The diagnosis and treatment of dementias have experienced unprecedented advances in recent years. From the possibility of detect Alzheimer’s syndrome through a simple blood analysis Until the imminent arrival of new drugs that could stop their progression, the neurology of behavior and dementias lives a crucial moment. To know firsthand these advances, as well as The impact of aging on the prevalence of these pathologies And its relationship with disability, we talk with Dr. Raquel Sánchez del Valle, coordinator of the Coordin of Behavior and Dementia Study of the Spanish Neurology Society.
What is the specialty of neurology of behavior and dementias?The neurology of behavior and dementia focuses on the study and treatment of diseases that affect cognition and behavior and that have a neurological basis, that is, that are caused by structural or functional alterations in the nervous system. Unlike psychiatric disorders, which cannot be observed through specific anatomical studies or biomarkers, the diseases we treat in this specialty can be identified by neurological tests, since they have alterations in neurons and other components of the brain.
What are the main pathologies addressed in this field?Alzheimer’s disease is the most prevalent, but it is not the only one. We also study and treat other neurodegenerative pathologies such as dementia with Lewy bodies, vascular cognitive deterioration, progressive primary aphasia, prion diseases and frontotemporal dementia, among others. All of them share the fact of progressively affecting the cognitive function and, in many cases, the patient’s behavior.
What is your role as coordinator of the Conduct and Dementia Study Group of the Spanish Society of Neurology?The Spanish Neurology Society has different study groups, and each aims to improve the quality of care in its specific area, to promote the continuous training of neurologists, promote research and disseminate information both professionals and the general population.
As a coordinator, I am part of a meeting composed of four members (a coordinator, a secretary and two vowels), which is renewed every two years, with the possibility of a second consecutive mandate. In addition, our society participates in the European Federation of Neurological Societies, which allows active international collaboration.
What have been the most recent advances in this area?In the last two years, one of the most significant advances has been the incorporation of plasma biomarkers in the clinical practice of Alzheimer’s disease. Before, these biomarkers could only be detected by lumbar puncture, but now blood tests have been developed that allow identifying proteins associated with the disease, facilitating a more accessible and early diagnosis.
Another important milestone is the recent recommendation of the European Agency for the Medication for the approval of a new anti -family drug, directed against the Alzheimer’s proteins. We hope that, once its marketing is approved in the European Union, we can initiate the necessary procedures in Spain to be available for patients in approximately a year or a half.
What research lines are currently exploring?More than new lines of research, at this time we are in a phase in which scientific advances begin to move to clinical practice. The development of therapies directed against the pathological proteins of Alzheimer’s is a crucial step, and the objective now is that these treatments can reach patients effectively. We also continue advancing in the use of biomarkers and in the development of non -pharmacological interventions that can delay cognitive deterioration.
From your experience, what relationship exists between these pathologies and disability?Initially, these diseases usually manifest with minor symptoms that do not generate disability. However, since they are progressive pathologies, over time they cause a significant loss of cognitive and functional abilities, which leads to greater dependence on the patient.
In some centers, the evaluation of perinatal disability, such as child cerebral palsy, is also carried out within this subspecialty, although it is not its main focus. In any case, the impact of these diseases on the quality of life is evident and requires a multidisciplinary approach.
What role do early detection, rehabilitation and innovative treatments in this specialty play?Early detection, or more precisely early diagnosis, is fundamental. We do not perform population screenings, but rather attend patients when they already have symptoms, and at that time it is crucial to identify the disease as soon as possible. Not only is it a patient’s right to know their diagnosis without unnecessary delays, but it also allows you to initiate therapeutic interventions before, which can improve their quality of life and slow down the advancement of the disease.
As for rehabilitation, although we cannot restore the lost cognitive function, there are strategies to slow down its deterioration. Non -pharmacological interventions, such as cognitive stimulation, speech therapy and physiotherapy in cases with motor affectation, play a key role in this regard.
These diseases mainly affect the elderly. Do you think this influences the perception and approach of these pathologies?It is undeniable that there is a social tendency to undervalue certain symptoms in the elderly, attributing them simply to aging. This can lead to a lack of awareness and less interest in the research and treatment of these diseases.
In addition, the fact that elderly are no longer considered productive in labor terms also influences the allocation of resources and the prioritization of certain treatments. However, from a medical and ethical point of view, each patient must be treated individually, without comparisons with other pathologies or age groups. Our goal is to improve the quality of life of each person affected, regardless of their age or condition.
Since Spain is one of the countries with the greatest life expectancy, does this make it a particular case in terms of the prevalence of these diseases?Spain has an aging population, but the differences with other European countries are not so significant as to suppose a radical change in the prevalence of these diseases. What is remarkable is that our long life expectancy is due, in part, to a good quality of the health system and favorable environmental factors. This means that we have a special responsibility to ensure that older people receive adequate and timely attention in the field of behavior and dementia neurology.
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