Expert Q & A about Dementia with Linda A. Hershey, MD, PhD

Getting Help with Dementia

What is happening in the brain to cause dementia?

Depending on the type of dementia, different degenerative processes are involved. For example, a normal protein (beta-amyloid) accumulates to an excessive extent in the brains of Alzheimer's patients. Another normal protein (alpha-synuclein) develops in excess in the brains of those who have dementia with Lewy bodies. Abnormal tau proteins accumulate in the brains of people with Pick's disease. Toxic amounts of these proteins are thought to be a factor contributing to cell death and inflammation in these diseases.

Are patients with dementia at greater risk for injury?

Yes. Patients with Alzheimer's are more likely to have automobile accidents because they have poor judgment and impaired concentration. Patients with vascular dementia and dementia with Lewy bodies are more likely to fall because their diseases cause poor balance and slowing of gait. Families can help prevent injury in dementia patients by taking away the car keys and by installing safety equipment in the home.

How can loved ones help dementia patients to cope with their illness?

Contact your local Alzheimer's Association. In most communities, there are support groups available for patients as well as for caregivers.

Are there any alternative /complementary therapies (such as light therapy or dietary supplements) that are effective in preventing or slowing dementia?

Light therapy is effective for dementia patients who happen to have seasonal affective disorder. Vitamin E might be effective in delaying nursing home placement in patients with moderate Alzheimer's disease. Lecithin was popular years ago, but it has since been discredited as being ineffective. I do not recommend using ginkgo biloba because it carries the risk of excessive bleeding. A Mediterranean diet (vegetables, fish, chicken and wine, but minimal animal fat) has been shown to delay the onset of Alzheimer's in those with mild cognitive impairment. Exercise can help prevent the physical changes in the brain that are associated with Alzheimer's disease.


Last updated August 2008

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