engleski

21st century epidemic

When Alois Alzheimer, German psychiatrist and neuropathologist, presented the case of Augusta D. to his colleagues on the conference in 1906, he was not aware that his family name will become one of the famous eponyms in the World. Augusta died when she was 51, after 5 years of evident clinical symptoms of forgetfulness, behavioural disturbances and psychiatric symptoms, which includes hallucinations and delusions. At that time, this case was considered as a rare one, with clinical picture which general practitioner will only read about in textbooks. Such opinion was present for next 60 years. But after that period, the cases of Alzheimer’s disease, which was the name given in honour of dr. Alzheimer, became more common in elderly. As the life span for general population, in western developed countries, became on average significantly longer, the morbidity of population also changes. As percentage of elderly in general population increases in more and more countries, that result in more cases of dementia. Today, we are facing the epidemic of dementia, mainly caused by Alzheimer’s disease, but also vascular, frontotemporal, Lewy body and mix forms are present as well. The longevity, as one of the most important achievement of human kind, unfortunately also developed a huge risk of dementia, which is almost 50% among oldest old. We assume that about 47 million people today live with dementia, and projection for 2050 is more than 115 million. New cases will occur more in non-develop countries, and disease is more associated with women, who are living longer than man. As still everybody wants to live even longer, we need to find the way to reduce other risk factors for developing dementia, such as: unhealthy life styles (high cholesterol, hypertension, diabetes, smoking), social isolation, insufficient brain activity after retirement, severe head trauma, low physical activity, etc. We believe, that if people follow five easy rules: 1. what is healthy for heart is also healthy for the brain ; 2. be physically active (walk every day several km) ; 3. provide healthy diet ; 4. keep your brain active ; 5. be socially active – this may lower the risk of developing dementia in later life, for about 30%. On the other hand, in a search for new anti- dementia drug more than hundred substances are being tested through inovative protocols, and this must sooner or later give some results. Hopefully, this intensive research in dementia field will in future result in finding the disease modifying therapies which will also help people with dementia to live well for quite long time. This will not help only persons with dementia, but also their caregivers, because Alzheimer’s has huge impact on whole family. In meantime, we all need to think how to provide the best possible care for people with dementia, regarding their stage of the disease, which also includes non-pharmacological treatments, and think how to develop dementia friendly communities and spots in our environment.

Alzheimer's disease ; dementia ; public health ; epidemic ; prevention

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