Dementia is a condition of aging, but in modern medicine, dementia is classified as a clear brain disease.
From a medical perspective, I will organize everything from the definition of dementia to its causes, symptoms, the latest clinical treatments,that has a huge impact not only on the patient but also on the entire life of their family. In the past, it was simply called "senility" and considered a natural process preventative measures, foods to avoid, and most importantly, the answer to the question, "Is it possible to cure it with modern medicine?"** in an easy-to-understand manner.
1. Medical meaning (definition)
Medically, dementia is not the name of a single disease. It refers to the 'total state'** where a person who used to live normally cannot maintain independent daily life due to continuous declines in various cognitive functions such as memory, language skills, spatial and temporal awareness, and judgment caused by damage or destruction of brain cells.
The biggest difference between simply worsening forgetfulness and dementia is whether or not one can handle daily life (such as meals, toilet management, banking, etc.) on their own.
2. Cause of Outbreak
There are over 70 underlying diseases that cause dementia, but 80-90% of all dementia cases are largely attributed to three causes.
Alzheimer's disease (approximately 70%): It is the most common cause. It is a degenerative disease in which a toxic protein called **'beta amyloid'** accumulates abnormally in the brain, killing brain cells, and **'tau protein'** becomes entangled, causing the brain to shrink overall.
Vascular dementia (approximately 15~20%): It is caused by damage to brain tissue due to conditions such as cerebral infarction (blockage of cerebral blood vessels) or cerebral hemorrhage (rupture of cerebral blood vessels). It often appears in people with high blood pressure, diabetes, and other conditions.
Lewy bodies and frontotemporal dementia, etc.: This refers to the accumulation of an abnormal protein called alpha-synuclein within brain cells (Lewy bodies), or the selective damage of cells in the front and sides of the brain. There is a characteristic that hallucinations or personality changes come first.
3. Key Symptoms of Dementia
Dementia symptoms gradually worsen in stages, from early to mid-stages to terminal stages.
Cognitive decline (memory and language): The first symptom that appears is short-term memory impairment, where one remembers events from a long time ago well but cannot recall "what just happened" or "the menu we ate yesterday." The conversation sometimes gets interrupted because I can't recall the words well.
Deterioration in spacetime and judgment: Getting lost on familiar paths or losing a sense of what year and month it is today. I become clumsy at calculating money and sometimes wear clothes that don't suit the season.
Psychobehavioral Symptoms (BPSD): As the stage progresses, the personality becomes violent, the 'thief delusion' of suspecting someone has stolen one's belongings, 'visions' of seeing people in an empty space, and mental changes such as depression and insomnia accompany these changes, making it the most difficult for caregivers.
4. Clinical Treatments (Drugs in Modern Medicine)
Currently, dementia treatments used in clinical trials are largely divided into two categories: **'symptom alleviators'** and the latest 'cause blockers (fundamental treatments).'
1 Traditional symptom relievers (cognitive function enhancers)
It is a drug that prevents the breakdown of 'acetylcholine,' a substance that transmits signals between nerve cells in the brain, or reduces excessive neuroexcitatory toxicity. Although it cannot be completely cured, it has the effect of delaying the progression by approximately 6 months to 2 years.
Acetylcholinese inhibitors: Donepezil, Rivastigmine, Galantamine
NMDA receptor antagonist: Memantine (primarily used in severely ill patients)
2 The latest fundamental treatment (anti-amyloid antibody therapy)
The biggest change in the medical community recently is the commercialization of injectable drugs that directly remove 'beta-amyloid protein,' the cause of dementia.
Lecanemab (product name: Rekembi): It directly cleans amyloid plaques in the brain, slowing the rate of cognitive decline in early patients by approximately 27%. It has been approved in Korea and is being used in clinical trials.
Donanemab (brand name: Kisunra): Similar to lecanemab, it is an injectable drug that removes the causative agent and has proven to slow the progression of the disease by approximately 35% in its early stages.
⚠️ Caution: These new drugs do not revive already destroyed brain cells, so they are only effective for patients with mild cognitive impairment or early dementia. In addition, there is a risk of side effects such as cerebral edema or microhemorrhage (ARIA), so regular MRI scans are required, and the cost burden is still very high due to the incomplete health insurance coverage.
5. Everyday Preventive Measures
Since brain cells are difficult to regenerate once they die, prevention and management are paramount. The recognized preventive rule in the medical community can be easily remembered with the slogan **"Do one, "Do your best, leave the rest to fate."**
Jin (Let's exercise until we sweat): If you do aerobic exercise more than three times a week, enough to make you sweat for more than 30 minutes at a time, blood flow to the brain becomes smooth, and factors that protect brain cells are released.
(Quit smoking without mercy): Smokers have a roughly 40-50% higher risk of developing dementia than non-smokers.
(Engage in social and brain activities): If you are isolated alone, brain function declines rapidly. Active reading, Go, foreign language study, and community center activities enhance the brain's 'nervous reserve (buffering power).'
(Protect the brain): Chronic diseases such as high blood pressure, diabetes, and hyperlipidemia can damage cerebral blood vessels, leading to vascular dementia, so they must be managed thoroughly with medication and diet.
6. Prohibited and cautionary foods that cause dementia
Foods that cause inflammation in brain cells and make blood vessels murky should be avoided.
Simple sugar and high-fructose corn syrup (sparkling drinks, snacks, instant coffee): Foods that rapidly raise blood sugar levels can cause insulin resistance in the brain. In the medical community, Alzheimer's is referred to as **'Type 3 diabetes'**, as blood sugar management is directly linked to dementia.
Ultra-processed foods and processed meats (ham, sausage, ramen): Foods containing large amounts of saturated fat and artificial additives cause residue to accumulate on the walls of cerebral blood vessels and induce systemic inflammation.
Excessive drinking (alcohol): Alcohol directly destroys the hippocampus, which is responsible for memory in the brain. Chronic excessive drinking is a major culprit in causing "alcoholic dementia," regardless of age.
7. Conclusion: Is a complete cure possible in modern medicine?
To be blunt, by 2026, modern medical technology cannot achieve a complete cure for dementia by completely restoring it to its previous healthy state. This is because the technology to restore lost memories and cognitive abilities due to the death of brain cells does not yet exist in the world.
However, the paradigm has changed. If past dementia treatment involved "sitting by simply observing and managing the symptoms," modern medicine has reached a level where **"managed treatment, which directly targets the cause of the onset and either halts or extremely slows its progression in the early stages"** is possible.
If discovered early, administered new drugs, and maintained proper lifestyle habits, it can be transformed into a **'controllable chronic disease'** where one can continue to recognize their family and lead daily life independently for a long time, even while suffering from dementia. Therefore, the only sure way to prevent dementia and benefit from modern medicine is through **'early diagnosis and detection'**.
Below is a video that helps you visually understand the mechanisms of dementia and the latest new drugs.
Amyloid protein, the cause of dementia, and the principles of new drugs
This video easily explains the medical principles of how recently commercially available dementia drugs (lecanemab, donanemab) target and eliminate beta-amyloid protein in the brain.