Oct 18, 2017

What is ‘Resilience’ in Terms of Alzheimer’s Disease?

“Dementia” is an impairment in a person’s ability to “mentate” (thus, de-mentia)

“Mentation” can involve memory, planning, and placing actions in the right sequence. So when a person has dementia symptoms, it means that they are unable to do this, in one way or another.  

Dementia is personal for Dr Sam Gandy – both his mother and grandmother lived with Alzheimer’s disease.

Alzheimer’s disease is the most common specific illness that causes dementia.

As a neurologist and cell biologist who works with different therapies, has spent the last three decades researching the effects of Alzheimer’s disease.

This is what he spoke about at Dementia Australia’s National Conference – where the theme this year was “be the change”.

“We’ve had some recent success with treatments, or at least targets for medicines, that appear to neutralise the pathology”.

“Something I never expected to see,” admits Dr Gandy.

“In addition, we understand much more now about a phenomenon known as ‘resilience’, and it’s possible to maintain cognitive function even in the face of Alzheimer’s pathology”.

‘Resilience’ described the ability to maintain memory and thinking even when plaques and tangles are present.

“It’s never too late to control your brain’s response or its “resilience” to this pathology”.

Dr Gandy highlighted the two most common types of dementia – alzheimer’s disease and vascular dementia.  

Vascular dementia is often described as “multiple small strokes”. Inadequate blood flow to the brain plays a role in both Alzheimer’s disease and vascular dementia.

When looking at all the people who are affected by dementia, around 70% of them have Alzheimer’s disease, but this may exist along with other types of dementia.

Approximately 17% of people are living with vascular dementia – but not Alzheimer’s disease.

While the remaining 13% have other, more rare, forms of dementia. This can include frontotemporal, Lewy Bodies, CTE just to name a few.

The common problem that is shared between Alzheimer’s and vascular dementia is the loss of brain substance.

In a person with Alzheimer’s disease, clumps of material known as amyloid plaques that form in the brain are the first detectable changes that can be found.

And now it is possible to visualise amyloid plaques on special brain scans.

However, clinical memory trouble might not develop for decades after amyloid begins to build up. Important clinical problems may never show up.

‘Resilience’ describes the ability to maintain memory and thinking even when plaques and tangles are present.

“It is possible for your brain to resist the functional changes of Alzheimer’s. In other words, it is possible to have full blown Alzheimer’s plaques and tangles and have normal cognitive function,” says Dr Gandy.

Mental and Physical Health for Alzheimer’s Disease

Most cases of Alzheimer’s disease are not inherited. However that said there is an ‘autosomal dominant’ disease which means that only one faulty copy of the gene is needed in order to inherit the disease. For people with the genetic connection it doesn’t mean a person’s fate is set in stone.

“It’s important to recognise that physical exercise regimens, for example, can neutralise the risk of [genetic Alzheimer’s],” Dr Gandy explained, “so this idea that genetics is destiny, is not entirely true”.

It was found in brain scans that people with the predisposed genes for Alzheimer’s disease could prevent the impact and levels of amyloid proteins through physical exercise.

“Physical exercise, mental exercise and controlling cardiac risk factors are the best established ways to reduce Alzheimer’s”.

“Controlling cardiac risk factors slows progression of both Alzheimer’s and vascular dementia”

“Social engagement is also important. Becoming withdrawn and isolated can accelerate the decline.”

So what kinds of exercises can be helpful? 

As Dr Gandy suggested the most effective exercises, research has found, is brisk walking and resistance training or weight lifting.

Expert recommend that exercise sessions be at least 30 mins long at least three times a week.

“Brisk walking not only neutralises the effect of the genes that lead to Alzheimer’s, it also slows down the progression of dementia after onset”.

“It’s never too late to begin exercise”.

“The recommendations for mental stimulations are a lot harder, in terms of reducing it to a prescription” says Dr Gandy.

Dr Gandy recommends to his patients something that’s mentally stimulating that they like to do, otherwise they won’t do it.

“This could be reading, or playing cards, that sort of thing…and we recommend doing those things all throughout their life.” 

“Socialisation and interacting with other people is essential to the brain in ways that are different to mental stimulation”.

“The one thing we are understanding now, in terms of ‘being the change’ we need to make people aware of their risks for Alzheimer’s”.

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