Causes of Alzheimer's Disease in the Elderly

Written by Zhang Hui
Neurology
Updated on September 06, 2024
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The causes of dementia in the elderly are not currently completely clear. Dementia in the elderly is mainly divided into familial and sporadic types. Familial dementia shows autosomal dominant inheritance, which is caused by a gene mutation on chromosome 21 leading to the accumulation of some toxins, resulting in the death of neurons and causing dementia fundamentally due to genetic mutations. However, most cases of dementia are sporadic and do not have a clear family history. The mechanisms and reasons for disease onset are not particularly clear. Some believe that abnormalities in cerebral vascular function may lead to neuronal cell functional disorders, resulting in decreased ability to clear certain cell toxins, thus leading to neuronal apoptosis and death, and consequently impaired cognitive functions. In addition, factors such as oxidative stress, inflammatory mechanisms, excessive fatigue, and emergency stress may also cause cell death. Overall, the causes of dementia in the elderly are not particularly clear.

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Written by Zhang Hui
Neurology
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precursors of senile dementia

The diagnosis of senile dementia must first meet the diagnostic criteria for dementia, primarily characterized by impairment in multiple cognitive areas such as memory, language skills, executive function, and computational ability, and these impairments affect daily life; this is called senile dementia. Before dementia occurs, there are some precursory signs, mainly slight declines in memory. For example, patients might occasionally forget to bring keys when going out, or forget to turn off the stove while cooking. These mild memory impairments are some of the precursors to senile dementia. Additionally, there is a decline in learning ability, including the symptoms of learning new knowledge and mastering new skills; these declines are also precursors to senile dementia. Therefore, the precursors of senile dementia can primarily be summarized as a slight decline in memory function and some slight decline in learning ability.

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Neurology
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How is Alzheimer's disease treated?

Senile dementia, also known as Alzheimer's disease, is the most common neurodegenerative disease worldwide. The pathogenesis of this disease is not particularly clear so far and may be related to genetic and environmental factors. Multiple factors act on neurons causing irreversible and progressive death of neuronal cells. Currently, the treatment of this disease mainly includes two aspects. The first aspect is general treatment, mainly including family care. Family members must pay attention to the care of the patient, prevent the patient from accidentally wandering off, prevent the patient from falling, and prevent some accidents that cause injuries. In addition, it is important for the patient to listen to music, interact with others, and exercise more, all of which can delay the progression of senile dementia. The second aspect is pharmacological treatment, mainly using drugs that inhibit the reduction of acetylcholine. These drugs can increase the content of acetylcholine and improve the cognitive functions of patients to a certain extent, but so far, these treatments cannot reverse senile dementia.

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Early signs of dementia

Dementia in the elderly, mainly refers to Alzheimer's disease. Early signs of this condition may manifest as some forgetfulness. For example, a patient might forget to add salt while cooking, or forget to bring their keys when leaving the house. These clinical signs should be highly alarming and should not be dismissed as mere forgetfulness, ignoring further examinations and treatments. It is recommended that if the elderly show signs of diminished memory function, they should promptly visit a hospital. Comprehensive assessments and further tests, including brain MRI scans, should be conducted to check for significant atrophy in brain areas such as the temporal lobes and hippocampus. If dementia is diagnosed, prompt intervention and treatment should be pursued.

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Neurology
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Is senile dementia hereditary?

Dementia primarily refers to Alzheimer's disease, which mainly has two types: The first type is sporadic Alzheimer's disease, which does not have a clear familial history. It is caused by the degeneration and death of neurons due to various reasons, leading to certain clinical symptoms. This type of sporadic dementia does not have a genetic predisposition. The other type of dementia has a clear family history, where patients typically exhibit mutations in the APP gene, leading to increased secretion, which in turn causes the death of neurons and results in the symptoms of dementia. This familial type of dementia has a genetic predisposition. Dementia is a common condition in neurology and is the most common neurodegenerative disease. Currently, there are no effective treatments available. Family members must pay attention to caregiving, and patients can take cholinesterase inhibitors, which can improve symptoms to a certain extent.

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What to do about senile dementia?

When dementia occurs in the elderly, there is a noticeable decline in cognitive function. Initially, it is important to identify the cause of the dementia; some cerebrovascular diseases can also cause dementia. For example, cerebral infarction in certain specific areas of the brain can lead to dementia if it affects the intelligence center. For dementia caused by these reasons, it is recommended to treat with antithrombotic medications, including antiplatelet aggregation drugs and brain cell protective medications. Additionally, if the dementia is caused by Alzheimer's disease, close care is needed to prevent incidents like the patient getting lost. It is advisable to write contact numbers in the pockets of their clothes and administer acetylcholinesterase inhibitors to increase the levels of acetylcholine in the brain, which can improve cognitive function to a certain extent. (Note: This answer is for reference only. Medication should be prescribed and managed under the guidance of a professional physician, and self-medication should be avoided.)