Why is Alzheimer’s disease grouped with mental illnesses?
Alzheimer’s disease is classified as a mental illness because it causes behavioural symptoms as well as cognitive symptoms. “Mental” means a manifestation of the function of the brain, and Alzheimer’s is certainly a manifestation of brain function. People sometimes wonder why psychiatrists are interested in Alzheimer’s disease, as psychiatrists typically and historically have delved into other kinds of conditions. But it should be noted that Alzheimer (the person after whom the disease was named) was a psychiatrist. So the profession has a long and noble history of dealing with mental phenomena and changes in mental states and helping people with these conditions. Often it is less the memory symptoms and more the other kinds of behaviour or perceptual symptoms that are the most troubling and most difficult to care for. And that is right up our alley, as psychiatrists deal with these kinds of symptoms every day in a variety of different conditions, not just dementia.
-John Breitner, MD, MPH, Mini-Psych School 2012
Is hiding things a typical behaviour in Alzheimer’s?
Based on our current understanding, this behaviour can be common. As people lose their grasp of reality and their ability to understand their surroundings, they lose things. This may be related to memory, but it may be related to other difficulties. People with a limited amount of insight into what is happening to them may believe that other people are trying to steal things from them. These people are likely to hide things. But this is just one explanation and just one example of disordered behaviour, of which there are many examples. So while fairly common, this behaviour is definitely not present in every case.
-John Breitner, MD, MPH, Mini-Psych School 2012
Are there gender differences in Alzheimer’s disease?
Evidence indicates that development rates of Alzheimer’s disease are almost identical for men and women up to about age 80, after which women develop the disease at an accelerated rate compared to men. One possible explanation for this is that women go through menopause, which is a violent change in the hormonal milieu of the brain. There is some evidence to suggest that menopause actually increases the risk of developing dementia, but the risk does not manifest until 20 or 30 years later. If this is the correct explanation, it would help us understand the gender difference after about age 80. The best and largest studies show this gender difference very consistently.
-John Breitner, MD, MPH, Mini-Psych School 2012
Is it true that having a glass of wine every day protects memory in the long run?
We are pretty sure that having a glass of wine, particularly red wine, will help your heart and your blood vessels. But this means one glass of wine and not ten. We also know that things that are good for the heart and the blood vessels are generally good for the brain. This is why we think that consuming a moderate amount of red wine could be helpful for the brain.
-John Breitner, MD, MPH, Mini-Psych School 2012
What is the difference between Alzheimer’s disease and dementia?
There are a lot of people who have masses of plaques and tangles in their brains and who don’t have dementia, while other people with dementia can have very little in the way of this type of brain pathology. We don’t understand this, but we have found some environmental circumstances or even some character or mood traits that seem to coincide with tangles without dementia. It’s an area of vast ignorance in our field.
The problem is that we don’t know what causes the dementia. We see the plaques and tangles, and we know they are present more often than not in people with what looks like clinical Alzheimer’s disease or Alzheimer’s dementia. This is why we think there is probably a cause-and-effect relationship. But certainly at the individual level, this is not necessarily true, so there is a lot more that we don’t know than we do.
-John Breitner, MD, MPH, Mini-Psych School 2012
Does reading/thinking or increasing the use of your brain help prevent Alzheimer’s disease?
The associated studies suggest that this is true. However, it is not clear whether this relationship is causal or whether it is a product of the fact that people with sharper brains or people who read more or do crosswords and Sudoku puzzles, etc. maintain their cognitive function longer into old age. There is a lot of research being conducted in this area, and exercising your brain certainly does not hurt.
-John Breitner, MD, MPH, Mini-Psych School 2012
