Data from the 1st National Dementia Report – to be published by the end of 2023 – should show a worrying situation for public health in Brazil. The number of people not diagnosed with Alzheimer’s Disease should be in the range of 75% to 95%, depending on the Brazilian region, according toBrazil Agencydoctor and researcher Claudia Suemoto, from the University of São Paulo (USP).
The report commissioned by the Ministry of Health – and coordinated by professor Cleusa Ferrim from the Federal University of São Paulo – should point out, for example, that the number of people with the disease could be in the range of 2.4 million. The disease is known for progressive memory loss, among other consequences. The incidence is mostly among elderly people.
“The non-diagnosis rates in Brazil are alarming. When we initially saw the data, we thought it was wrong. We recalculated and that was it. We need to have more awareness about Alzheimer’s. There are still stigmas”, says the researcher. The 2023 campaign for Alzheimer’s Awareness Month (Purple September) has the theme “Never too early, never too late”, with a greater focus on prevention.
“The more we talk, the less non-diagnoses we will have. There will be less stigma and more prevention”, said the professor.
Medicine professor Einstein de Camargos, from the University of Brasília, explains that carrying out early diagnosis allows for more possibilities for interventions. “Not only with medications, but above all with cognitive therapies, stimulation, occupational therapy, physical exercise, making this process slower.” He understands that, even though there is underreporting of the disease, there is greater visibility of Alzheimer’s cases.
Biggest risk factor
Experts point out that there is a consensus that, among the risk factors for the disease, there is one that is not strictly related to health: low education.
“This is a modifiable factor for dementia conditions (such as Alzheimer’s disease). If we improve the quality of education, for example, for the Brazilian people, we will reduce the risk of dementia. This is actually the most important risk factor in Brazil”, says professor Claudia Suemoto.
Professor Einstein de Camargos, from UnB, understands that this data is extremely important because it shows that the greatest prevention is not within the area of health itself. Schooling can be transformative for health in different ways. And in this case it is organic.
Doctors explain that resistance to the effects of illness must be related to the cognitive reserve that a person has. “If a person has had greater cognitive stimulation during their life, they will have greater ‘savings’, with a large number of neurons”, says the professor
Resistance
What is observed in the brains of people who have developed Alzheimer’s disease is the accumulation of beta-amyloid protein. The greater the brain “strength”, the more resistance there will be against the presence of the protein. Camargos states that this resistance is, in addition to increasing education, reducing smoking and controlling diabetes and blood pressure.
It is, therefore, good news that they are modifiable risk factors in the life of the individual and society. Claudia Suemoto points out that it is estimated that 48% of cases are related to early life factors (low education), middle age (high blood pressure, hearing loss, head trauma, obesity and excessive alcohol consumption) and old age (diabetes , smoking, depression, social isolation, environmental pollution and lack of physical activity).
“These are all simple factors, but quite prevalent. If we changed their frequency in the population, we would definitely be preventing dementia”, says the professor. The good news is that better living conditions reduce new cases.
Evolutions
If, on the one hand, there is underreporting, according to Professor Claudia, what has happened in the last 10 years, especially for Alzheimer’s disease, is that diagnosis has improved a lot. In the past decade, when there was a memory complaint, the person would do some tests in the office.
“But now we can measure proteins deposited in the brain that are associated with Alzheimer’s disease.” It was doctor Alois Alzheimer who described the disease at the beginning of the 20th century, identifying brain lesions.
Previously, however, it was not possible to measure these proteins with living people. It is currently possible to measure these proteins in liquor (the liquid that surrounds the brain). However, to carry out the exam a very invasive procedure was necessary. Today, the exam has become more accessible with the help of nuclear medicine.
Medicines
Doctor Claudia Suemoto understands that there is also some evolution in medicines. “Today, we already have three drugs that clear this beta-amyloid protein with promising results. They clear these proteins in people with milder disease. So, we are trying to understand what the long-term effects are”, says Claudia.
It contextualizes that there are side effects to these drugs that need to be evaluated. “It’s all very new, but finally we have a medication that seems to affect the disease mechanism”, she says.
Einstein de Camargos believes that medicines are still very expensive and are still far from being applicable.
Search for help
Doctors explain that memory complaints are the best-known symptoms related to the disease. Memories of the present, important facts from the past, and names of people become unknown to those who have the disease. But it is also possible to identify loss of planning and mental confusion as possible symptoms.
“The person had household chores and is having some difficulty. You can no longer drive, remember your routine… These factors are the ones that attract the most attention in everyday life. Other than that, attention should be paid to unusual behavior. The person should see a doctor to rule out Alzheimer’s disease as the first cause”, explains Camargos.
Sleep and physical activity
Experts also agree that there are fundamental prevention measures to avoid the disease, and also the need to rest. “Those who sleep less than six hours a night increase their risk of having dementia by 35%. Research over the last 10 years has shown that sleeping well helps the brain clear the day’s toxins,” he reveals.
And when you’re awake, physical activity is important. Researchers at the University of Brasília are developing a detailed study to highlight the influence of physical exercise on this brain cleaning system. “I will use a simple term. We need to find the brain cleaners who need to work better and with more conditions. This way, we will have a reduction in this disease”, he concludes.
With information from Agência Brasil
The post Lack of diagnoses for Alzheimer’s worries experts appeared first in Jornal de Brasília.
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