The onset times and forms of diseases, and sometimes their causes, the factors accompanying their onset, diagnoses, and treatments, can lead to contradictory views. The most important of these contradictions is assuming, by looking at disease symptoms that appear suddenly or within very short periods, that these symptoms actually formed suddenly or within short periods. 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-term symptoms. However, there are long processes that prepare the onset of these diseases' symptoms and to which risk factors contribute. For example, no matter how sudden the onset of a stroke may be, factors such as a family history of stroke, and previously diagnosed conditions like hypertension, diabetes, and high cholesterol are among the risk factors that prepare the stroke over the years.
Similar processes operate with different risk factors for epilepsy and headache. In short, saying that an onset is sudden (acute) does not mean that the disease appeared at that exact hour or moment. On the contrary, the potential for recurrence over time shows that these are not truly sudden conditions.
It can be said that the exact opposite misconception applies to Alzheimer's disease. Although this disease matures over time accompanied by certain risk factors like the diseases mentioned above, nobody talks about the disease itself and its development until the final stage of the disease, which is the dementia stage, is reached. Yet, this stage is also one where almost all kinds of treatment opportunities are reduced to zero. However, what remains valid is the fact that Alzheimer's is a disease before it results in dementia. This perspective on the subject, namely looking at Alzheimer's as any brain disease, reminds us that there may be factors that weaken and strengthen our hand in combating 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 encountering or being introduced to it quite late and in its state that ultimately leads to dementia. In other words, it is late diagnosis. Because Amnestic Syndrome, which emerges at the point reached after perhaps five or perhaps ten years representing the past process of the disease, is a stage reached as the final stage of the disease, and mental deficiencies far exceeding forgetfulness, behavioral abnormalities, and deficiencies in daily life activities have appeared in the patient. At this stage, we have no treatment chance other than treating behavioral abnormalities.
Another factor that weakens our hand is that new drugs with therapeutic (stopping or slowing) effects on disease symptoms have not been introduced into use within the last thirty years. During this elapsed time, many drug studies have been conducted, many of these studies could not be completed due to side effects, and it has been understood later that the remaining ones have a partial effect in early stages and are devoid of effect afterwards.
Another factor that weakens our hand regarding the disease is Early-Onset Alzheimer's, a genetically transmitted disease whose onset ages drop down to the 40s. Three (1, 14, 21) of the four chromosomes (1, 14, 19, and 21) involved in Alzheimer's disease are responsible for early-onset disease. Chromosome 19, which is involved in late-onset Alzheimer's, is actually a vascular disease chromosome and its role is limited.
The existence of other factors that weaken our hand regarding the disease can also be mentioned. These factors are; low education level, narrow social circle-lifestyle, and the effect of other diseases. Many studies have shown that a low level of education is a risk factor for the disease. The same is said for an introverted lifestyle isolated from social relations. It has been stated that those with a history of chronic depression diagnosis have at least a threefold increased risk of the disease. It is known that the presence of vascular disease risk factors, and especially hypertension and diabetes, increases the risk both for vascular dementia on their own and for Alzheimer's.
To summarize; it can be said that the factors that weaken our hand in Alzheimer's are late diagnosis, inadequacy of treatment, genetic transmission, low education level, narrow-restricted lifestyle, and the effect of other diseases. Except for genetics and inadequacy of treatment, it is entirely up to our approach for the remaining of these factors to transform into factors that strengthen our hand.
What Are the Factors That Strengthen Our Hand in Alzheimer's?
Chief among the factors that strengthen our hand in Alzheimer's is the earliest possible diagnosis of the disease. Early diagnosis of the disease is the diagnosis made before dementia symptoms appear. Early diagnosis of the disease to be made before reaching dementia can be made by demonstrating the presence of recent forgetfulness that is mentally only tending to recur, without any behavioral and daily life-occupational abnormality appearing.
This stage called Mild Cognitive Impairment (MCI) is by no means dementia and it is not certain whether it will evolve into dementia or not. In studies conducted, it has been understood that when diagnosed at this stage, namely just the stage of recurrent recent forgetfulness, during regular test follow-ups, 60% of these individuals progressed toward turning into Alzheimer's while 40% progressed toward not turning into it.
There is an impression that using existing drugs at the early diagnosis stage has a slowing effect in those who receive an early diagnosis and are recommended drugs. Therefore, drug use in the early diagnosis group can be accepted as a factor slowing down the potential for conversion to dementia.
There is a great similarity between the initial symptoms of major depression and Alzheimer's. Among these similarities, forgetfulness and attention deficit draw attention. In this regard, there is a link between the successful treatment of depression and the reduction of Alzheimer's risk in subsequent years.
Similarly, it can be said that active combat against vascular risk factors and the implementation of a dietary style called the Mediterranean Diet, which is a requirement of this combat, are among the factors that indirectly strengthen our hand.
In summary, just as there are factors among those that weaken our hand in Alzheimer's that we currently have no impact on, it is possible for some factors that we can address to transform into factors that strengthen our hand in this way. These are as follows;
- Early diagnosis,
- Preventive drug administration and regular test follow-up,
- Mind exercises,
- Social life activities,
- Combat against depression and cerebrovascular diseases,
- Dietary style similar to the Mediterranean Diet.