Mix of brain abnormalities behind dementia in most elderly people

Drugs targeting the buildup of abnormal proteins in the brain, which researchers believe contribute to Alzheimer’s disease, have so far proved unsuccessful in stemming dementia. Some experts now believe that it is time to reframe research by focusing on other pathologies that may be causing dementia, according to an article in the April 8, 2019 New York Times.

Autopsies have shown that the brains of people with Alzheimer’s contain plaques and tangled strings of proteins, but most elderly patients’ brains show additional potential problems, according to the article. Given that the risk of developing Alzheimer’s or another form of dementia greatly increases with age, some researchers suggest that there may be something else in the brain besides Alzheimer’s-related plagues and tangles that sets off a cascade of pathologies over time.

Albert Hofman, chair of the Department of Epidemiology at Harvard T.H. Chan School of Public Health, believes that diminished blood flow to the brain is the key factor in dementia. He told the Times that studies have shown a consistent decline in incidence of new Alzheimer’s cases in the U.S. and Western Europe in recent decades.

“Why is that? I think the only reasonable candidate is improved vascular health,” Hofman said in the article, adding that this is likely due to a decline in smoking and better control of high blood pressure and cholesterol levels.

Read the New York Times article: The Diagnosis Is Alzheimer’s. But That’s Probably Not the Only Problem.

Hofman answered questions about dementia in an April 17 article in Psychology Today. Read article

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Light in the Shadows (Harvard Public Health magazine)