Throughout my career as a general surgeon specialising in stem cell therapy and regenerative medicine, I have had a strong interest in what regenerative approaches can offer patients with complex, progressive conditions. Dementia has become a particularly important part of that work.
My experience with dementia patients has been deeply encouraging. I have seen improvements in communication, attention, responsiveness, interaction and general engagement with their surroundings. What is especially meaningful to me is seeing changes in the functions that shape a patient's everyday life and their ability to connect with the people closest to them.
Understanding dementia and its impact
Dementia is an umbrella term for conditions involving a progressive decline in cognitive function. Alzheimer's disease is the most common form; vascular dementia, Lewy body dementia and frontotemporal dementia are also important. Depending on the cause and how far it has progressed, people can experience significant changes in memory, speech, concentration, recognition, emotional regulation, reasoning and their ability to manage everyday activities.
As the condition progresses, these difficulties increasingly affect independence, relationships and quality of life. For families, watching someone they love gradually lose parts of their memory, personality, communication and independence can be extremely distressing. My interest in regenerative medicine has led me to explore how stem cell therapy can help support neurological function and the cellular environment in people with dementia.
What I have seen in my patients
My interest in this field comes from my own clinical experience. I have seen particularly encouraging improvements in people with dementia, with some of the most positive changes in patients in the early and middle stages of the disease.
- Better communication and more attempts to interact
- Improved attention and greater alertness
- More engagement with family members and their surroundings
- Better responsiveness and social interaction
- More participation in everyday activities
These changes are especially meaningful because they affect a patient's daily life and their relationships with the people closest to them. They are a large part of why I continue to use stem cell therapy with dementia patients.
Why I use umbilical cord-derived mesenchymal stromal cells
One of the approaches I use involves umbilical cord-derived mesenchymal stromal cells (UC-MSCs). These cells have attracted considerable scientific and clinical interest because of how they interact with immune, inflammatory and cellular signalling pathways.
MSCs have immunomodulatory properties and release growth factors, cytokines and other signalling molecules that take part in communication between cells and the surrounding tissue. In dementia, I am particularly interested in how these properties influence the neurological environment and support the function of the existing neural tissue.
Neuroinflammation and the neurological environment
Chronic neuroinflammation is an important feature of several neurodegenerative conditions, including Alzheimer's disease. Microglia, astrocytes and other immune-related pathways contribute to the inflammatory environment associated with neuronal dysfunction and progressive neurological change.
This is one reason I find the immunomodulatory properties of mesenchymal stromal cells so interesting. I am particularly interested in the relationship between these biological mechanisms and the clinical improvements I have personally observed, and understanding it is an important part of my continuing work.
The importance of early assessment
One of the clearest lessons from my clinical experience is how much the stage of dementia matters. I have seen the most encouraging improvements in patients in the early and middle stages. At these stages, patients generally retain more cognitive function, communication and neurological activity, which gives more opportunity to support the abilities they still have.
I encourage families to seek specialist advice as soon as dementia is diagnosed, rather than waiting until the condition has progressed significantly. In my experience, the earlier patients are assessed, the more encouraging the results have been.
Understanding the patient's neurological condition, existing abilities, general health and individual needs is essential before any treatment. Early assessment also sets a baseline against which later changes can be measured.
How I assess progress
I consider the whole person rather than only the diagnosis. I look for changes in memory, recognition, communication, speech, attention, concentration, responsiveness and interaction with family members, and equally in emotional behaviour, social engagement and the ability to take part in everyday activities.
Family observations are an important part of this, because relatives often notice subtle changes in behaviour, recognition and communication that may not be apparent during a clinical appointment. I document these observations and assess each patient over time, taking into account their starting condition, treatment history and overall health.
Why I continue this work
The changes I have seen involve parts of everyday life that matter enormously to patients and their families. Seeing a patient become more responsive, communicate better, engage more with loved ones or take a more active part in their surroundings is meaningful, and it has strengthened my commitment to this work.
I believe individual assessment, careful observation and continued clinical experience are essential when working with complex neurological conditions. My intention is to keep building on what I have observed and to explore regenerative medicine as an additional approach within the wider management of dementia.
A message to families
I understand how difficult a dementia diagnosis is for patients and their families. Many relatives go through considerable distress as they watch someone they love change in memory, communication, recognition and independence.
My advice is to seek an early medical assessment, get a clear understanding of the patient's individual condition, and discuss all appropriate treatment and supportive care options with qualified medical professionals. Every patient is different, and treatment decisions must take into account the underlying diagnosis, the stage of the disease, general health and individual circumstances.
Families should continue appropriate conventional medical care and monitoring alongside any additional treatment.
Dr. Fermín Celma, general surgeon, stem cell therapy and regenerative medicine, Puebla, Mexico.