ADVERTORIAL
Dementia and Alzheimer ' s disease – an urgent need for early intervention
By Chantelle van der Weyden | BPsych ( Hons ), AdvDip ( Nat ), AdvDip ( NutMed )
Snapshot
• Dementia and Alzheimer ’ s disease pose not only an enormous individual , health care and economic burden , but also have devastating effects on families and loved ones .
• The preclinical phase of Alzheimer ’ s disease is thought to commence up to 20 years prior to the onset of symptoms .
• There are currently very limited medical treatments available for Alzheimer ’ s disease .
• This extended preclinical phase affords the opportunity for early intervention .
It is estimated that there are currently over 50 million people globally living with dementia , and this number is expected to reach 152 million by 2050 . 1 As the single greatest cause of disability in people aged 65 and over , dementia poses an enormous individual , health care and economic burden , likely to cost the Australian community an estimated $ 18 billion by 2025 . 2 Equally , if not more concerning , are the devastating effects dementia can have on caregivers and family members . Levels of psychological distress , social wellbeing and physical health are significantly lower in dementia caregivers than in caregivers of those with a physical disability , with this difference even greater when compared with non-caregivers . 3 Evidence suggests that the pathophysiological process of dementia commences many years , if not decades , before a clinical diagnosis is reached . 4 This extended preclinical phase affords the opportunity for early intervention that allows not only for a reduction in disease burden and symptomology , but may also significantly reduce the cost to the community and loved ones .
Dementia is a syndrome involving a progressive decline in various behavioural parameters including thinking , memory , social functioning and the ability to perform everyday tasks . 5 Alzheimer ’ s disease ( AD ) is the most common form of dementia and accounts for 60-80 % of dementia diagnoses . 6 Mild cognitive impairment ( MCI ) encompasses clinically significant memory impairment that does not meet the criteria for AD , but is generally considered preclinical AD . 7 It is estimated that 5-10 % of those with MCI will progress to AD . 7 This initial asymptomatic , preclinical phase of AD is thought to commence up to 20 years prior to the onset of symptoms , and various risk factors for the progression from MCI to AD have been identified . These include type 2 diabetes , depression , physical inactivity , poor diet , mental inactivity , hypertension , obesity and compromised vascular function , 6 , 8 , 9 all of which are modifiable with dietary and lifestyle intervention .
Despite the significant public health issue that AD poses , and the extended preclinical phase , there are currently only five medical treatments that have been approved for AD . 10 These treatments act to control or modify the symptoms of AD rather than alter the course of the disease . Currently there are no drug treatments to improve cognitive function , slow or halt the progression from MCI to AD , and at this stage cognitive decline and AD is considered irreversible . 7
New and novel clinically trialled natural medicines are available to help manage this insidious disease . Reach out to your BioMedica practitioner consultant for more information .
REFERENCES
1 . Lynch , C . ( 2020 ). World Alzheimer Report 2019 : Attitudes to dementia , a global survey . Alzheimer ’ s & Dementia , 16 ( S10 ), e038255 . https :// doi . org / 10.1002 / ALZ . 038255
2 . Dementia Australia ( 2020 ). Dementia Statistics . Available at https :// www . dementia . org . au / statistics
3 . Brodaty , H ., & Donkin , M . ( 2009 ). Family caregivers of people with dementia . Dialogues in Clinical Neuroscience , 11 ( 2 ), 217 . https :// doi . org / 10.31887 / DCNS . 2009.11.2 / HBRODATY 4 . Morris , J . C . ( 2005 ). Early-stage and preclinical Alzheimer disease . Alzheimer Disease and Associated Disorders , 19 ( 3 ), 163 – 165 . https :// doi . org / 10.1097 / 01 . WAD . 0000184005.22611 . CC
5 . Meletis , C . D . ( 2020 ). Alkyl-acylglycerols and the important clinical ramifications of raising plasmalogens in dementia and alzheimer ’ s disease . Integrative Medicine ( Boulder ), 19 ( 3 ), 12 – 16 .
6 . Crous-Bou , M ., Minguillón , C ., Gramunt , N ., & Molinuevo , J . L . ( 2017 ). Alzheimer ’ s disease prevention : From risk factors to early intervention . Alzheimer ’ s Research and Therapy , 9 ( 1 ): 71 . https :// doi . org / 10.1186 / s13195-017-0297-z
7 . Li , S ., Guo , Y ., Men , J ., Fu , H ., & Xu , T . ( 2021 ). The preventive efficacy of vitamin B supplements on the cognitive decline of elderly adults : a systematic review and meta-analysis . BMC Geriatrics , 21 ( 1 ). https :// doi . org / 10.1186 / S12877- 021-02253-3
8 . Barnes , D . E ., & Yaffe , K . ( 2011 ). The projected effect of risk factor reduction on Alzheimer ’ s disease prevalence . The Lancet . Neurology , 10 ( 9 ), 819 – 828 . https :// doi . org / 10.1016 / S1474- 4422 ( 11 ) 70072-2
9 . Gottesman , R . F ., Schneider , A . L . C ., Zhou , Y ., Coresh , J ., Green , E ., Gupta , N ., Knopman , D . S ., Mintz , A ., Rahmim , A ., Sharrett , A . R ., Wagenknecht , L . E ., Wong , D . F ., & Mosley , T . H . ( 2017 ). Association between midlife vascular risk factors and estimated brain amyloid deposition . JAMA , 317 ( 14 ), 1443 . https :// doi . org / 10.1001 / JAMA . 2017.3090
10 . Briggs , R ., Kennelly , S . P . & O ’ Neill , D . ( 2016 ). Drug treatments in Alzheimer ’ s disease . Clinical Medicine ( London , England ), 16 ( 3 ), 247 – 253 . https :// doi . org / 10.7861 / CLINMEDICINE . 16-3-247
Disclaimer : The views and opinions expressed in these advertorials are those of the authors and do not necessarily reflect the opinions of ATMS or its Directors .
JATMS | Spring 2021 | 175