Professor names common causes of dementia

Dementia is a heterogeneous cognitive disorder and can be caused by various diseases. The appearance of obvious symptoms of cognitive decline is preceded by signs of mild forgetfulness and decreased mental activity. On February 25, Gyuzyal Tabeeva, MD, professor of the Department of Nervous Diseases of the First Sechenov Moscow State Medical University, president of the Russian Society for Headache Research, told Izvestia about preventive measures, methods of diagnosis and treatment.

According to her, memory disorders are a key sign of cognitive decline, which meanwhile can have different manifestations. Explaining how to distinguish between a symptom of the disease and memory problems due to increased workload, she specified that mnestic disorders can be manifested by slight forgetfulness or difficulty in reproducing names, titles, dates. This can be transient and compensated for by different strategies and is more characteristic of older age. While disorders of remembering new information and decreased attention are often associated with emotional stress and mental strain, but they are mostly reversible.

About the pathological nature of memory disorders can be said in the case of persistence of these disorders and a tendency to progression, the professor wrote.

"Most often, dementia is associated with the consequences of chronic or acute disruption of blood supply to the brain (vascular dementia), conjugated with the presence of cardiovascular diseases and pathological processes in the nervous tissue (for example, neuroinflammation). Dementia is also widespread in Alzheimer's disease, associated with the accumulation of pathological forms of protein molecules (beta-amyloid) as a result of various causes, including neuroinflammation in brain tissue," Tabeeva said.

Among other causes of dementia, there is a form associated with traumatic brain injury. There are forms of post-traumatic encephalopathy with pronounced and persistent cognitive disorders after severe brain injury, the expert added.

"Chronic exposure to mental stress is an established risk factor for cognitive impairment as well as progression of moderate cognitive impairment to dementia stage. Therefore, control of chronic stress exposure can be considered as an effective strategy for the prevention of stress-associated cognitive disorders," Tabeeva pointed out.

The professor said that 40% of dementia cases are associated with potentially modifiable risk factors: low level of education, vascular disorders (hypertension), hearing impairment, smoking, obesity, depression, physical inactivity, diabetes, low level of social contacts, excessive alcohol consumption, brain injury and air pollution.

"The diagnosis of any form of dementia is clinical and is based on the manifestations and pattern of disease course. Neuroimaging methods are important to confirm the diagnosis and differential diagnosis of various forms of dementia. At the same time, there may not be strict correlations between MRI changes and clinical manifestations. Even in the case of repeated MRI studies, the detected changes often cannot be used in terms of predicting the course of the disease," the expert said.

She also explained that most dementias are referred to persistent, steadily progressive disorders, which are caused by processes that develop several decades before clinical manifestation. They begin with mild signs of cognitive dysfunction, such as occasional forgetfulness, inattention.

"Symptoms of cognitive impairment intensify over time and progress to the next stage in severity - moderate cognitive impairment. They are manifested by noticeable memory disorders, difficulty in orientation in unfamiliar surroundings and difficulties in decision-making, constant fatigue, a feeling of "cotton-wool" head. At this stage, patients are quite aware of the change in their cognitive state and can still maintain performance," added the professor.

However, if you do not start non-drug and drug correction in time, moderate cognitive impairment will progress in a few years. At the same time, it often becomes much more difficult to help the patient in the late stages of dementia.

Earlier, on February 10, neurologist doctor of the medical company "SberZdorovye" Polina Lepilova told "Izvestia" that the consumption of fast food, fried food negatively affects health because of trans fats and saturated fats. These substances increase the level of "bad" cholesterol, which eventually leads to the development of atherosclerosis. At the same time, the consumption of foods with a high salt content - more than 5 g per day - is associated with the development of arterial hypertension, which is a risk factor for stroke and can lead to dementia.