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What is Dementia?
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“One in ten persons over 65 and nearly half of those over 85 have Alzheimer’s disease. Today, 4 million Americans have Alzheimer’s disease. Unless a cure or prevention is found, that number will jump to 14 million by the year 2050. Worldwide, it is estimated that 22 million individuals will develop Alzheimer’s disease by the year 2025. In a national survey, 19 million Americans said they have a family member with Alzheimer’s disease, and 37 million said they knew someone with the disease.” (www.alzheimersassociation/treatingcognitivesymptoms.html) What is Dementia? Dementia is a term used to describe the loss of cognitive or intellectual function. It is a biological brain syndrome that results in cognitive impairments. It can occur as a result of a variety of neurological diseases. One of the better-known dementing diseases is Alzheimer’s disease (AD). Statistically AD is the most significant dementing disease occurring in over fifty percent of demented patients. Dementia is a long-term advancing disorder. (www.alzheimers.org/pubs/prog00.html) Nineteenth Century The study of dementia dates back to the early nineteenth century. The great French psychiatrist Pinel attempted the initial steps at the beginning of that century. Pinel’s observations led him to the conclusion that the term dementia should be used in relation to the “progressive mental changes seen in some idiots.” (www.geocities.com/bigmike_75/aessays/a48.html) Much of today’s knowledge about dementia was gathered throughout the second half of the nineteenth century, and the first decade of the twentieth century. Dr. Alois Alzheimer first described Alzheimer’s disease in 1906, as a degenerative brain disease that usually begins gradually, causing a person to forget recent events or familiar tasks. (www.alzheimersassociation/frequentlyaskedquestions.html) Gender/Ethnic Differences Dementia is known as the quiet epidemic, but it affects a large portion of our population. In 1989 the Canadian consensus estimate about 250,000 cases of dementia with 25,000 new cases occurring annually. There are no significant gender differences in prevalence and incidence rates for dementia as a whole. However, for AD, there is an increased prevalence in females. It is estimated that the female to male AD prevalence ratio of 1.6. (www.geocities.com/bigmike_75/aessays/a48.html) Ethnically there seem to be important differences in both prevalence and subtype of dementia. Out of a random sample of 4,116, sixteen percent of African Americans had dementias compared to only 3.1 percent of Caucasians. The same study also found that mixed (dementia with both cortical and sub cortical features, and MID is a example of mixed dementia) and Multi-infarct dementia (MID) was more likely in African Americans. (www.geocities.com/bigmike_75/aessays/a48.html) In both Europe and North America most studies conclude that AD is the most common dementing illness; whereas in Asia MID predominates. The high rate of stroke in Japan is consistent with a high MID rate. Possibly the higher level of stress in Japan leads to more strokes and therefore a higher incidence of MID. (www.geocities.com/bigmike_75/aessays/a48.html) Risk Factors Many conditions cause dementia. Several other diseases also cause dementia, such as Parkinson’s, Creutzfeldt-Jakob, Huntington’s, and multiinfarct or vascular disease, caused by several stokes in the brain. (www.alzheimersassociation/frequentlyaskedquestions.html) Age is the biggest risk factor for developing dementia. According to a model proposed by Jorm et al. (1987) a doubling of the prevalence rate occurs every 5.1 years. For the elderly population aged 65 and above the prevalence of dementia is estimated at about ten percent. Whereas in the very elderly it can reach up to forty percent. (www.ninds.nih.gov/health_and_medical/disorders/alzheimerdisease_doc.html) Genetic factors are important in some dementing diseases. The genetic evidence in AD is less conclusive. Farrer et al. (1990) suggests that AD appears as an autosomal dominant in families in which the average onset among kindred’s is under fifty-eight. Supporting evidence for this comes from studies, which have linked EOAD with Down Syndrome (DS). Individuals who are afflicted with DS and who survive to age forty almost always develop AD. (www.alzheimers.org/pubs/unravel.html) The increased risk for AD to patients born to mothers over forty is consistent with DS risk curve. It has been proven that an increased risk for dementia is dependent on a strong chemical binding between the main ingredient of SP, the Beta amyloid protein, and the APOE-e4. (www.alzheimers.org/pubs/prog00.html) Lower education has also been linked with dementia. Animal studies demonstrate a relation between environmental stimulation and dendritic growth. It is also known that dendritic growth in humans continues throughout life.
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