痴呆症是一种综合症 - 通常是慢性或逐渐退化发展性的认知功能（即处理思维的能力）恶化超出正常衰老所预期的程度。它影响记忆，思考，阅读，写作，口语，方向感，理解，计算，学习能力，语言和判断能力，但意识不受影响。认知功能的损害通常伴随着情绪控制问题，恶化正常的社交行为和动机。痴呆症是由多种主要，或次要影响大脑的疾病和损伤引起的，如阿尔茨海默病或中风。

痴呆症是全世界老年人残疾和依赖的主要原因之一。它不仅对病人本身，而且对他们的照顾者和家庭来说都产生很大的压力和痛苦。通常缺乏对痴呆症的认识和理解，导致耻辱感，诊断和护理障碍。痴呆症对照顾者，家庭和整个社会的影响，可以带来身体，心理，社会和经济的极大伤害。


痴呆的类型 

阿尔茨海默病：老年人中最常见的痴呆症诊断， 可能占60-70％的病例。它是由大脑的变化引起的，包括蛋白质的异常堆积，称为淀粉样斑块和 tau 缠结。



额颞叶痴呆：一种罕见的痴呆形式，往往发生在 60 岁以下的人群中。它与蛋白质 tau 和 TDP-43 的数量或形式异常有关。 


路易体痴呆症：一种由称为路易体的蛋白质 α-突触核蛋白在神经细胞内堆积，异常沉积引起的痴呆症。 


血管性痴呆：一种由损害大脑血管或中断血液和氧气流向大脑的疾病引起的痴呆。 



混合性痴呆：两种或两种以上痴呆的组合。


症状和体征阶段

痴呆症以不同的方式影响每个人，取决于疾病的影响和生病前人的性格， 痴呆症状可能有所不同， 可能包括：

• 经历记忆丧失、判断力差和混乱 

• 说话、理解和表达想法或阅读和写作有困难

• 在熟悉的街区徘徊和迷路
• 无法负责任地处理金钱和支付账单
• 重复问题 
• 使用不寻常的词来指代熟悉的物体 
• 需要更长的时间来完成正常的日常任务 

• 对正常的日常活动或事件失去兴趣 
• 出现幻觉或经历妄想或偏执 
• 冲动行事 
• 不关心别人的感受 
• 失去平衡和运动问题


与痴呆症相关的体征可以分三个阶段来理解：

早期阶段：痴呆症的早期阶段往往被忽视，因为起病是渐进的发展， 长达十多年之久。常见症状包括： 
•健忘 
•忘记时间 
•在熟悉的地方迷路。
 
中期阶段：随着痴呆症进展到中期阶段，症状和体征变得更加清晰，更具限制性。这些包括： 
•忘记最近发生的事件和熟人的名字 
•在家附近迷路 
•沟通难度增加 
•需要个人护理方面的帮助 
•经历行为改变，包括徘徊和反复提问。
 
晚期阶段：痴呆症的晚期是几乎完全依赖和不活动的阶段。记忆障碍严重，体征和症状变得更加明显。症状包括： 
•变得不知道时间和地点 
•难以识别亲戚和朋友 
•对辅助自我护理的需求日益增加 
•行走困难 
•体验可能升级，并包含恶化的攻击行为。


痴呆症的比率

全世界约有5000万人患有痴呆症，每3秒就有一个新病例，其中近60％的人生活在低收入和中等收入国家。每年有近1000万新病例，到2050年，痴呆症患者人数将增加两倍。女性高于男性，65%女性在她的一生中可能患痴呆症， 60%的女性需要被人照理。 越来越多的痴呆症患者缺乏治疗，将严重影响社会和经济发展，使得各国必须专注于减少痴呆症防御措施，降低得病风险因素。 在特定时间内，预计到2030年，痴呆症患者总数将达到8200万；2050年达到1.52亿；60岁及以上痴呆症的人口估计比例在5-8％之间。这一增长大部分是由于生活在低收入和中等收入国家的痴呆症患者人数不断增加。

根本的原因 

1.炎症：它来自于感染，饮食，创伤或其他原因，如：过度锻炼，体内所产生的大量自由基。  
2.缺乏神经支持性营养素；随着年龄的增长，荷尔蒙水平的下降；和其它脑细胞分子的减少。 
3.金属或生物毒素等毒素物质（霉菌等微生物产生的毒物），重金属和霉菌在体内的堆积。环境
  污染因素也是致痴呆症根源的关键。空气污染与痴呆症相关，可能是由于暴露于二氧化 （NO2）和主要道路附近经常发现的高密度细颗粒粉尘。事实上，估计高达6.1％的痴呆病例可
  归因于空气污染水平升高。交通噪音和噪音污染也可能导致大量发病。

预防 

1. 均衡饮食：精制糖或甜食，饱和脂肪，过量吃碳水化物会损害大脑功能。均衡饮食或偏于地
   中海饮食可以保护你的大脑，改善记忆力。 
2. 坚持锻炼：每周至少进行两次有氧运动和两次力量训练。 
3. 保证睡眠：每晚需7-8个小时的睡眠。睡觉之前，限制看屏幕或手机时间。 
4. 保持社交活动：通过志愿者工作，棋盘游戏或其它业余爱好来广泛结交朋友，互相交流。 
5. 经常使用牙线：一些研究人员认为慢性牙龈疾病与阿尔茨海默氏症有关。因此，每天刷牙两
   次和用牙线，以避免斑块积聚。 
6. 降低压力：一项研究发现压力荷尔蒙皮质醇与记忆问题有相当大的关系。要尽量减少工作和
   生活中的压力，而且要学会释放压力。

事实上，近几年的科学研究告诉我们，这些大脑疾病不仅是可以预防的，还可逆转。如果您想了解更多的老年痴呆中的阿尔茨海默症、 请关注我的下一篇博客：阿尔茨海默症和逆转。

如果您希望得到专业人士的支持和帮助，请加我微信：sally9559。我是加拿大注册的整体营养咨询师。整体营养就是身体，心里，精神三维一体的营养，通过改变饮食和生活方式，适当补充临床营养素来预防疾病，修复亚健康状态。专业化大数据和个体性营养评估，查出亚健康的根源，教您一整套适合于您的饮食和营养调理方案。 痴呆症是可以通过饮食营养和生活方式的改变来停止发展，甚至逆转。


Dementia

Dementia is a syndrome – usually of a chronic or progressive nature – in which there is deterioration in cognitive function (i.e. the ability to process thought) beyond what might be expected from normal ageing. It affects memory, thinking, reading, writing, speaking,orientation, comprehension, calculation, learning capacity, language, and judgement. Consciousness is not affected. The impairment in cognitive function is commonly accompanied, and occasionally preceded, by deterioration in emotional control, social behaviour, or motivation. 

Dementia results from a variety of diseases and injuries that primarily or secondarily affect the brain, such as Alzheimer's disease or stroke.

Dementia is one of the major causes of disability and dependency among older people worldwide. It can be overwhelming, not only for the people who have it, but also for their carers and families. There is often a lack of awareness and understanding of dementia, resulting in stigmatization and barriers to diagnosis and care. The impact of dementia on carers, family and society at large can be physical, psychological, social and economic. 

Common forms of dementia

Alzheimer’s disease： the most common dementia diagnosis among older adults，contributing to 60–70% of cases. It is caused by changes in the brain, including abnormal buildups of proteins, known as amyloid plaques and tau tangles.

Frontotemporal dementia： degeneration of the frontal lobe of the brain， a rare form of dementia that tends to occur in people younger than 60. It is associated with abnormal amounts or forms of the proteins tau and TDP-43.


Lewy body dementia： a form of dementia caused by abnormal deposits of the protein alpha-synuclein (abnormal aggregates of protein that develop inside nerve cells), called Lewy bodies.

Vascular dementia： a form of dementia caused by conditions that damage blood vessels in the brain or interrupt the flow of blood and oxygen to the brain.


Mixed dementia： a combination of two or more types of dementia.



Symptoms and Signs  

Dementia affects each person in a different way, depending upon the impact of the disease and the person’s personality before becoming ill. The symptoms of dementia can vary and may include:

•Experiencing memory loss, poor judgment, and confusion
•Difficulty speaking, understanding and expressing thoughts, or reading and writing
•Wandering and getting lost in a familiar neighborhood
•	Trouble handling money responsibly and paying bills
•Repeating questions
•Using unusual words to refer to familiar objects
•Taking longer to complete normal daily tasks

•Losing interest in normal daily activities or events

•Hallucinating or experiencing delusions or paranoia

•Acting impulsively
•Not caring about other people’s feelings

•Losing balance and problems with movement


The signs linked to dementia can be understood in three stages：

Early stage: the early stage of dementia is often overlooked, because the onset is gradual. Common symptoms include: 
-forgetfulness
-losing track of the time 
-becoming lost in familiar places.

Middle stage: as dementia progresses to the middle stage, the signs and symptoms become clearer and more restricting. These include: 
-becoming forgetful of recent events and people's names
-becoming lost at home
-having increasing difficulty with communication
-needing help with personal care
-experiencing behaviour changes, including wandering and repeated questioning.

Late stage: the late stage of dementia is one of near total dependence and inactivity. Memory disturbances are serious and the physical signs and symptoms become more obvious. Symptoms include:
-becoming unaware of the time and place
-having difficulty recognizing relatives and friends
-having an increasing need for assisted self-care
-having difficulty walking
-experiencing behaviour changes that may escalate and include aggression.

Rates of dementia
 
Worldwide, around 50 million people have dementia and, with one new case every three seconds, with nearly 60% living in low- and middle-income countries. Every year, there are nearly 10 million new cases and the number of people with dementia is set to triple by 2050. women are higher than men by 65% of patients and 60% of caregivers. The increasing numbers of people with dementia, its significant social and economic impact and lack of curative treatment, make it imperative for countries to focus on reducing modifiable risk factors for dementia.
The estimated proportion of the general population aged 60 and over with dementia at a given time is between 5-8%. 

The total number of people with dementia is projected to reach 82 million in 2030 and 152 million in 2050. Much of this increase is attributable to the rising numbers of people with dementia living in low- and middle-income countries.

Root Causes

1. Inflammation：caused by infection, diet, injury, and other causes, such as excessive exercise generating masive free-radicals. 
2. Decline and shortage of supportive nutrients, hormones, and other brain supporting molecules
3. Toxin substances such as metals or biotoxins (poisons produced by microbes such as molds)。 Environmental factors are also taking centre stage in understanding the root causes of dementia. Air pollution     has been linked to dementia-related outcomes potentially due to the exposure to nitrogen dioxide (NO2) and high density of fine particles frequently found near major roads. In fact, it is estimated that up to 6.1% of dementia cases may be attributed to elevated air pollution levels. Traffic noise and noise pollution may also contribute to a significant number of cases.

Prevention
1. Eat a balanced diet: Refined sugar and saturated fats hurt brain function. A Mediterranean diet can protect your brain and improve memory.
2. Exercise regularly: Aim to do both aerobic exercise and strength training twice a week.
3. Get quality sleep: Aim for 7-9 hours of shut-eye every night. Limit screen time before your snooze.
4. Stay socially engaged: through volunteer work, board games, or a hobby.
5. Floss regularly: some researchers think chronic gum disease is tied to Alzheimer’s. Therefore, brush and floss twice a day to avoid plaque build-up.
6. Lower your stress: one study found the stress hormone cortisol is linked to memory problems.

In fact, science is telling us, these mental health ailments are not just treatable, but preventable in the first place. If you are interested in knowing more information about the dementia: Alzheimer's Disease, please follow up with me to read my next blog that will specially talk about Alzheimer’s Disease and Reverse.


References:

1. Metagenics Institute: https://www.metagenicsinstitute.com/articles/dementia-linked-to-air-pollution

2. WHO. Dementia. http://www.who.int/news-room/fact-sheets/detail/dementia. Accessed October 8, 2018.

3. https://www.ncbi.nlm.nih.gov/pubmed/28063597

4. Dr. Dale E. Bredesen: https://grandrounds.ifm.org/watch/WJmJ8SU3NzyDX8LLe2EHXX

5. https://www.nia.nih.gov/health/what-dementia-symptoms-types-and-diagnosis