There is a disease in which the patient may not feel pain, but it will bring distress to the family. Its onset is hidden and easily overlooked, there is no specific drug, and the cause is still unknown.
It is Alzheimer's disease, commonly known as Alzheimer's disease.
Recently, a French study published in the journal Lancet Digital Medicine showed that Alzheimer's disease may have some associated symptoms 10 years before diagnosis, and if people can cause vigilance, early detection, and timely diagnosis and treatment, they can prevent the occurrence of old people.
"Life Times" (search for "LT0385" in WeChat to pay attention to) combines new research and interviews with experts to interpret several early warning signals before the arrival of the old idiot.
Experts interviewed
Zhang Yuhu, director and chief physician of the Department of Neurology of Guangdong Provincial People's Hospital
Attending Physician of the Department of Neurology, Guangdong Provincial People's Hospital Feng Shujun
Wang Wei, deputy chief physician of the Department of Neurology, Xuanwu Hospital, Capital Medical University
This article is written by | Life Times reporter Li Zhenyu
This article was edited | Ren Linxian
10 years ago, the idiot had an early warning signal
On the mainland, the number of Alzheimer's disease patients is about 10 million, and as the population ages, the number of patients is expected to exceed 40 million by 2050.
According to the "Investigation Report on the Diagnosis and Treatment Status of Alzheimer's Disease Patients in China (2021)", nearly 60% of patients only see a doctor for the first time after symptoms have appeared, while only 10% of patients are further diagnosed and treated after physical examination or cognitive screening finds problems, and the prevention and treatment situation is worrying.
Some symptoms of Alzheimer's disease are easily overlooked and the best time for diagnosis and treatment is missed, even if the patients who visit the doctor early, there are not many patients who insist on treatment, and the final outcome of the patient is often a huge loss of survival and quality of life in later life.
Early and effective prevention, strangling Alzheimer's disease in the embryo, and trying to delay its appearance.
A multidisciplinary team of scholars at the Paris Brain Institute in France recently published a study that took the records of about 40,000 Alzheimer's disease patients from France and the United Kingdom, and analyzed the association between 123 different disease diagnoses (or symptoms) and Alzheimer's disease. The results showed that some symptoms were significantly associated with the subsequent diagnosis of dementia in the 10 to 15 years before diagnosis, 2 to 10 years, and the first 2 years.
The scientists specifically explored the correlation of 10 symptoms with Alzheimer's disease in patients in two countries, including: depression and anxiety, severe stress and adaptation disorders, hearing loss, constipation, spinal disease, abnormal weight loss, fatigue (due to decreased emotional physiology), memory loss, syncope, and prostration.
Among them, depression and anxiety appeared 9 years before the diagnosis of Alzheimer's disease, and constipation and abnormal weight loss appeared 7 years before diagnosis.
In the 2 years prior to diagnosis, symptoms such as sleep disturbances, hearing loss, hypothyroidism, hypotension, and cerebrovascular disease were closely associated with Alzheimer's disease.
Zhang Yuhu said that some of the symptoms related to Alzheimer's disease mentioned in the study were concluded through big data analysis. Judging from the results of the study:
Between 10 and 15 years after diagnosis, no symptoms significantly associated with Alzheimer's disease were found;
In the 2 to 10 years before diagnosis, symptoms such as anxiety and depression, constipation, abnormal weight loss, memory loss, and hearing loss are closely associated with the occurrence of Alzheimer's disease, which is generally in line with the recommendations of the generally accepted guidelines for the prevention and diagnosis of Alzheimer's disease;
Within 2 years before diagnosis, depression and anxiety, abnormal weight loss, and especially memory loss increased significantly in association with Alzheimer's disease.
In addition, there are some relatively unfamiliar symptoms, such as urinary tract infections, dizziness, fractures, etc., although studies have shown that they are related to Alzheimer's disease, but further scientific demonstration is needed.
Wang Wei said the study was based on case analyses from two countries, the United Kingdom and France, and could not represent all races.
Genes are not the same, morbidity, disease outcome (disease transfer and development) can not be generalized, the biggest value of this study is to remind us that in the first 10 years before the diagnosis of Alzheimer's disease, there will be early warning signals, if you can detect early, early intervention, it is possible to prevent the occurrence of old people.
People with 8 manifestations are in danger
According to the above research, experts have combined the current pathogenesis characteristics and clinical experience to summarize and remind that the following early symptoms or causative factors need special attention.
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Memory loss
Memory loss is most closely associated with Alzheimer's disease. The above study shows that people who have symptoms of memory loss within 2 years can increase the incidence of Alzheimer's disease by 3.4 to 6.6 times in the future.
Mainly refers to the decline of subjective cognitive function, that is, they think that their memory is not as good as before, but they have not reached the level of dementia.
Depression, anxiety
Abnormal secretion of some neurotransmitters in the brain can lead to emotional problems in patients, indirectly affecting the information transmission and reception of brain nerve cells, which in turn leads to cognitive decline and dementia.
Before the appearance of anxiety and depressive symptoms, the related severe stress adaptation disorder, the decline of emotional physiological functions such as fatigue due to large emotional fluctuations, etc., are also important signals.
Abnormal weight loss
In people over the age of 55, if there is abnormal weight loss (under a normal diet, weight loss exceeds 10% of the original body weight in a month) may be a risk factor for dementia.
The absorption of nutrients in the intestine, affected by neurotransmitters in the intestine, may lead to dementia if food is difficult to digest and absorb normally, resulting in weight loss and intestinal flora disorders.
constipation
The intestine is the "second brain" of people, and after the intestinal flora is out of balance, it can induce neurotransmitter abnormalities in the brain through the brain-intestinal axis, affecting neuroinflammation, β amyloid deposition, and inducing dementia.
In addition, the following symptoms occurred within 2 years before the diagnosis of the patient, which also have clinical significance and need to be paid attention to:
Hearing impairment
Hearing loss can increase the incidence of dementia by 30%. Hearing is an important way to socialize and receive information, which is very important for the protection of cognitive function, hearing loss leads to problems in information input, and the speed of brain aging will increase rapidly.
Sleep disorders
These include insomnia, structural abnormalities in sleep (e.g., decreased deep sleep, frequent micro-awakenings), and sleep-disordered breathing. Brain recovery relies mainly on deep sleep, and a decrease in deep sleep can lead to a decrease in the rate of amyloid clearance in the brain, resulting in brain damage.
Hypotension
Hypotension may lead to a decrease in whole-brain perfusion, causing metabolic dysfunction in brain cells.
Hypothyroidism
Hypothyroidism can lead to cognitive decline, causing another type of dementia, Hashimoto encephalopathy, which also requires attention.
Intervene when memory declines
For Alzheimer's disease, early detection and early treatment are particularly important. In particular, people with the above 8 manifestations should go to the hospital as soon as possible to follow the doctor's instructions for treatment.
Wang Wei said that the most critical symptom is memory decline, which belongs to cognitive decline, which is the most intuitive early manifestation of Almerzheimer's disease.
Cognitive function has 6 major cognitive areas in the clinic, including memory, computing, language expression, time and space orientation (can not remember dates, seasons and time flow), and executive ability. Problems in any one cognitive area can lead to dementia.
The 10 Warning Signs of Dementia published by the International Alzheimer's Disease Association includes:
Memory loss
Don't do the familiar work well
Decreased language skills
I can't figure out the time and place
Decreased ability to judge thinking
It is difficult to grasp the progress of doing things
Stuff misplaced
Mood and behavior change
Understanding visual and spatial information is difficult
Withdraw from work or social activities
What is the difference between obsession and forgetfulness?
Many people are worried about their "bad memory" or their families, and in general, the difference between the two is reflected in the following 6 aspects:
Near memory impairment & instantaneous memory impairment
Senile forgetfulness is manifested as a near-memory disorder, and it is partial, and can be recalled after prompting, while Alzheimer's disease is dominated by instantaneous memory impairment, which is complete and cannot be recalled after prompting.
No cognitive deficits & time, place, numeracy disorders
Senile forgetfulness is not accompanied by cognitive deficits, and Alzheimer's disease patients are often accompanied by time, place, and numeracy impairments.
Maintain normal emotions & apathy and desirelessness
Forgetful old people will maintain normal moods such as mood and sorrow, while Alzheimer's patients often become indifferent and lack basic emotional performance.
Clear thinking & confused thinking
Forgetful elderly people have clear thinking, language expression ability and reasoning and analysis ability, while Alzheimer's disease patients have confused thinking, poor language, and lack of sound reasoning and analysis ability.
Anxious about poor memory & not aware of memory loss
The elderly with forgetfulness often show a very anxious attitude towards poor memory, while Alzheimer's patients do not realize that their memory is declining.
Have the ability to take care of themselves in life & gradually lose the ability to take care of themselves
The forgetful elderly can maintain a normal ability to take care of themselves, while the elderly with Alzheimer's disease will gradually lose their ability to take care of themselves even if they have no physical disease.
People with brain diseases, familial dementia and lonely people are more susceptible to disease, and special attention should be paid to early prevention. Middle-aged people should pay attention to lifestyle, maintain appropriate social and good emotional state, and avoid suffering from hypertension and diabetes; the elderly should pay attention to insisting on exercise, avoiding brain injuries, and can carry out some stimulating mental activities such as reading, playing chess, and playing cards. ▲
Editor: Wang Xiaoqing
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