Everything you need to know about migraine

 Migraine is a medical condition that typically causes severe headaches that may feel throbbing or pulsing. Other symptoms include nausea, light aversion, and dizziness.

A migraine episode is a type of headache. An episode usually occurs in stages and can last for several days. Severe cases can affect a person’s daily life, including their ability to work or study.

However, the condition of migraine is more than a headache type. It is a complex neurological condition that typically involves headaches. However, not everyone with migraine will experience the headache aspect during an episode.

Migraine can affect people in different ways, and the triggers, severity, symptoms, and frequency can vary. Some people have more than one episode each week, while others have them only occasionally.

This article further explains what migraine is. It also goes over the symptoms, causes, and treatment for the condition.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth.

What is a migraine?

Migraine is a complex neurological condition that often involves a severe headache. It is generally characterized by moderate to severe throbbing, and pulsating pain on one side of the head. People with migraine often experience recurrent episodes.

In 2021, researchers found that approximately 4.3% of adultsTrusted Source over the age of 18 in the United States had experienced a migraine episode or a severe headache within the last 3 months.

This research also found that migraine affects just over 7.4% of females versus 2.5% of males. Episodes often occur in people ages 18–44 years, but they can happen at any time, including during childhood.

Untreated episodes of migraine can last anywhere from 4–72 hoursTrusted Source. For many people, migraine may be worse in the morning. Some may also experience an episode at a predictable time, such as during menstruation or at the weekend following a stressful working week.

While most people may feel weak or exhausted following a migraine episode, they generally experience times being symptom-free in between episodes.

Research data on race and ethnicity

Migraine can be a debilitating condition that is underdiagnosed and challenging to treat. This can be seen especially in BIPOC populations. Minorities are less likely to receive the diagnosis of migraine and the treatment than white people.

A study from 2017 using survey information from 2006–2013 notes that among the 50 million people who visited a healthcare professional for migraine-related issues between those years, 41.3% were African American. However, of those numbers, 47.3% received no abortive treatment for the condition.

Other research from 2021 found that Latino people are 50% less likely to receive a formal migraine diagnosis than white people. These disparities can impact treatment and therapies.

While these figures could lead to the conclusion that white people experience more migraine episodes than other groups, an analysis from 2015Trusted Source of nine studies looking at the average prevalence of severe headaches or migraine from 2005–2012 in the U.S. found that the prevalence rates of episodes across all groups were similar:

• 17.7% of Native American people
• 15.5% of white people
• 14.5% of Hispanic people
• 14.45% of Black people
• 9.2% of Asian people

Furthermore, females in all groups were approximately twice as likely to experience migraine episodes than males.

Overall, studies that discuss migraine and use racial and ethnic differences for clarity often do not consider contributing factors. Further research is warranted, and this should consider behavioral, environmental, genetic, and socioeconomic factors, as well as access to healthcare.

Symptoms of migraine

Symptoms of migraine tend to occur in stages:

Before the headache: According to a 2023 review of migraine, around 77% of peopleTrusted Source with migraine experience symptoms that start hours or days before the headache.

At this stage, a person might experience a “prodrome,” which may involve emotional changes, specifically depression and irritability. A prodrome can also include yawning, dizziness, thirst, frequent urination, and sensitivity to light and sound.

Sometimes an aura can occur. This involves physical or sensory symptoms, such as flashing lights in the field of vision.

During the headache: Alongside a mild to severe, throbbing or pulsing headache, symptoms may include nausea, vomiting, neck pain, dizziness, and nasal congestion.

Resolution: After the headache, tiredness and irritability may last another few days. This is sometimes called the “migraine hangover.” Officially, it is known as the postdrome phase.

Other common features of migraine are:

• head pain that worsens during physical activity or straining
• an inability to perform regular activities due to the pain
• increased sensitivity to light and sound that can sometimes be relieved by lying quietly in a darkened room

Other symptoms may include sweating, feeling unusually hot or cold, a stomachache, and diarrhea.

Find out what else can cause a headache, nausea, and fatigue.

Migraine vs. headache

A migraine episode is different from a typical headache. The experience is different, and they can have different causes.

Writing down the symptoms and when they occur can help a person and their healthcare professional identify migraine episodes. Examples of what to note include:

• the time that symptoms start
• possible triggers, such as stress or menstruation
• the nature of the headache
• any other symptoms
• how long symptoms last
• any noticeable indicators of migraine, such as an aura
• any medications and their effects

Learn more about the differences between migraine and a headache.

Causes and triggers of migraine

The exact causeTrusted Source of migraine is not fully understood. However, there are certain factors that experts believe may contribute to the development of the condition.

Genetic features may also play a role — having a family history of migraine is a common risk factorTrusted Source.

Migraine triggers vary from person to person. However, there are certain factors that are common triggers.

Many people find that hormonal changes, such as those related to menstruation, can trigger migraine headaches.

There are various emotional triggers, that include:

• stress
• depression
• anxiety
• excitement

Certain dietary factors can trigger migraine, including:

• alcohol
• caffeine
• chocolate
• nuts
• cheese
• citrus fruits
• foods containing the additives tyramine and monosodium glutamate (MSG)

Some people may find certain medications a triggering factor, such as:

• sleeping pills
• hormone replacement therapy (HRT)
• some birth control pills

Various environmental factors can potentially trigger migraine, including:

• flickering screens
• strong smells
• secondhand smoke
• loud noises
• humidity
• stuffy rooms
• temperature changes
• bright lights

Some other possible triggers include:

• tiredness
• a lack of sleep
• shoulder and neck tension
• poor posture
• physical overexertion
• low blood sugar
• jet lag
• irregular mealtimes
• dehydration

Avoiding triggers, when possible, may help reduce the frequency of migraine episodes.

What causes headaches?

Risk factors

Anyone can develop migraine. However, there is a slightly higher risk for people with:

• depression
• bipolar disorder
• fibromyalgia
• irritable bowel syndrome
• overactive bladder
• sleep disorders
• obsessive-compulsive disorder (OCD)
• anxiety

Is there a link between migraine and COVID-19?

Migraine treatment

There is no cure for migraine. However, medications can help manage the symptoms when they arise, and people can take steps to reduce the frequency and severity of episodes.

However, it is important to keep in mind that these medications can have side effects.

Medications

Pain relief and other types of medication can often help. Taking medication as soon as symptoms start may keep them from becoming severe.

Some over-the-counter (OTC) pain relief medications that may benefit people with migraine include:

• naproxen (Aleve)
• ibuprofen (Advil)
• acetaminophen (Tylenol)

Other options include:

• triptans, such as sumatriptan (Imitrex), to help reverse the brain changes that occur during an episode
• antiemetics to manage any nausea and vomiting
• gepants to block a protein involved in inflammation and pain, called calcitonin gene-related peptide (CGRP)
• ditans, which interact with 5-HT1F receptors on the sensory nerves and blood vessels

It is important to avoid overusing medication because overuse can cause a rebound headache. A healthcare professional can help inform an individual how much of each medication is safe and effective.

Find some tips for instant migraine relief.

Home and natural remedies for migraine

Some home care strategies that can help relieve migraine symptoms include:

• using flexible cold packs or masks
• staying in a quiet, darkened room
• sleeping, when necessary

The following supplements might help prevent migraine. However, there is limited evidence that they work, and not much is known about their side effects:

• herbal extracts, such as feverfew
• magnesium
• coenzyme 10
• butterbur
• riboflavin

Other nondrug approaches may include acupunctureTrusted Source, neck exercises, or physical therapy.

Before trying any of these, speak with a healthcare professional. Research has not shown that these approaches work.

Anyone looking for an alternative therapy, such as acupuncture, should go to a qualified and experienced professional.

What are some natural remedies for a headache?

How to prevent migraine episodes

While it is not always possible to prevent migraine episodes, there are ways to reduce their frequency and severity.

Medications

The following prescription drugs may help reduce the number of episodes that a person with severe migraine experiences:

• topiramate (Trokendi XR), an antiseizure drug
• propanolol (Inderal), for treating high blood pressure
• antidepressant medications
• Botox
• gepants and CGRP inhibitors

It may take several weeks to see an improvement.

The best treatment in children or adolescents may be different from that in adults. A healthcare professional can help recommend the most effective approach.

Identifying and avoiding triggers

A migraine episode sometimes happens in response to a trigger. To identify a trigger, a person might keep a diary and record how they felt and what they did, ate, and drank before the symptoms appeared.

It may be particularly helpful to avoid:

• low blood sugar
• physical overexertion
• stress
• certain foods, such as chocolate and any that contain tyramine or MSG
• certain medications, including HRT and some birth control pills
• bright lights and flickering screens

The following strategies may help reduce the frequency of migraine episodes:

• getting enough sleep
• reducing stress
• drinking plenty of water
• having healthy posture
• avoiding known dietary triggers
• getting regular physical exercise

If making these changes does not ease the severity and frequency of migraine episodes, a healthcare professional may suggest medication or other options.

Types of migraine

There are various types of migraine. A major distinguishing factor is whether they involve aura-sensory changes.

Migraine with aura

Aura is a disturbance of the senses in the early stages of a migraine episode.

Aura can involve:

• having confusing thoughts or experiences
• seeing strange, sparkling, or flashing lights that are not there
• seeing zig-zagging lines of light
• having blind spots or blank patches in the field of vision
• having a pins and needles sensation in an arm or leg
• having difficulty speaking
• having weakness in the shoulders, neck, or limbs
• seeing things that are not there out of one eye, such as transparent strings of objects
• not being able to see part of something clearly
• having part of the field of vision disappear, then reappear

A visual aura may feel like the aftermath of a very bright camera flash, but the visual changes may last for several minutes or up to 1 hour.

Anyone experiencing an aura for the first time should contact a healthcare professional to rule out serious neurological problems, such as a stroke or a brain tumor.

Find out more about migraine aura.

Migraine without aura

More commonly, a person experiences no sensory disturbances before an episode. This type of migraine accounts for around 70–80% of cases.

Other types

Some other types of migraine include:

• Chronic migraine: This involves having an episode on more than 15 days per month.
• Menstrual migraine: This occurs in a pattern that follows the menstrual cycle.
• Hemiplegic migraine: This causes temporary weakness on one side of the body, and it is very rare.
• Abdominal migraine: This involves migraine episodes with irregular function in the gut and abdomen, often with nausea or vomiting. It also typically involves abdominal pain. It mainly affects children under 14 years of age.
• Vestibular migraine: Severe vertigo is a symptom of this type.
• Basilar migraine: This rare type is also called “migraine with brainstem aura,” and it can affect neurological functions, such as speech.

Anyone who may be experiencing any new neurological symptoms should seek medical attention. People who need treatment for migraine should consult a healthcare professional.

Diagnosis

The International Headache Society recommends the “5, 4, 3, 2, 1” criteria to diagnose migraine without aura. These numbers stand for:

• having 5 or more episodes, each lasting 4 hours to 3 days
• having a headache with at least 2 of the following qualities:
  • occurring on one side
  • pulsating
  • causing moderate-to-severe pain aggravated by activity
• having at least 1 additional symptom, such as:
  • nausea
  • vomiting
  • sensitivity to light
  • sensitivity to sound

A healthcare professional may recommend imaging or other tests to exclude other causes of the symptoms, such as a tumor, meningitis, or a stroke.

When to see a doctor

A person should consult a healthcare professional if they experience:

• what seems like a first migraine episode
• worsening or unusual migraine symptoms
• severe symptoms

If any of the following occur, seek immediate medical help:

• an unusually severe headache
• visual disturbances
• a loss of sensation
• difficulty speaking

These could indicate another condition that may need urgent attention, such as a stroke.

When is it sensible to worry about a headache?

Summary

Migraine is a medical condition that involves a headache and other symptoms. It is not just a bad headache and it can have a significant impact on daily life, making it difficult to work and do everyday activities.

Identifying and avoiding triggers can often help reduce the frequency or severity of episodes, though it is not always possible to prevent them.

Medication and other treatments can help manage migraine symptoms. Anyone who has concerns should contact a healthcare professional.

Source - Medical News Today

In Conversation: New directions in dementia research

 Millions of people around the world live with a form of dementia, which severely affects both their own and their carers’ quality of life. The specific causes behind dementia remain unclear, but researchers are making steady progress in finding out more about its mechanisms. This instalment of In Conversation looks at some of the realities of dementia, and presents new directions in dementia research.

Dementia is a neurocognitive syndrome that refers to a collection of symptoms related to memory loss and the decline of cognitive function.

The most common form of dementia is Alzheimer’s disease, which affects millions of people worldwide. According to data from the Centers for Disease Control and Prevention (CDC), in the United States alone, in 2020, as many as 5.8 millionTrusted Source people had Alzheimer’s disease.

Research conducted by the Alzheimer’s Society in 2019 indicates that over 850,000 people were living with dementia in the United Kingdom that year, and globally, more than 55 millionTrusted Source people live with dementia, according to the World Health Organization (WHO).

There are some treatments that can help alleviate some dementia symptoms, but most forms of dementia are currently incurable, and researchers continue to investigate the mechanisms through which this syndrome develops with a view to developing better treatments and prevention strategies.

In our latest instalment of In Conversation, we spoke with Paula Field, who is a caregiver for her mother who lives with Alzheimer’s disease, and with Dr. Kamar Ameen-Ali, who is a lecturer in biomedical science at Teesside University in the United Kingdom, and who specializes in neurodegenerative diseases, including Alzheimer’s.

This article provides an edited and shortened record of this instalment of our podcast. We have added reference links to key research findings mentioned in it. Please listen to the podcast — below or on your preferred platform — for the full discussion.

Dementia: Definition and genetic risk

Dr. Hilary Guite: Let’s start with an overview of dementia and its causes.

Dr. Kamar Ameen-Ali: I always think that it’s good when we are discussing dementia to start off with a definition of what we mean by it. Often you might hear people use it interchangeably with things like Alzheimer’s disease, but they’re very distinct things.

Dementia, we kind of describe it as an umbrella term. It describes a set of symptoms, it’s a clinical syndrome — those symptoms are often associated with memory impairment. But for a diagnosis of dementia, you also have to have an impairment in one or more other cognitive domains as well — this might be personality, it might be visual-spatial skills, for example.

And as I mentioned, dementia as a clinical syndrome is distinct from something like Alzheimer’s disease, which is a type of brain disease that leads to dementia.

Dr. Guite: Is dementia hereditary?

Dr. Ameen Ali: It depends on what brain disease we’re talking about. So if we’re going to talk about Alzheimer’s disease — which I think is a good idea, because it’s the most common brain disease that leads to dementia — there are some types of Alzheimer’s disease that are hereditary and some types that aren’t.

The most common type of Alzheimer’s disease is what we call sporadic Alzheimer’s disease, and that counts for 97% of Alzheimer’s disease cases. So 3% of cases of Alzheimer’s disease will have that known genetic origin, and this is caused by genetic mutations.

So only a small percentage of actual Alzheimer’s disease cases have got that genetic, known hereditary link.

The real-life impact

Dr. Guite: Thank you. So Paula, you’ve been looking after your mother with dementia alongside working. Can you tell us what you first noticed?

Paula Field: Yes, I am. I think my sister and I first noticed that there were some issues with her memory after my father had died. I think that she had started to develop some form of dementia before that, but [our parents] sort of helped each other out. And I think [our father] helped her through a lot of those daily things.

After he died, I think it became much more obvious [that something was wrong], but, you know, at that stage, we weren’t sure whether [her symptoms were] sort of a grief thing. But it gradually progressed. And it probably took us about 6 months or so after he died to realize that, you know, we probably did need to take her to the doctor, and to find out what was happening.

Dr. Maria Cohut: Paula, how did this affect you and your sister financially and during day to day life?

Paula: Well, I think in the early days, you could have a conversation [with our mother]. [My sister and I] were both working full-time, we’d go visit weekends, so we were there really regularly. In terms of financial impact, at that stage, there wasn’t very much, we just carried on as usual. We didn’t have any [additional] carers or anybody at that stage, we used to just go in as often as we could.

Then, once it got to the point when we had to take her to the doctors for her first memory test, and once the results came back, that’s when we had to start thinking about [arranging] more care. And that’s resulted in my sister having to take a day off a week from her work and spend two afternoons a week with my mom.

She has been doing that for nearly 4 years now. And we have other carers going in about twice a day now want to make sure that she gets up, and give her some lunch and the other one in the evenings, to give her some dinner. They do that about 4 days a week, and we pick up the rest.

How doctors diagnose dementias

Dr. Guite: What sorts of scans and diagnostic process happens nowadays?

Dr. Ameen-Ali: There are different types of scans that can be done, [such as] PET scans and MRI scans.

In terms of how well they can contribute to the diagnosis of brain diseases? Questionable, I think, because if we’re looking for brain changes that are associated with Alzheimer’s disease, for example, the question is how well can we see that pathology in the brain in life. Something like Alzheimer’s disease can actually only be diagnosed post mortem, when we can confirm that those pathological changes in the brain are actually there.

But something like a PET scan or a CT or an MRI scan, they can see whether there is that general atrophy in the brain, and that is something that we would expect to see in something like Alzheimer’s disease, particularly atrophy around the hippocampus, which is the part of the brain that is responsible for different memory processes.

So to a certain degree, these brain scans can help with the diagnosis of a certain brain disease that is leading to dementia, but we have to remember that it can only ever be confirmed post mortem.

Dr. Guite: You mentioned there atrophy, what does that mean?

Dr. Ameen-Ali: Atrophy is basically where the brain tissue degrades. If you were to see a brain that had atrophy, you’d see essentially shrinkage of certain areas of the brain.

Dr. Guite: My understanding is that the new PET scans can look at how the brain metabolizes nutrients, like sugar, and that they can show whether or not there are are some some proteins that get misfolded. Can you just explain what those proteins are — amyloid and tau — and how important they are?

Dr. Ameen-Ali: Amyloid and tau are the kind of characteristic pathological features of Alzheimer’s disease. Amyloid is a protein that will aggregate and clump together in the brain and form plaques, and that’s what we see in Alzheimer’s disease.

These plaques then disrupt neuronal cell function, and then that leads to a lot of those cognitive issues that we talked about earlier.

There’s also tau, which is [another] protein in the brain. Again, it’s another characteristic pathological feature of Alzheimer’s disease. Normally, it’s a protein within axons of nerve cells, and it helps to form what we call microtubules that are responsible for transporting nutrients within the cells.

What we see in Alzheimer’s disease, is that it aggregates into these tangles, and it disrupts cell function in that way, and it affects how cells communicate with one another.

Changes in personality and behavior

Dr. Guite: Paula, after that initial phase and the the memory loss, what else did you start to notice [in your mother]?

Paula: Well, we noticed that she became quite isolated. She didn’t leave the house, she did start to leave her peas on the cooker. And I think, you know, that was the point where we started to go, “Eek, this is getting quite serious.”

She still has some sort of instinctual habit, so she’ll still switch off the switches at the end of the day. That’s something that she’s done forever. But pretty much everything else…

She knows there’s a fridge in her house, and she knows that there should be something on the shelves, and she will put stuff in the fridge. It could be a packet of crisps or it could be a cup. She has this sort of visual memory of the fridge, she sort of knows what it’s for, but she doesn’t quite know how to use it.

But that’s about it. She doesn’t feed herself. If she won’t drink water, she certainly couldn’t take medicines. She does not wash [on her own]. If we ask her to wash her face or something, she’s quite canny, she’ll go in the bathroom, close the door, won’t let you in, and then come out again.

She still believes that she cooks her own dinner, she still believes that she can do all the things that she’s always done. I don’t think it’s denial, necessarily. I think she just [thinks that] it’s happened, therefore, she must have done it.

She has no idea who myself and my sister are — she recognizes us [as familiar faces], but she doesn’t know who we are. She has no knowledge of people going in every day to help her.

She’s not very active, she pretty much sits on her chair everyday with the TV on and looks into space.

Risk factors and what happens in the brain

Dr. Guite: Kam, can I come back to you from that devastating description of change in personality change in behavior, what’s actually happening in the brain? Because earlier you said [changes] started in the hippocampus, which is the area related to managing memories. But it sounds like more things are happening. What what would actually be happening as the dementia progresses?

Dr. Ameen-Ali: This is one of the complexities of these types of brain diseases that lead to dementia: First of all, how they can affect people very differently based upon the parts of the brain that are affected by the disease.

With something like Alzheimer’s disease, we we know that the pathology progresses into certain areas. And as the disease progresses, it starts to affect more areas of the brain, which is why you might initially see some memory problems.

But a lot of people might dismiss them as just getting older until then the disease progresses, and more and more cognitive domains start to be affected. So as the disease progresses to more of the cortical areas, you might see more issues around language around personality, and then visual-spatial issues that you might see later on as the disease progresses into those cortical areas.

Dr. Guite: Can we just look back to and understand why these things are happening? What are the risk factors related to chronic disease and exposures?

Dr. Ameen-Ali: If you remember, earlier on I mentioned sporadic Alzheimer’s disease — the Alzheimer’s disease that occurs in most cases. And it’s usually over the age of 65 that we would see that, so that when we’re talking about risk factors, they’re associated with that type of Alzheimer’s disease.

We have what we call non-modifiable risk factors. Those are those risk genes that I mentioned earlier on. Age and sex are also non-modifiable risk factors. Age is actually the biggest risk factor for something like Alzheimer’s disease.

But we also have these 12 modifiable risk factors. These are things that we do in our life that potentially we could change that can reduce our risk of dementia. And there are also, generally, things that we can do to promote good brain health, generally.

These modifiable risk factors include things like obesity, hypertension, diabetes, smoking, physical inactivity, loneliness… Brain injury is a big one as well.

Dr. Cohut: So some of the risk factors, but also the preventive interventions that get a lot of press are education and social activity. Presumably, the the longer you stay in education, and the more socially active and involved that you are the lower the risk of dementia. What about your mom, Paula? What was her experience of education and also social life?

Paula: Education minimal, if at all. You have to remember, she was born in the early ’30s. Her social social life was pretty good. [My parents] did have a group of friends when they were into their 50s–early 60s. They’d go on holidays together and and stuff like that. But that was quite sporadic.

And then they might see their friends every now and then. But predominantly, I would say they sort of stuck together. My dad was the social one, he had a much more active life.

Dr. Guite: How old was your mom when she left school?

Paula: Certainly no more than about 13. She wasn’t there very often. You’ve got to remember the [impact of the] war and evacuation and all that sort of stuff.

Dr. Guite: What is happening when we’ve got these elements of education, hearing impairment, social contact — how are they protecting against or reducing the incidence of dementia?

Dr. Ameen-Ali: These risk factors that we’ve talked about, we know that they’re associated with an increased risk of dementia. But what we’re trying to work out as scientists and as researchers is: What actually is the mechanism that is linking these risk factors with the kind of the disease that we see that then leads to dementia?

Because we can do studies where we can find out whether there is a significant correlation between these factors and dementia, but what exactly is causing something like brain injury to increase somebody’s risk significantly to then develop dementia?

The way that I like to imagine it is that our research into trying to understand these mechanisms is like the black box, that we’re trying to work out what’s happening inside that black box. So we’ve got these risk factors on one side, which is the input, and then the disease and the pathology, which is the output, but what is happening on the inside?

It’s almost like you’ve got risk factors and protective factors. And, you know, it’s all about that balance between minimizing your risk factors and maximizing the protective factors.

And it’s a game of probability, really, because there’s no guarantee that doing any of these things, you will get dementia. And there’s no guarantee that if you don’t do any of the things that you’ll be protected from it, but it’s all about managing risk, essentially.

Does neuroinflammation play a role?

Dr. Guite: I read that all of those 12 risk factors only account for 40% of dementia cases. So you’ve got the other 60%, which is in your black box. Can I come back to your black box now? Because we’ve got amyloid and tau, and we’ve got these risk factors, but what else is going on?

Dr. Ameen-Ali: Neuroinflammation is quite a significant area of research in terms of looking at a potential mechanism that would be driving brain diseases that lead to dementia.

Neuroinflammation is something that I’m interested in. There is a type of immune cell in the brain called microglia, and they’re involved in an inflammatory response in the brain.

A lot of the research that I’ve done is around brain injury. So I’ve looked at these cells, these microglial cells, and both the acute inflammatory response and also a chronic inflammatory response as a result of brain injury, and how that might be the mechanism that is increasing the risk of dementia after brain injury.

So it’s all about how the cells respond as part of a neuroinflammatory response in the brain. And how, over time, if there is a chronic response, because we know that neuroinflammatory responses are originally designed to be protective, but if it’s if the cells are activated long term, as in chronic activation, could they actually be causing damage? And could that be what is then leading to the development of the pathology that we see in something like Alzheimer’s?

Dr. Cohut: I was also thinking about some recent research that’s been looking at the gut-brain axis, so the link between the bacteria in our gut and what goes on in our brain. And there’s been some talk about the influence of gut bacteria on the brain in the context of dementia. So I’m wondering if that might have anything to do with neuroinflammation at any level?

Dr. Ameen-Ali: It’s possible, because when we’re talking about neuroinflammation, this could be systemic inflammation. It could be inflammation that’s happened at some point in a person’s life. It could be inflammation that has happened and then affected the brain.

So there is the possibility of inflammation that’s happened somewhere else in the blood, in the body that has then led to an inflammatory response in the brain. It doesn’t necessarily have to be from an injury that I look at in the brain, it can be systemic inflammation as well.

Early diagnosis is crucial

Dr. Guite: How are you feeling about the future for dementia and Alzheimer’s?

Paula: It’s a tricky one. I think, in our situation, if we’re to be brutally honest, it’s too late for any sort of treatment for my mom. For us, it’s just about keeping her safe, making sure she’s fed, making sure she drinks…

You know, my question is at what point do you think that people should approach their doctor for a diagnosis or a brain scan? Because, you know, in her case, we didn’t notice it, it was too late. I’m not saying they could have stopped it.

But at what point do you think that we need to get on top of this, and actually not wait until the diagnosis? Because once you’ve got a diagnosis, you know, there’s pretty little that you can do, and it’s sad, it’s a waiting game, and we don’t know what to expect. We had no warning, there was nothing that we could do about it in advance.

Dr. Ameen-Ali: I would say that [obtaining a] diagnosis as early as possible is the best thing to do, really. And that can be really challenging, because often, those early signs can be just dismissed as getting older or not really significant enough.

[However,] the earlier the diagnosis, the better, because [then] treatments will be the most effective. They can’t stop the disease, but they can have a much more significant impact on symptoms the earlier that they’re delivered.

I do think that going forward, we need to be able to diagnose much earlier, if we want to have effective treatments. And in terms of developing treatments, it’s unlikely that we’re going to have one single drug that is going to have a significant impact. Because there’s lots of these different potential disease mechanisms, it’s likely that we’re going to need different drugs that administered together, in parallel that will have any significant effect on disease progression.

Paula: Do you think that, potentially, we could get to a place where testing for or diagnosing dementia will be something like you’d have for breast cancer screening that becomes a routine part of your everyday medical self-care?

Dr. Ameen-Ali: I think so. I think if we have better cognitive tests that are more sensitive to certain types of memory decline, because different types of memory decline at different rates.

If we have sensitive tests, then we can certainly administer them at a certain age when your risk increases. And then hopefully that will start picking people up at an earlier rate when the disease is in its earliest stages. And that’s what I think will have a significant effect on on dementia in the future.

Alzheimer’s and dementia resources

To discover more evidence-based information and resources for Alzheimer’s and dementia, visit our dedicated hub.

Source - Medical News Today