Preventive measures of neurological diseases

1. PREVENTIVE MEASURES OF NEUROLOGICAL DISEASES

Kyzambayeva Assel, 548-GM

2. Stroke Statistics

• Stroke is the third leading cause of death ranking
behind diseases of the heart and cancers
• Killed 150,147 people in 2004; females accounted
for 60.9 percent of stroke deaths.
• About 5,700,000 stroke survivors are alive today.
2,400,000 are males and 3,300,000 are females.

3. Risk Factors for Ischemic Stroke

Non-Modifiable
• Age
• Gender
• Low Birth Weight
• Race/ethnicity
• Genetic factors
Modifiable
• Hypertension
• Exposure to cigarette smoke
• Diabetes
• Atrial fib and other cardiac
conditions
• Dislipidemia (ischemic stroke)
• Post-menopausal hormone
therapy
• Poor diet
• Obesity/body fat distribution
• Inactivity

4. Nutrition-Related Factors and Stroke Risk

(BMI = body mass index)

5. Hemorrhagic Stroke

• Intraparenchymal hemorrhage: prevalence of
hypertension is 80%; vessel inside the brain
ruptures
• Subarachnoid hemorrhage (SAH): ruptured
aneurism in the subarachnoid space; or due to
head trauma
• 15% of all strokes

6. AHA Guidelines for Primary Prevention of CVD and Stroke: 2006 Update

• Smoking: complete cessation (Class I,
evidence level B
• Avoid exposure to environmental tobacco
smoke (Class IIA, evidence C)
• BP control: goal <140/90 mmHg with lower
targets in some subgroups (<130/80 in
diabetes)
Goldstein et al, Primary Prevention of Ischemic Stroke, Stroke 2006;37:15831633)

7. AHA Diet/Lifestyle Guidelines for Primary Prevention of CVD/Stroke: 2006 Update

• Reduced intake of sodium and increased intake of
potassium to lower blood pressure (Class I, evidence A)
• Recommended sodium intake <2.3g/day; potassium
>4.7g/day
• DASH diet emphasizing fruits, vegetables, lowfat dairy
products is recommended to lower BP (Class I, evidence A)
• High fruit and vegetable intake may lower risk of stroke
(Evidence C)
• Wt reduction is recommended because it lowers BP
• Increased physical activity (>30 minutes of moderateintensity activity daily)
Pearson et al. (Circulation. 2002;106:388-391.)

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11. Lipids and Stroke

• Cholesterol is a very weak risk factor for
ischemic stroke, in contrast to CAD
• Cholesterol reduction with diet and nonstatin
drugs is not effective in stroke prevention,
although reductions in levels of cholesterol
are modest
• Statins produce a statistically significant 25%
reduction in the risk of stroke
Briel M, et al Am J Med 2004;117:596-606

12. Alzheimer’s Disease

Most common form of dementia
Increases exponentially after age 40
Prevalence in white males at age 100 is 41.5%
Higher prevalence in women (3X) due to lower
mortality

13. Symptoms of Alzheimer’s Disease

• Forgetfulness: may forget recent events,
activities, names of familiar people or things
(anomia).
• Forget how to do simple tasks, such as
brushing teeth, brushing hair
• Get lost in familiar surroundings
• Repeat words spoken by others (echolalia)
• Loss of comprehension (agnosia)

14. Symptoms of Alzheimer’s Disease (cont)

• Motor skills deteriorate: loss of reflexes and
shuffling gait
• Bowel and bladder control lost
• Limb weakness and contractures
• Intellectual activity ceases
• Vegetative state

15. Alzheimer’s Disease Risk Factors

• Age: risk doubles every five years after age 65
• Family history: early onset strongly hereditary;
late onset has a genetic component
• Those with a parent or sibling with AD are 2-3
times more likely to develop AD

16. Alzheimer’s Disease Risk Factors

Head injury
Down syndrome
Low level of education
Female gender

17. Alzheimer’s Disease Prevention: Research Areas

• AD risk is associated with CVD,
hypertension, diabetes
• AD risk associated with exercise, staying
mentally active, social engagement
• Research ongoing into use of antioxidants
(vitamins E and C), ginkgo biloba
• Research into estrogen and AD suggests
that estrogen treatment in postmenopausal
women may risk of dementia

18. Treatment of Alzheimer’s Disease

• No drug can stop or reverse AD
• Some drugs may slow progress (tacrine
(Cognex®), donepezil (Aricept®), rivastigmine
(Exelon®), or galantamine (Razadyne®)
• Other medications may treat symptoms such
as sleeplessness, agitation, wandering,
anxiety, and depression
National Institutes on Aging, Alzheimer’s Disease Education and
Referral Center http://www.alzheimers.org/treatment.htm

19.

• Preventing aneurysms
• Although not all aneurysms are hereditary, there
is some evidence that people are more likely to
develop an aneurysm if a family member has had
one. Frequent screening tests are recommended
if aneurysms have occurred in your family.
• Lifestyle changes to maintain healthy blood
vessels can help prevent aneurysms, including
not smoking, exercising regularly and eating a
balanced, low-fat diet.

20.

Preventing carpal tunnel syndrome
Avoid repeated stress on the hands.
Do hand and wrist exercises and stretches periodically.
Use proper hand and wrist positioning and pay attention to
ergonomics.
Take breaks during work.
Set your computer monitor at eye level, and keep elbows at
a 70- to 90-degree angle and wrists in a neutral position.
Wear splints at night.
Use tools and equipment in your daily tasks that are
designed to minimize the risk of wrist and hand injury.
Use cold treatments (such as ice packs) to reduce
inflammation in the hands
Treat underlying medical conditions that contribute to the
development of carpal tunnel syndrome, such as diabetes,
thyroid disease and arthritis.