What is dementia?

In the most general sense dementia can be defined as a decline in cognitive performance from some previous state. Some of the more common forms of dementia in the elderly include Alzheimer’s disease, Vascular dementia, Frontotemporal dementia, Dementia with Lewy bodies, normal pressure hydrocephalous, and Parkinson’s disease with dementia. While there is some overlap between each of these disorders there are important clinical and pathological differences between each of these disorders. Additionally it is important to point out that there can be cases of mixed dementia, in which multiple forms of dementia are present in the same individual. The Institute is working to understand the basis by which aging promotes each of these disorders in order to develop better ways of detecting the disease and developing interventions which prevent dementia in the elderly.

How is Alzheimer’s different from dementia?

Alzheimer’s disease is one common form of dementia in the elderly, possibly accounting for up to 70% of dementia in the elderly. As is pointed out above there are many other types of age-related dementias besides Alzheimer’s disease, as well as a number of alternative medical conditions which can promote dementia (stroke, vitamin deficiency, alcohol abuse). Alzheimer’s disease can be distinguished from other dementias based on the fact that it is a relatively slow onset and progressive disease that affects multiple aspects of cognitive performance including memory, language, and personality. Also, it is important that these changes often occur in the absence of significant impairments in regulating basic body functions and the ability to walk.

What causes dementia?

While there are clearly some cases of dementia that are caused by the presence of genetic mutations or the presence of pro-dementia genes, it appears that the vast majority of cases of dementia in the elderly cannot be explained on the basis of genetics alone. Aging is the single biggest risk factor for the development of dementia. Additionally, studies at the PBRC and other institutions are finding that a number of dietary and lifestyle choices can modulate the development and progression of dementia and brain pathology. Similarly, obesity and diabetes may be potent modulators of dementia. Lastly, studies are still needed to understand how pathology in the brain can possibly promote specific aspects of dementia in the elderly. Understanding how each of these factors can alter the incidence and severity of dementia are critical to preventing the disease, and are a major focus of the Institute.

How many people have dementia?

In the US there are believed to be at least 5 million individuals with age-related dementias. In Louisiana there are at least 100,000 individuals with age-related dementia. These numbers will only to continue to rise with the aging of the US population. It is estimated that 1 in 6 women, and 1 in 10 men, who live past the age of 55 will develop dementia in their lifetime. Alzheimer’s disease accounts for up to 70% of the dementia in the elderly, with vascular dementia accounting for the majority of the remaining dementia cases in the elderly. However it is important to point out that the percentage of individuals listed as having Alzheimer’s disease is likely an overestimation, since the majority of these individuals are diagnosed with probably Alzheimer’s disease, and not with definitive Alzheimer’s disease (which requires an autopsy).

Do all people with dementia progress the same?

The one thing that is certain with dementia is that it is heterogenic, which means that there is no one way the disease progresses in all people. There is a tremendous variability in the speed with which the disease and brain pathology progresses in individuals, and this variability very likely is important in understanding the basis for dementia in the elderly. It is important to point out that the progression of dementia in even the same person can vary over time. For example, it is known that people with late stage dementia can have “good days” or “better days”, and often do better in the morning and afternoon as compared to the late evening hours. A focus of the Institute is to understand the basis by which “good days” occur and to develop interventions which increase the number and duration of “good days” in individuals with dementia as an important means of treating dementia in the elderly.

What is the impact of dementia on society?

In addition to the considerable direct financial costs associated with medical care of patients with dementia, there are a number of less obvious costs that dementia has on society. For example, in Louisiana there is estimated to be over 150,000 individuals who spend a significant amount of their time as the primary care provider for the individual with dementia. This impact on the caregivers is believed to have a financial impact (lost wages, decreased productivity, illness, etc.) on society of approximately 1.5 billion dollars. In addition to each of these financial costs there are clearly a large number of emotional costs on friends and families with dementia, which together have a significant impact on society as a whole.

How is the Institute working to prevent dementia?

The Institute will be focused on developing a community of individuals which will work together in their own unique way to prevent age-related dementia in Louisiana. This community will include the participation of community advocates, researchers, and clinicians. The first goal of the Institute is to implement a longitudinal study in individuals over the age of 60, with individuals in the study analyzed each year for changes in their cognitive status using the well characterized Uniform Data Set (UDS) exam. This study will help in identifying the earliest stages of dementia in the elderly, and provide insight on how to prevent dementia. Ultimately these efforts will lead to additional benefits to the community including access to cutting edge to neuroimaging and a large number of clinical trials for the treatment and prevention of dementia. The second goal of the Institute is to provide a research platform and infrastructure for researchers to identify therapeutics for the prevention of dementia, and additionally build a base of talented and productive scientist in Louisiana who are dedicated to the eradication of dementia in the elderly. Lastly, the Institute will conduct conferences which promote education on the latest in dementia and dementia prevention to the citizens and caregivers in Louisiana.

How can I help?

To learn more about the opportunities to help with the efforts of the Institute please contact us at:
Institute for Dementia Research & Prevention
Pennington Biomedical Research Center
Louisiana State University System
6400 Perkins Road
Baton Rouge, LA 70808 USA
Phone: (225) 763-2973
Email: dementia@pbrc.edu

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