Can dementia be cured?

What is dementia?

Dementia is a broad term used to describe a wide range of disorders that result in the deterioration of cognitive functioning over time. While a reduction in cognitive abilities is expected as we age, dementia reduces cognitive skills to the point that it interferes with daily life.^[2]

The most common types of dementia include the following:

• Alzheimer’s disease - Alzheimer’s is the most common type of dementia and is primarily caused by protein buildup in the brain. These proteins - amyloid plaques and tau tangles - cause significant changes in the brain that result in forgetfulness, impaired judgment, and reduced social skills, among other symptoms.^[2]
• Vascular dementia - Vascular dementia stems from damage to the blood vessels in the brain. This damage reduces oxygen and blood flow in the brain, resulting in typical dementia symptoms like misplacing items, language expression difficulties, and personality changes.^[3]
• Lewy body dementia - The protein alpha-synuclein, or Lewy bodies, causes this type of dementia. As these proteins build up, symptoms like hallucinations, uncoordinated movements, and unpredictable changes in cognitive abilities, including disorganized thoughts, difficulty concentrating, and confusion, might appear.^[4]
• Frontotemporal dementia - This type of dementia is caused by tau and TDP-43 proteins, which occur in abnormal forms and amounts. Frontotemporal dementia is rare and often occurs in people less than 60 years old. Typical symptoms include communication difficulties, emotional dysregulation, and motor-control issues, like difficulty walking.^[5]
• Mixed dementia - Mixed dementia occurs when two or more types of dementia damage occur in the brain simultaneously. This is most common with Alzheimer’s and vascular dementia, though some people develop Alzheimer’s, vascular dementia, and Lewy body dementia co-occur.^[6]

Other conditions might cause dementia-like symptoms as well. For example, delirium (a sudden state of confusion), heavy use of alcohol, and Huntington’s disease (a progressive brain disease) can all result in cognitive decline.^[2]

The symptomatology of dementia depends in part on the type of dementia. For example, some people with frontotemporal dementia don’t initially show signs of memory problems, as is common with other types of dementia.^[5]

Nevertheless, there are general symptoms common to most cases of dementia. These might include:^[2]

• Memory loss
• Confusion
• Poor judgment and impulsivity
• Apathy regarding the feelings of others
• Hallucinations, delusions, or paranoia
• Difficulties with movement, including a loss of balance
• Difficulties producing speech, reading, and writing
• Getting lost in familiar locations

Many dementia patients also experience difficulties with tasks of daily living, like paying bills on time. Frequently, a loss of interest in once enjoyable daily activities also occurs.

Is there a cure for dementia?

As noted earlier, there is currently no cure for dementia. Moreover, since each type of dementia has a different cause, the likelihood of a single cure being found is slim. The damage that occurs to the brain as a result of dementia is also irreversible.

However, researchers have made great strides in identifying the specific causes of the dementias outlined earlier. With a better understanding of why these diseases occur, researchers have focused on developing treatments that minimize risk factors, slow the progression of dementia, and address the symptoms of dementia.

What is the best treatment method for dementia?

Several treatments are available for dementia. The best treatment depends on many factors, not the least of which is the type of dementia a patient has. Some current and promising treatments for dementia are outlined below.

Drug therapy

Two drug therapies for Alzheimer’s disease help reduce cognitive decline and improve overall functioning. Both treatments - lecanemab and aducanumab - target beta-amyloid proteins to achieve their effects.

Other medications provide relief from some dementia symptoms by slowing their development. This, in turn, improves the overall quality of life of the patient, albeit temporarily.^[7]

Developing a new medication to treat dementia takes years and years of development. It’s also a costly process. For these reasons, researchers are examining how existing drugs might treat dementia.

For example, drugs used to treat rheumatoid arthritis, type-2 diabetes, and high blood pressure are being investigated for their potential to reduce dementia symptoms.^[1]

Gene therapy

Gene therapy minimizes the number of proteins that cause dementia, like the tau protein in Alzheimer's.^[1] Some studies have shown great promise in slowing the progression of Alzheimer’s by injecting genetically modified cells directly into the brain.

For example, one clinical trial found that genetically modified cells that produce nerve growth factor (which naturally helps cells grow and repair damage) slowed the progression of Alzheimer’s by 50 percent. Though this is not a cure for the disease, it shows promise as a treatment for slowing its development.^[7]

Stem Cell Research

Stem cells have been extensively researched for their role in future dementia treatments. Since stem cells are foundational, they can develop into many types of cells, including those in the brain.

Research with stem cells has yielded scientists crucial insights into how dementia-related damage starts in the brain. Likewise, researchers can use stem cells to explore how this damage can be prevented in the first place. Stem cells can also be used for testing dementia treatments for efficacy.^[1]

Immunotherapy

Immunotherapy is a technique in which the body’s immune system targets and destroys dementia-causing plaques. In some cases, vaccines to protect against abnormal protein buildup are used to fight the development of Alzheimer’s disease.

In other cases, manufactured proteins called monoclonal antibodies are used to target abnormal proteins to slow the development of Alzheimer’s. Unfortunately, this technique has not been successful up to this point, though research in this field is quickly advancing. In fact, the Food and Drug Administration (FDA) is currently reviewing a possible immunotherapy treatment using an aducanumab antibody.^[1]

Immunoglobulin, a filtered blood product rich in antibodies, is another potential immunotherapy treatment for dementia. In clinical trials, immunoglobulin has shown promise for improving cognitive functioning in patients with mild Alzheimer’s disease.^[8]

Will there ever be a cure for dementia?

As noted above, research for a dementia cure has made great strides. And while no cure has been found yet, the future could yield discoveries that help prevent some types of dementia from developing.

Specifically, finding the gene or genes responsible for developing Alzheimer’s and other dementias is vital in working toward a cure. Targeting treatments to reduce plaque buildup, for example, might not provide a complete cure for dementia but may significantly relieve symptoms.^[9]

The research needed to produce these kinds of results takes a very long time to develop and requires large sums of money. Investing in dementia research now will help fuel discoveries in the future that may one day provide an all-important cure.

What causes death in dementia patients?

People with dementia most commonly die of other conditions, with pneumonia and heart disease leading the way.^[10] This is because people with late stage dementia are likely to have weakened immune systems, which can increase the risk of contracting fatal infections.

Knowing when a dementia patient is about to die can be difficult to gauge. However, the last stages of dementia before death usually include incontinence, minimal speech, and a diminished appetite. Difficulty swallowing, an inability to walk or stand, and a limited understanding of speech are further signs of late-stage dementia. If these symptoms appear and grow in severity, death might be near.