Brain Health: Key Facts About Alzheimer’s, Dementia From Marcus Neuroscience Institute Neuropsychologist

The family of Bruce Willis made headlines recently when they announced the actor is suffering from a form of dementia. Some 6 million Americans are living with Alzheimer’s disease, a progressive illness with no cure, and millions more have been diagnosed with other forms of dementia.

June is Alzheimer’s & Brain Awareness Month. In Top of Minda video program that focuses on neuroscience services at Baptist Health, Raphael Wald, PsyD., a neuropsychologist with Marcus Neuroscience Institute, part of Baptist Health Brain & Spine Care, which also includes Miami Neuroscience Institute, answers questions about brain health, Alzheimer’s and dementia.

Q: The numbers of Alzheimer’s and dementia cases are going up. By 2050, we’re expected to see nearly 15 million Americans diagnosed with Alzheimer’s disease. Why such an increase?

A: Our population is aging. As we have more treatments for other conditions, people are living longer. As people are healthier into older age, there is more opportunity for them to live long enough to develop dementia.

Q: What is the difference between dementia and Alzheimer’s?

A: Dementia is an umbrella term. A person with dementia has an impairment in cognitive skills, in their memory and at least one other thinking skill. There are many things that can cause dementia, from vascular dementia, frontotemporal dementia, primary progressive aphasia, to Parkinson’s disease and the list goes on and on. But the most common type of dementia is Alzheimer’s disease.

Q: Is there any pattern to the type of people who get Alzheimer’s compared to those who do not?

A: That’s a complicated question. There is a genetic component to it, but there are lots of people who have dementia who do not have any other family history. Women tend to be affected more frequently than men. And people who are generally unhealthy are affected more than people who are healthy.

Q: If you have a parent, grandparent or another relative who has Alzheimer’s, how does that increase your risk?

A: There are a couple of genes that put a person at a dramatically increased risk of developing Alzheimer’s disease. The APOE e4 gene is one of them. There are some other genes that are linked to early-onset Alzheimer’s. Having a variant of one of these genes, doesn’t mean you will get dementia. And in people who don’t have these genes, if they have family members with Alzheimer’s disease, it can also increase their risk.

Q: What are some of the general risk factors?

A: The number one biggest risk factor is increasing age, and that’s something we can’t do anything about. The second biggest risk factor, and probably the most important since we can control it, is cardiovascular disease. So that means high blood pressure, high cholesterol, thyroid disease, sleep apnea, peripheral vascular disease, atrial fibrillation, diabetes ― anything that puts your heart at risk also puts your brain at risk.

Q: What can we do lessen our risk for Alzheimer’s and dementia?

A: A lot of the things you can do are things your doctor tells you at every single visit. Get exercise. It is really crucial both for prevention and if you are diagnosed because it gives you the best chance at a high quality of life. Also, eat healthy, have your regular checkups. And, if you do have any cardiovascular problems, you want to be aggressive in managing them with your doctor.

Q: What about people who say they forget things sometimes. Or they have become more forgetful as they have gotten older. What is normal?

A: The way I like to explain it is that if a person is 75 years old, they probably can’t throw a baseball the same way they did when they were 30. Your body ages, your muscles don’t work the same way. The brain is the same. You’re not going to be able to remember things the same way you could when you were 30. You’re not going to be able to come up with words as easily as you did when you were 30. But the real question is, are you aging normally or is your brain aging at a faster pace than we’d want it to? That’s difficult to know and that’s why you go to your doctor to figure out what is happening.

Q: Besides memory loss, what are some of the other symptoms of dementia or Alzheimer’s?

A: Everyone is different, but many people experience more difficulty in reasoning and thinking, a decline in judgement, and trouble performing simple tasks. They may seem confused, have difficulty communicating and ask the same questions repeatedly. Often, there are also behavioral changes, such as mood swings, anger or apathy. Symptoms progressively worsen.

Q: Tell us about treatments that are available for Alzheimer’s?

A: While there is no cure for Alzheimer’s, there are some medications that help slow the progression and, generally speaking, give a person a cognitive boost. I’ve seen some patients get good benefit and others with little or no benefit. Two classes of medications have been around for a long time. One is the NMDA receptor antagonist, the other is the acetylcholinesterase inhibitor. There are also some newer medications, like monoclonal antibodies, that are becoming very popular. Essentially, they use the immune system to help respond to abnormal bodies in the brain as if they are invaders, attacking them and breaking them up. But there can be complications and safety issues and research is continuing.

Q: If patients come to Marcus Neuroscience Institute for any type of memory disorder, what can they expect?

A: The doctors here are very smart, but one of the things I find most remarkable is that they are really personable human beings that you feel you can talk to and that are easy to understand. That’s not always an easy thing to find. While a number of conditions can cause memory loss, it’s important to find a diagnosis because early treatment offers the best opportunity to slow progression. The experts at Baptist Health Brain and Spine Care offer a full range of services for patients with memory disorders, dementia and Alzheimer’s disease.

For more information on the Marcus Neuroscience Institute program at Boca Raton Regional Hospital, click here. For information about Miami Neuroscience Institute’s program, click here.

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