Dementia covers the most widespread age-related neurological and psychiatric disorders, and the trend is growing. Alzheimer's disease accounts for about 2/3 of all dementias.
The neurologist Dr Andreas Winkler, medical director of the Klinik Pirawarth, head of neurological rehabilitation and vice-president of Alzheimer Austria, answers the most important questions about preventing and treating dementia.
Question 1: how many people in the world live with dementia?
Andreas Winkler: dementia is the health problem of the 21st century. An estimated 40 million people over the age of 70 worldwide live with dementia, and that number will double over the next 20 years, at least until 2050.
Although this global trend mainly affects developing countries, the figures in European and highly developed countries are lower, probably thanks to better measures to protect the blood vessels and brain health.
The rate rises with age: from about 2% among people aged 65 to 69, to roughly 10-17% among those aged 80 to 84, and to more than 30% among those aged 90.
Question 2: what are the known causes of dementia?
Over the past 20 years it was assumed that deposits of toxic proteins such as beta-amyloid 42 and tau protein, which are still the main hallmarks of these diseases, trigger the illness. Today, thanks to more modern research methods, we know that this interplay is probably far more complex.
Question 3: the disease is still incurable. What is happening in research at the moment?
The severity of the disease can only be eased symptomatically with medication, not cured. To make a cure possible worldwide in the future, new therapeutic approaches are being developed, based above all on immunology.
However, since the disappointing results of studies into treatments directed against beta-amyloid mean starting again from scratch, it will take another 5-10 years for potentially effective drugs to be ready for the market. Hopes rest on further therapeutic approaches, such as beta-secretase inhibitors, which are currently only in the early stages of clinical research.
Question 4: what can be done to reduce the risk of falling ill?
We have to keep hoping for an effective therapy and a cure, yet today you can already reduce your own risk of memory decline preventively. Because if you look after your brain, you also protect yourself from other diseases, especially cardiovascular ones such as stroke or heart attack!
Question 5: how important is a healthy diet in this context?
It is very important, because a “brain-friendly” diet in the sense of the Mediterranean diet matters a great deal. Meanwhile it has also been shown that supplying certain nutrients in certain combinations and doses, which are important for the function of the synapses on nerve cells, was tested in large clinical studies and was able to demonstrate a positive effect on memory performance.
