Médico estima que doença afete de 12,5 a 17,5% dos idosos no país
POR TÂMARA FREIRE – AGÊNCIA BRASIL (https://agenciabrasil.ebc.com.br/)
A demência por corpos de Lewy, diagnosticada no cantor Milton Nascimento, de 82 anos, é uma doença sem cura, mas os medicamentos adequados podem atenuar os sintomas e retardar as perdas cognitivas. Essa é a terceira forma mais comum das chamadas síndromes demenciais, atrás do alzheimer e da demência vascular. Não há dados oficiais de quantas pessoas têm demência no Brasil, mas os estudos mais recentes estimam que elas afetem entre 12,5% e 17,5% da população idosa do país. 
De acordo com o médico André Felício, coordenador da pós-graduação em Neurologia da Afya Educação Médica, é esperado que o desempenho cognitivo seja afetado pela velhice, mas nem sempre isso significa um quadro demencial.
“A suspeita vem no momento em que esses problemas cognitivos, por exemplo, perda de memória para fatos recentes, ou não conseguir mais prestar atenção ou entender as coisas que lê, começam a interferir na rotina e os mais próximos precisam supervisionar o que você faz. O ponto chave que diferencia alguém com demência e sem demência é independência”, explica o neurologista.
No entanto, muitas condições podem impactar o desempenho neurológico dos idosos, por isso é necessário que um especialista conduza uma investigação a partir da observação de sintomas, associada a testes neuropsicológicos e exames de imagem.
“Esses testes avaliam os campos cognitivos, ou seja, a memória, a linguagem, a atenção e por aí vai”, ele complementa. Já os exames ajudam tanto a confirmar a demência, quanto a especificar de que tipo ela é.
“A ressonância magnética de crânio, por exemplo, na doença de Alzheimer, mostra atrofia em uma região do cérebro, nos lobos temporais, onde fica o hipocampo. E a gente não vê isso na demência por Lewy, por exemplo. Outra coisa é o exame de avaliação da dopamina no cérebro, que em Lewy está alterada e em Alzheimer, não”
Essa alteração de dopamina explica outra importante característica da demência por corpos de Lewy: os sintomas parksonianos, ou seja, característicos da doença de Parkinson
“Quando a gente faz um diagnóstico de Lewy, é muito comum que essas pessoas antes tenham sido diagnosticadas com Parkinson. Na verdade, elas sempre tiveram Lewy, mas o quadro cognitivo ainda não tinha se manifestado.”
O próprio Milton Nascimento se encaixa nesse padrão, já que foi diagnosticado com Parkinson há cerca de dois anos. Os principais sintomas são tremores e rigidez muscular.
Apesar de a ciência ainda não ter desvendado as causas da demência, André Felício destaca que alguns fatores que diminuem ou aumentam o risco são conhecidos.
“Parece redundante falar, mas a gente vai voltar ao básico, aos hábitos de vida saudável. A gente sabe que exercício físico é neuroprotetor. A gente sabe que o sono é neuroprotetor. A gente sabe que uma alimentação que lembra a dieta mediterrânea e que você criar uma reserva cognitiva ao longo da vida são neuroprotetores. Assim como a gente sabe o contrário: o álcool vai piorar isso, o sedentarismo, a hipertensão, o diabetes, a obesidade e por aí vai”
As orientações do especialista vão ao encontro dos resultados de um estudo recente, liderado por pesquisadores da Universidade de São Paulo, que concluiu que 60% dos casos de demência podem ser atribuídos a fatores modificáveis e, portanto, poderiam ser prevenidos.
Foto: © Marcelo Camargo/Agência Brasil
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