For the elderly, Alzheimer’s dementia is a more fearful disease than cancer. Degenerative changes in the brain make it difficult to judge and act on one’s own, making family care absolutely necessary. The economic cost burden of care is also large. Anyone can develop Alzheimer’s dementia, which increases the risk of developing it as one ages. As the human brain ages, its size decreases, nerve cells in the brain die, and the synapses connecting them decrease. On Mental Health Day (October 10th), we heard from Professor Seo Sang-won (Director of Gangnam-gu Dementia Relief Center) of the Department of Neurology at Samsung Seoul Hospital about prevention and management of Alzheimer’s dementia, a mental illness in old age.
Q: As the population ages, the number of people suffering from dementia, a degenerative brain disease, is rapidly increasing.
A: “I’m worried. According to ‘Status of Dementia in Korea 2022’ published by the Central Dementia Center, the number of dementia patients is expected to exceed 1.42 million in 2030 and 3.15 million in 2050. If dementia is diagnosed and treated early, the progression of the disease can be slowed and the period of independent daily life can be increased. To this extent, admission to a medical institution can be delayed. Reductions in social and economic costs can also be expected. “Preventative management to prevent dementia progression is necessary from the stage of mild cognitive impairment.”
Q: Even if you have mild cognitive impairment, you can live your daily life without any major problems. Why is treatment necessary?
A: “Mild cognitive impairment is a strong warning signal sent by the brain. Compared to people of the same age group, the rate of decline in brain cognitive function is pathologically fast, making them unfavorable to dementia. The likelihood of deteriorating from mild cognitive impairment to Alzheimer’s dementia is approximately 10 times higher than that of the general elderly population. However, the extent to which brain cognitive function is maintained varies depending on how one spends the period of mild cognitive impairment. This is the background for the medical community to focus on mild cognitive impairment, which is the stage before progressing to dementia. “The sooner you respond, the better it is for maintaining brain cognitive function.”
Q: If my memory is poor, should I suspect mild cognitive impairment?
A: “Deteriorating memory, including forgetting and forgetting, is a typical symptom of mild cognitive impairment. However, poor memory does not necessarily mean that a person is suspected of having mild cognitive impairment. It is difficult to distinguish between memory decline due to aging, mild cognitive impairment, and Alzheimer’s dementia based on symptoms alone. This is why it is difficult to diagnose Alzheimer’s dementia in the clinical setting. If you experience persistent or repeated memory decline, we recommend that you visit a hospital and undergo a neuropsychological test to examine the state of brain cognitive functions such as memory, concentration, judgment, and spatiotemporal organization ability. In particular, if a neuropsychological test shows a decline in brain cognitive function and a brain
MRI (magnetic resonance imaging) test shows brain atrophy, a brain imaging test that measures how much amyloid beta has accumulated in the brain, which increases the risk of transition from mild cognitive impairment to dementia. “It is recommended to undergo an amyloid
PET (proton emission tomography) test.”
Q: Are there cases where people are genetically susceptible to Alzheimer’s dementia?
A: “Yes.
This is when the ApoE4 gene is present. Chris Hemsworth, who played the superhero character Thor in the movie ‘Marvel series’ , became famous after being found to have the
ApoE4 gene, a gene at risk for developing Alzheimer’s disease, through genetic testing. If you have the
ApoE4 gene, which has a weak degree of protection for brain nerve cells, the risk of developing Alzheimer’s dementia is higher due to the accumulation of amyloid beta protein in the brain. When testing for mild cognitive impairment, etc., it is also helpful to consider genetic testing to check for the presence of the
ApoE4 gene. Worldwide, the rate of people carrying at least one
ApoE4 gene, which increases the risk of developing Alzheimer’s레고토토 dementia, is quite high at 20%. East Asians, including Koreans, are more vulnerable to Alzheimer’s dementia due to a sub-mutation of the
ApoE4 gene. The extent of brain damage is wide, and the progression of Alzheimer’s dementia is faster. “There is a need to expand national support for screening, diagnosis, and treatment of Alzheimer’s dementia, mild cognitive impairment, etc.”
Q: Is it possible to prevent Alzheimer’s dementia by treating mild cognitive impairment?
A: “The brain, which controls memory and judgment, ages at a different rate depending on how we live our daily lives. When we analyzed the incidence of dementia according to lifestyle habits in groups with a high risk of developing dementia, we found that the group that maintained healthy lifestyle habits such as regular exercise, smoking cessation, and a Mediterranean diet had a 32% reduced risk of dementia compared to the group that did not. There are also studies. If the patient progresses to a serious condition where brain cognitive function declines and independent daily life becomes difficult, the burden of care on the family will only increase. Although it has not yet been introduced in Korea, in July of this year, the U.S. Food and Drug Administration (
FDA ) approved a new drug that prevents the accumulation of abnormal proteins such as amyloid beta in the brain, making it possible to more effectively deal with mild cognitive impairment and dementia caused by Alzheimer’s in the future. ”
