Understanding Dementia

To understand why long-term care is challenging, we must first understand what dementia is. Diseases that cause dementia can make daily activities difficult and dangerous, which necessitates intensive care, as found in long-term care homes...

This is a very brief overview. Dementia is a group of symptoms associated with many neurodegenerative diseases, with Alzheimer’s Disease (AD) being the most common. Increased age (50-60+) is the strongest risk factor, but early-onset cases associated with genetic vulnerabilities are also possible. There are a wide range of causes and risks. However, our lifestyle choices, the risks that we can control, have been shown to delay onset. Given the diversity of diseases of dementia, it is important to note that deficits go beyond amnesia and can affect all areas of the brain. In dementia, there is irreversible damage and destruction of neurons. Unlike other cells in the body, these cells do not regenerate effectively. It is currently believed that accumulation of misfolded proteins, beta-amyloid plaques and tau tangles, is what accelerates cell death. By the time memory deficits are noticed, the disease has progressed well beyond what can be helped. As such, no reliable drug or therapy exists that can widely prevent or cure dementia. Some researchers associated with UofT recently suggested that a drug for diabetes may help.

Early screening may also help, but currently, there is no reliable way to predict or diagnose dementia. Ongoing research focuses on identifying different biomarkers to detect dementia. Check out this very recent article, which describes how a blood test may be used to find a biomarker for tau and screen for AD.

In developed countries, prior to COVID-19, dementia was the biggest and most pressing public health issue we were preparing to face. Prevention is the key. Watch this brief TED-Talk to understand what that means:

Given the complications with COVID-19, caring for patients with dementia has become even more difficult. The added stress of infection and isolation has worsened loneliness and mental health for patients and caregivers alike. Imagine going through this pandemic, unable to understand the panic and the threat. People with dementia are unlikely to understand new public health vocabulary or engage in telecommunications to stay connected to their support networks.

Our biggest hope right now is that there is a lot of research in the works to address screening, prevention, caregiving, and one day, curing. Meanwhile, there’s plenty of work we must do to reduce stigma and help make care more accessible.

Look out for our next posts on the biology of neurodegenerative disease and caregiving challenges.

Here are some fantastic resources to check out in the meantime:
1. TED-Talk playlist on Alzheimer's
2. Understanding risk factors for dementia
3. Our partner, the Alzheimer Society of Canada, also has more information

References:
1. Batsch, N. L., & Mittelman, M. S. (2015). World Alzheimer Report 2012. Overcoming the Stigma of Dementia.Alzheimer’s Disease International (ADI), 5

2. Lloyd-Sherlock, P., Ebrahim, S., Geffen, L., & McKee, M. (2020). Bearing the brunt of covid-19: older people in low and middle income countries. Bmj, 368, m1052. https://10.1136/bmj.m1052
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3. Wang, H., Li, T., Barbarino, P., Gauthier, S., Brodaty, H., Molinuevo, J. L., Xie, H., Sun, Y., Yu, E., & Tang, Y. (2020). Dementia care during COVID-19. The Lancet, 395(10231), 1190-1191.

​- Post made by Saloni Gupta, edited by Jerry Li.