Forgetting where you left your keys, taking a few seconds to remember a name, or missing an appointment can happen as we age. However, when forgetfulness is no longer isolated, interferes with daily activities, or is accompanied by changes in orientation, behavior, or decision-making ability, it is important to pay attention and consider a neurological evaluation to determine its possible causes.
When these changes are persistent and begin to affect daily life, they may be related to some type of dementia, including Alzheimer’s disease. According to estimates from the 10/66 Dementia Research Group, more than 100,000 people in the Dominican Republic could be living with dementia, based on an estimated prevalence of 11.7% among people aged 65 or older. Projections indicate that this figure could increase and reach around 125,000 people by 2030 and 240,000 by 2050, according to Alzheimer’s Disease International.
While Alzheimer’s is a progressive brain disease and the most common cause of dementia, it is not the only possible explanation behind a cognitive change. Some medical conditions can produce symptoms that resemble cognitive impairment. Therefore, it is advisable to seek a specialized neurological evaluation for Alzheimer’s, which can more accurately determine the possible causes of the symptoms, establish a timely diagnosis, and define the most appropriate therapeutic approach.
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Brain alterations behind memory loss
But what exactly is Alzheimer’s disease? It owes its name to the German physician Alois Alzheimer, who in 1906 first described unusual alterations in the brain of a patient who had presented with memory loss, disorientation, and other cognitive changes. Upon examining her brain tissue after her death, he identified accumulations and tangled fibers that are known today as amyloid plaques and neurofibrillary tangles, two of the main characteristics associated with the disease.
“Plaques and tangles are still considered the characteristic lesions of Alzheimer’s disease,” explains Dr. Teresa Gomez-Isla, a neurologist in charge of the Memory Division at Massachusetts General Hospital. These alterations progressively affect regions of the brain linked to memory, reasoning, language, and behavior, which helps explain why symptoms can go far beyond memory problems.
The disease usually affects people over 65 years of age and, although its exact cause is unknown, it is considered that it may develop from a combination of different factors such as brain changes associated with age, family and genetic history, some environmental factors, and lifestyle aspects, such as the level of physical activity.
As these alterations progress, they begin to be reflected in different cognitive and behavioral abilities. At first, the changes may be subtle and vary from person to person, but they tend to become more evident as the disease progresses. Among the signs and symptoms of Alzheimer’s in the early and middle stages are:
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• Memory loss
• Confusion
• Difficulty performing daily tasks
• Changes in mood and personality
• Increased anxiety, depression, or aggression
• Difficulty speaking or communicating
• Changes in sleep patterns
“As the disease progresses, memory loss and confusion become more evident. People may even have difficulty recognizing their family members or friends,” notes Dr. Gomez-Isla.
Research opens possibilities for detecting and treating Alzheimer’s
Although there is no cure for Alzheimer’s, there are certain medications that can help manage the symptoms. Recently, the Food and Drug Administration (FDA) has approved new medications for patients in the early stages, which reduce amyloid plaques in the brain and may slow the progression of the disease.
For the Mass General Brigham specialist, these advances open up new possibilities: “Thanks to the new medications available and an increasing understanding of the origins of Alzheimer’s, we can improve the quality of life for patients and their caregivers around the world.” However, she warns that “we are all unique and respond differently to medications. It may take some time to find the right medication and dosage for you or your loved one.”
At the same time, research continues to advance. In that effort, Gomez-Isla and his colleagues at Mass General Brigham, an institution committed to teaching and research for the development of new treatments and cures for various diseases, are studying new diagnostic tools and therapeutic strategies. “We hope to use this knowledge to predict who will have the disease and develop therapies that allow us to delay or prevent it,” he explains.
One of those lines of research found that difficulties in using a simple telephone menu could be associated with an increased risk of developing Alzheimer’s. “The data show that we might be able to identify and treat people long before they present significant symptoms,” the specialist indicates.
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Further evidence comes from the long-term monitoring of an extensive Colombian family with a history of early-onset Alzheimer’s due to a genetic mutation. In carriers of that mutation, researchers detected amyloid plaques up to 15 years before the onset of the first symptoms.
“These pioneering studies provide us with a deeper insight into the disease. Likewise, they offer potential key clues for developing future treatments that can protect people and prevent them from developing Alzheimer’s,” concludes Dr. Gomez-Isla.
As research opens up new possibilities for early detection and the development of advanced medical treatments for Alzheimer’s, access to specialized neurological evaluation is also becoming increasingly relevant. Institutions like Mass General Brigham, one of the largest healthcare systems in the United States, provide international patients with high-quality, personalized care. In this way, they bring their medical expertise and centers of excellence to patients from different parts of the world, facilitating access to specialized care tailored to each person’s needs.
