Doctors oversee patient.
(photo credit: DANI MACHLIS/BGU)
The abnormal brain changes that lead to dementia also cause changes in the skin that give rise to pressure ulcers, according to researchers at Jerusalem’s Herzog Medical Center.
Thus, they say, a skin test can be used as a tool for early detection and diagnosis of dementia and could delay or halt the disease.
Dr. Ephraim Jaul, director of the complex nursing department at the geriatric-psychiatric hospital and an expert in the treatment of pressure ulcers, noted that many patients with Alzheimer’s and other dementias – especially at an advanced stage – are more likely to develop pressure sores. He linked the two conditions.
In a quantitative examination conducted at the Herzog, Jaul found that 67% of geriatric patients with pressure ulcers had dementia, whereas among those who did not suffer from pressure ulcers, only 23% had dementia. In recent years, Jaul has published three studies in the International Wound Journal showing a significant link between dementia and pressure ulcers, focusing on advanced dementia, as opposed to most studies in the field of early dementia and in preventing its development.
In February, Jaul and Dr. Oded Meiron – a researcher at the hospital’s brain research center and director of its electrophysiology and neurocognition lab – published their theory of the relationship between the two seemingly unrelated diseases.
Jaul also presented the theory at the winter conference of the Israel Geriatric Society.
Their hypothesis is that the abnormal brain changes leading to dementia occur in other body systems as well. Changes in the skin tissue of dementia patients make them more vulnerable to the development of pressure ulcers. “We expect to see these changes occurring in patients with mild cognitive impairment, not only those with advanced dementia,” Meiron suggested.
The practical implications of their theory are two-fold: Treatment of mild dementia patients will include more intensive preventive treatment in view of the increased risk, such as frequent changes in the patient’s posture, special mattresses and other means to prevent the formation of pressure sores. From the research perspective, clinical studies of the neurodegenerative examination of the skin layer will be advanced to better define the type and stage of dementia and to use non-invasive means to inhibit and suppress the disease.
The skin test can be a powerful tool for early detection and specific diagnosis of dementia because not all dementia requires the same treatment and not every cognitive decline ends in dementia, they said.
“This information will help clinicians design appropriate treatments to slow down and stop the progression of dementia to the extent that pressure sores and cognitive impairments can be fatal. If we can identify the early stages of dementia, it will be possible to intervene and inhibit accelerated cognitive decline through non-invasive brain stimulation and the use of cognitive empowerment programs.”