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According to the author's statement of "20 years old, go to the hospital to find out dementia", she is more likely to have mild subjective discomfort and has not yet met the clinical diagnostic criteria for the disease. Young people have a much lower chance of developing dementia than older people, and the process of diagnosis must be carried out by professional medical personnel.
Verifier: Hu Yuandong | Doctor of Medicine, Deputy Chief Physician, Youth Committee Member of Science Popularization Branch of Chinese Medical Association
Not long ago, an article titled "20 years old, go to the hospital to find out dementia" has aroused the attention of many young people to the problem of dementia. Is the situation described in this article really Alzheimer's disease? What are the odds of young people getting dementia?
1. What is Alzheimer's disease? Is the situation in the case really the case?
Senile dementia is not an independent disease, but a group of chronic progressive mental decline diseases common in old age, caused by Alzheimer's disease (AD), vascular dementia (VaD), Lewy body dementia (DLB), Parkinson's disease dementia (PDD), frontotemporal lobe dementia (FTD) and other progressive organic damage to brain structures, resulting in persistent, comprehensive intellectual hypotrophy in patients in a state of conscious consciousness, manifested as memory, computing, judgment, Attention, abstract thinking, decreased language function, emotional and behavioral disorders, loss of the ability to live and work independently.
The case in the online article is a twenty-year-old young man, because she can't remember things, forget things faster, the doctor of the memory cognition clinic told her "nothing, go back to take some medicine", the author went to buy medicine and found that the medicine prescribed to her by the doctor said "suitable for vascular dementia, senile dementia and other diseases caused by memory and intellectual disorders", and then the author wrote this article titled "20 years old, go to the hospital to find out dementia". In fact, from this process of medical treatment, we can see that first of all, the doctor did not ask him to do further examination (no differential diagnosis is required), nor did he do more diagnosis and treatment explanations, indicating that the author's situation is more likely to be due to irregular work and rest, lack of sleep and other reasons caused by slight subjective discomfort, has not yet met the clinical diagnostic criteria of the disease.
For example, when I go out in the morning, a four-legged animal at the entrance of the community barks at me twice, and then I still have palpitations when I go to the office, and the animals I call are four feet, aren't lions and tigers all four feet? So I opened the computer and wrote a "In the morning, I met a lion at the door of the community", obviously, the possibility that the animal I called was a wild cat and a wild dog was far greater.
Second, will young people get Alzheimer's disease? What factors are involved?
As the name suggests, the incidence of "elderly dementia" in the elderly population is significantly higher than that of other age groups, and the prevalence of dementia in people over 60 years old in China is 7.2%, and the global average is 6.2%. The prevalence is much lower among young people, with a British study finding that the prevalence of dementia is 54/100,000 in people aged 30 to 65 years, 98/100,000 in people aged 45 to 65 years, and a Japanese study found that the prevalence of Alzheimer's disease was 42/100,000 among people aged 18-65 years. This picture on the Lancet shows the trend of age in the prevalence of Alzheimer's disease as the main cause of dementia with age, as can be seen in the figure, the incidence of the disease is extremely low before the age of 55, and it does not increase rapidly until the age of 65.
Figure note: The prevalence of dementia at all ages, with the red line being male and the blue line being female. Image credit: Lancet Neurology
Various diseases that cause dementia in the elderly are basically multifactorial, taking Alzheimer's disease, which occupies the most dominant position, as an example, including immutable factors such as age, sex, and heredity, as well as modifiable factors such as hypertension, hyperglycemia, hyperlipidemia, obesity, smoking and drinking, and cardiovascular and cerebrovascular diseases.
Obviously, in order to reduce the risk of Alzheimer's disease, it is necessary to start from the above modifiable risk factors, control blood pressure, blood sugar, and blood lipids within the normal range, quit smoking, limit alcohol, control weight, and treat various comorbid chronic diseases. Unlike other chronic diseases, the risk of Alzheimer's disease seems to have a lot to do with educational attainment and intellectual activity, and higher levels of education, increased complexity of intellectual activity, and especially activities dealing with people can protect Alzheimer's disease.
Whether vitamins have the effect of reducing risk or improving cognitive impairment is also one of the research areas of Alzheimer's disease, and some low- or moderate-quality evidence shows that cognitive impairment is associated with lower vitamin B levels, and vitamin supplementation can play a role in preventing dementia, but there is a lack of high-quality evidence to confirm this hypothesis.
Is there a so-called "sign" of Alzheimer's disease?
If we consider "signs" to be early manifestations of the disease, then the answer is yes. Common early manifestations of dementia include amnesia that affects daily life; difficulty in solving problems in a planned way, difficulties in completing tasks that were otherwise familiar; confusion in the sense of time or space; difficulty understanding visual images and spatial relationships; problems with language expression; misplacing things and losing the ability to retrace steps; Deterioration of judgment; work and social impairments; Mood and personality changes and so on.
It should be noted that it is impossible to diagnose whether there is Alzheimer's disease based on certain independent manifestations alone, and it is clinically necessary to combine the process of onset, the degree and process of cognitive impairment, and the use of professional scales for assessment, and it is possible to make a correct diagnosis, and the diagnostic process must be carried out by professional medical personnel.
This article was edited by Ryanding
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