How to reduce the risk of dementia in old age

ALMATY. KAZINFORM Every year on September 21, World Alzheimer’s Day is celebrated – the most common form of dementia. At a press conference in Almaty, Kazakh doctors answered questions: what can be done to prevent or slow down the development of dementia and how to recognize the disease, Kazinform correspondent reports.

According to the forecasts of world scientists, by 2050 more than 150 million inhabitants of the Earth will suffer from dementia. To prevent this disease, you need to know the risk factors for its development. The first factor is age: the older you are, the higher the risk. The second is genetics. If your grandparents suffered from memory loss and became dependent, then you need to engage in the prevention of Alzheimer’s from an early age. Other important risk factors are hypertension, high cholesterol (dyslipidemia), atherosclerosis, diabetes mellitus, obesity, unhealthy diet, sedentary lifestyle, head injuries, drugs (sedatives), smoking, especially passive smoking, dirty air, pesticides.

“If it weren’t for the two-year pandemic we experienced, then Alzheimer’s disease would be called an epidemic today. There are 55 million elderly people with dementia in the world, 10 million new cases are detected annually, or a new case every three seconds. We have a lot of myths, for example, people believe that memory loss is typical for the older generation, even doctors broadcast that “this is old age, it cannot be cured.” In fact, the process of healthy aging is characterized by the improvement of many cognitive functions. For example, verbal memory (this is a lexicon, speech, thinking) and practical intelligence (the ability to cope with difficulties) should improve with age, as experience and knowledge crystallize, ”comments a psychotherapist, candidate of medical sciences, head of the center for the treatment of neuroses and diseases Alzheimer’s Zhibek Zholdasova.

President of the Association of Family Doctors of Kazakhstan, Doctor of Medical Sciences Damilya Nugmanova believes that family doctors and nurses play a big role in identifying risk factors in children, young people, middle-aged people, as well as increasing alertness about Alzheimer’s disease among the attached population.

“Knowing the whole family, including the older generation, a general practitioner can alert family members and help fight risk factors. Also, the local doctor will help to identify dementia early, give recommendations, prescribe treatment and refer, if necessary, to a specialist. The role of primary health care in the prevention and treatment of so-called manageable or modifiable risk factors for dementia, such as arterial hypertension, dyslipidemia, prediabetes and diabetes mellitus, obesity, and smoking, is especially important. However, doctors can only help, suggest, prescribe non-drug and drug treatment. The main role belongs to the person himself, his family. It is up to you whether to follow or ignore the recommendations of doctors. And the sooner you start preventive treatment, a healthy lifestyle, the more you postpone the catastrophe with your brain, ”she says.

Doctor of Medical Sciences, Professor of the Department of Neurology, Neurosurgery of KazNMU named after. Asfendiyarova, chairman of the NGO “Association of Neurologists” Yerkin Nurguzhaev drew attention to the stroke. According to him, more than 40 thousand cases of stroke are registered in Kazakhstan every year, which is terrible not only with a large percentage of mortality, but also with consequences.

“Even with a favorable outcome and minimal lesion size, most patients develop post-stroke cognitive impairment. The deterioration of memory, concentration and executive functions leads to the fact that patients who need physical rehabilitation after a stroke cannot fully master the rehabilitation program. And in cases of already pronounced dementia, rehabilitation measures become impossible for the patient and lose their relevance. I would like to note the need and importance of interdisciplinary interaction between doctors of all specialties – psychologists, speech therapists and rehabilitation therapists. It is important to draw the attention of patients and relatives to this problem, to be able to use tests to detect cognitive impairment in order to prevent their progression at an early stage, thereby maintaining independence and improving the quality of life of patients,” the professor added.

Lyudmila Zhangeldina, General Director of Acino Kaz, a company of the Swiss pharmaceutical group ACINO, said that an active lifestyle will help preserve a person in old age.

“Regular walking, gymnastics, puzzles, cereals, arithmetic, housework, and an active social life are recommended not only for healthy retirees, but also for those who have already begun to show signs of dementia. There is another concept that protects against symptoms – this is a cognitive reserve, i.e. stock of knowledge, experience that a person has. The wider this margin, the more potentially Alzheimer’s is. Therefore, the constant mastering of new skills and development is the best protection against age-related ailments,” the speaker noted.

Zhibek Zholdasova, head of the Center for the Treatment of Neuroses and Alzheimer’s Disease, said that there are many incurable diseases in the world, including Alzheimer’s disease. But there are various drugs that support immunity.

“There are clear data and statistics. If we identify a patient at an early stage of the disease, for example, when he only has forgetfulness and difficulty in choosing words, and prescribe treatment, then he will have to go to the hospital four years later. Even if it came to the hospital, the terms of treatment in the hospital will be four times shorter. Timely prescription of drugs will preserve the independence of a sick person for at least five years. That is, you can leave it at home for another five years. He can dress himself, take care of himself, do something, he will be able to have a productive dialogue with you, and you will not have to adapt, because the person’s condition will be stable for several years. It’s very good,” she said.

According to her, if the patient is not prescribed treatment in a timely manner, then Alzheimer’s disease will quickly progress, and the condition will worsen. The doctor added that scientists around the world are conducting clinical trials of drugs that will affect the cause of the disease.

“If we eliminate proteins in the brain that lead to memory impairment, then we can preserve a person’s memory for much longer than five years with the usual treatment that exists today. In America, clinical protocols with the use of the drug aducanumab have already been approved. While this treatment is very expensive, but over the past year the price has halved. The annual course of treatment is 28 thousand dollars. But the technology will progress, the drug is still controversial, but this is already a huge step forward for the emergence of a new generation of drugs that will treat Alzheimer’s disease. I hope that in the next 10 years new drugs will appear, because there are already four drugs in line today that are already undergoing clinical trials. Not everything is so bad,” said Zhibek Zholdasova.


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