimer's disease, there are some factors that we currently have no influence on, and some factors that we can address may turn into factors that strengthen our hand in this way. These are as follows;
- Early diagnosis,
- Preventive medication and regular test follow-up,
- Exercises for the mind
- Social life activities,
- Fighting depression and cerebrovascular diseases,
- It is a diet similar to the Mediterranean Diet.