Dementia

Dementia is not a specific disease; it is a general term to describe a decline in cognitive functions.  There are seven stages of dementia, but one is not medically diagnosed with dementia till they hit stage 4.  Most people miss early signs and notice it when it interferes with daily life around stage 3 to 4. The cognitive changes may occur over decades and will often be dismissed as aging.  Memory loss is the most well-known symptom and is often given precedence over other signs and symptoms
Symptoms of dementia can vary greatly, however; at least two of the following core cognitive functions are to be significantly impaired if it is to be considered dementia:

  • Memory
  • Communication and language
  • Ability to focus and pay attention
  • Reasoning and judgment
  • Visual perception

People with dementia may have problems with short-term memory such as keeping track of a purse or wallet, paying bills, planning and preparing meals, remembering appointments or even directions around the neighborhood. Many dementias are progressive, meaning symptoms start out slowly and gradually get worse. If you or a loved one are experiencing memory difficulties or other changes in cognitive skills don't ignore them; seek professional help as soon as possible.  

If care is sought in the mild to moderate stages, it allows for better outcomes and slower decline.  Unfortunately, those who wait till the severe stage may not see enough improvement that is manifested in daily function.   A thorough professional evaluation may detect an underlying treatable condition even if symptoms suggest dementia. Early diagnosis allows a person to get the maximum benefit from available treatments and provides time to plan for the future.

Alzheimer’s is the most common and fastest growing type of dementia as it accounts for 80 percent of all cases. Vascular dementia is the second most common type and usually occurs as the result of a stroke. There are many other conditions that can cause dementia-like symptoms such as thyroid problems, vitamin deficiencies, and infections in the elderly.



Inflammation in the Brain

Amyloid plaque leads to neurofibrillary tangles, which together are considered hallmarks of Alzheimer’s.  For the past few decades, amyloid plaque was considered to be the cause of neuron damage.  Currently, research is suggesting these plaques acting as a shield of protection against a foreign substance such as a virus.

Recently research is starting to shift towards inflammation as the cause.  It is well known that type 2 diabetes increases the risk of Alzheimer’s and for this reason, you will see research call Alzheimer’s type 3 diabetes.  Diabetes is more than a rise in blood sugar.  The inability to process the sugar results in inflammation.  Shared characteristics between Alzheimer’s and type 2 diabetes: inflammation, insulin resistance, glucose intolerance, and cognitive deficits.  

Inflammation has also been seen with chronic viral presence and poor gut health.  Gut health is impacted by stress, medications, diet, exercise, smoking, drinking, and sleep.  Another reason inflammation is suspected is that autopsies show abundant amyloid plaque in individuals who showed no signs of Alzheimer’s.        

Impact on Neuron Health and Function

Dementia is caused by damage to neurons, specifically those that utilize the neurotransmitter acetylcholine.  Acetylcholine is the neurotransmitter responsible for learning and memory.  The damage to neurons leads to interferences in the ability to communicate with each other. When there is a disruption in communication, it can lead to abnormal functions of cognition, including emotions, behavior, and learning.

The brain is composed of many regions.  Some regions have simple functions, while others are involved heavily in processing and distributing information to other areas. In each region, there are neuronal groups that each have specific functions like memory, judgment, and movement. When neurons within a specific region are damaged, that group cannot carry out its local or global functions correctly.

An area of considerable importance in dementia is called the hippocampus. It is the center of learning and memory in the brain. The brain cells in this region are often the first to be damaged. This is why short-term memory loss is often one of the most noticeable symptoms of Alzheimer's.

While most changes in the brain that cause dementia are enduring and worsen over time, neuroplasticity, the ability for the brain to change and learn, allows for new pathways to be built to help regain lost function.

Traditionally there are many questionnaires that are used to score cognitive function.  Based upon your score, you are given a severity rating.  There are currently no standardized blood or imaging tests globally accepted, even though imaging such as PET scans are showing promise.  


Our Individualized Approach

Dementia impacts each the individual, caregivers, and loved ones differently.  For this reason, no two patients receive the same treatment.  In order to deliver the best results possible, you will undergo a comprehensive review of medical history, physical examination, and laboratory tests.  With the results, you will be educated and empowered.  We have seen many patients slow the progression, temporarily stop declining, or improve to a new baseline.  This is due to our integrative approach.   

Research for years has linked many factors to dementia.  It is known that diabetes, inflammation, infection, gut health, lifestyle, stress, sleep, and exercise impact the onset and progression of dementia.  As you can see there are many factors that need to be taken into consideration to best help you.  We will address any of these factors we identify and refer out as necessary.  

Treatment in office is based on specific brain-based stimulation, balance therapy, proper brain oxygenation, supplements, and diet.  A specific form of brain-based stimulation is delivered utilizing repetitive Transcranial Magnetic Stimulation (rTMS).  rTMS is showing promise improving symptoms in those impacted by dementia in early studies.     

Due to the degenerative nature of dementia, it is important to know that treatment needs to be ongoing.  This not only include return visits to the office, but adherence to the home treatment plan your team creates for you.  This plan will often include physical and cognitive exercises, diet, and supplements.      


Please contact our patient advocate to see if you or your loved one would be a good candidate for our care.

 

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