Alzheimer

Summary of Alzheimer’s Disease

Alzheimer’s disease or disease is a chronic disease that mainly affects the elderly population. It is a form of dementia that affects the memory, cognitive functions and ability to carry out tasks of its sufferers. The symptoms of the disease evolve progressively. It is characterized by a loss of cholinergic neurons, which reduces the number of brain connections. It is estimated that around 1.2 million patients in Brazil have the disease, with the appearance of 100,000 new cases per year. The most affected individuals are the elderly, however there is a form that affects people under the age of 65, known as early or familial Alzheimer’s.

Although the causes are still not well known, it is attributed to genetic, environmental and lifestyle factors that trigger Alzheimer’s disease. Age is certainly the main risk factor for the development of the disease, however other variables may contribute to its appearance, such as smoking, family history of Alzheimer’s and diabetes. Junk food (junk food) very rich in fast sugars and saturated fats, is increasingly questioned by scholars, some even speak of type 3 diabetes to characterize Alzheimer’s disease

Initial symptoms include memory loss. As the disease progresses, other patient skills are compromised, such as the ability to make judgments and reasoning, spatial orientation and balance.

The diagnosis is performed by neurologists through various mental status, neuropsychological and imaging tests. Complications include an increased incidence of falls and infectious diseases of the respiratory tract.

Current treatments are based on the use of acetylcholinesterase inhibitors (galantamine, donepezil and rivastigmine) and NMDA receptor antagonists (memantine). Dietary supplements (such as vitamin B and vitamin E) and herbal extracts (such as huperizine A) can help with deteriorating mental functions.

It is important that the caregiver of the patient with Alzheimer’s is aware that this is a serious disease and that the patient will need their full help. Establishing a pleasant and safe environment, providing adequate nutrition, encouraging the patient to exercise and regularly giving medications are practices that improve the patient’s overall condition. Some preventive measures such as quitting smoking, regular physical exercise and a healthy diet can prove to be beneficial.

Definition

Alzheimer’s is an increasingly common chronic disease among the population. It is a disease that affects memory and mental faculties in general, and that evolves in a progressive and irreversible way, due to a degeneration of brain tissue, which leads the person to a state of dementia. Alzheimer’s disease belongs to the dementias, a disease group that leads to a loss of intellectual and social abilities. Alzheimer’s is by far the most common dementia.

Alzheimer’s disease, in its most frequent form, usually appears around 60-70 years of age and is not always diagnosed. A rarer form of the disease, which is also known as the familial or precocious form, occurs before the age of 65, and as its name indicates a very marked hereditary (genetic) compound. A large proportion of people with the early form have alterations in three genes: APP, PSEN1 and PSEN2.

We emphasize that with the aging of the population in the West (Europe, America) and Japan, the disease tends to reach more and more people and can bring real problems of financial resources and manpower in countries.

A brief history of the origin of the name Alzheimer

Alzheimer’s disease owes its name to the physician who discovered it in 1906, Dr Aloïs Alzheimer.

Epidemiology

– In the United States, more than 5 million people suffer from Alzheimer’s Disease (source: CBSNews, November 23, 2016)
In the United States, Alzheimer’s Disease is the sixth leading cause of death, according to the National Institute of Health (NIH).

– Alzheimer’s disease and related disorders affected an estimated 44 million people worldwide in 2014 and this number “will double every 20 years”, according to a 2012 WHO report.

By age group

– It is estimated that after the age of 65, between 1 and 6% of the population suffer from Alzheimer’s. In Europe, the percentage is around 4%. With an increase of more than 150,000 cases per year in France alone.

– After the age of 85, it is estimated that 10% to 30% (depending on sources) suffer from Alzheimer’s disease.

– At age 95, about 50% of women are affected by Alzheimer’s disease and about 32% of men.

by sex

– From the age of 70, women are more affected than men by this disease. It is estimated that at the age of about 70 years, approximately 4% of women suffer from Alzheimer’s disease and about 3% of men. At age 95, as we saw above in the age group section, almost one in two women suffer from Alzheimer’s, versus one in three men.
One reason why women suffer more from Alzheimer’s than men is simply because they live longer.

– Between 65 and 69 years old, men are slightly more affected than women by this disease (2% for men and 1.4% for women). [Source: Science & Vie magazine, February 2014 issue]

Causes

The causes of Alzheimer’s disease are still not fully understood.

However, it is very likely that Alzheimer’s has a genetic (hereditary) origin. Certain people who carry a specific gene are more likely to acquire the disease. In addition, scientists believe that environmental factors and lifestyle can contribute to the onset of the disease.

Although the causes of the disease still need to be elucidated, its causes in the brain are well established. Alzheimer’s disease causes brain neurons to die, reducing the amount of existing connections. Analyzes of the brain of patients with Alzheimer’s disease reveal 2 types of important abnormalities:

– Plaques of beta-amyloid protein, which causes neuronal death.

– Tau protein tangles. This protein forms abnormal fibrils that lead to breakdowns in nutrient transport systems, resulting in cell death.

– According to a study by the Karolinska Research Institute, in Stockholm, published in November 2008, a diet rich in sugar, fat and cholesterol, found, for example, in fast food, can favor the development of Alzheimer’s disease.

– A study published in October 2010 by Finnish researchers showed that in smokers (who smoke a lot especially between 50 and 60 years old), the risk of developing Alzheimer’s disease was doubled.

– In July 2011 a study conducted in the USA showed that traumatic brain injury can be a cause of Alzheimer’s disease, note that, these results are preliminary. Brain injuries can be seen in veterans and former football players.

– Prolonged use, for more than 3 months, of certain sleep aids and anti-anxiety drugs from the benzodiazepine family can significantly increase the risk of developing Alzheimer’s disease, according to a study published in September 2014. The increase the risk of developing the disease can reach up to 51%.

Researchers have discovered five new genes involved in the onset of Alzheimer’s disease. This important discovery helps identify people at higher risk of having the disease.

Infectious origin or influence of Alzheimer’s disease
– A study published in June 2018 points towards an infectious origin or influence, particularly viral, to explain Alzheimer’s disease. Indeed, a team of renowned researchers, under the direction of New York’s Mount Sinai Health System – New York’s Mount Sinai Health System, from New York, discovered that several viruses may be involved in the development of Alzheimer’s disease and, in particular, two types of herpes virus (HHV6a and HHV7), which are very common. These viruses infect most people during childhood. This study looked at samples from nearly 950 brains from people who had died. But the study authors note that viruses are not necessarily the cause of Alzheimer’s disease, but rather trigger an immune response that can lead to the buildup of plaques found in patients’ brains. In other words, researchers still don’t know whether viruses are the cause or consequence of Alzheimer’s disease. An interesting conclusion from this study is that the brain is not a sterile place, as there are viruses. This study was published on June 21, 2018 in the scientific journal Neuron(DOI: 10.1016/j.neuron.2018.05.023).
This is not the first study that shows an influence of infectious agents on the development of Alzheimer’s disease, other studies have focused on bacteria and parasites.

Risk factors
To summarize (see also Alzheimer’s disease prevention) a US study published in July 2011 showed that these seven risk factors below could significantly promote the development of Alzheimer’s disease: low level of education (in 19% of cases), smoking (14%), physical inactivity (13%), depression (11%), hypertension (5%), obesity (2%) and diabetes (2%).See also Alzheimer’s risk.

Read also: Discovery of a gene that doubles the risk among blacks

Alzheimer’s and diabetes

Alzheimer’s disease can result in insulin resistance in the brain. That is, in Alzheimer’s disease, the brain is unable to fully assimilate glucose. Some experts speak of type 3 diabetes or cerebral diabetes to characterize Alzheimer’s disease. An American experiment carried out on rats showed that junk food, that is, the excessive consumption of sugary foods with saturated fatty acids, caused significant destruction of the brain. This hypothesis is still controversial, but is increasingly on the agenda of scientists. Researchers are thinking of new ways to treat Alzheimer’s disease, insulin delivery to brain tissue could be one.

Groups of risk

People who are more likely to develop Alzheimer’s are:

Alzheimer’s risk groups – people over 65 years old.

– People who have a family history of Alzheimer’s, as the disease has a strong hereditary component.

– People suffering from depression. This psychic illness can accelerate the symptoms of Alzheimer’s disease.

– Diabetics or pre-diabetics (according to studies from 2007, diabetes increases the risk of developing Alzheimer’s by about 75%).

– People with a relatively low level of education.

– People who eat badly.

– Women may be at greater risk of developing the disease, in part because they live longer than men.

– Smokers (especially between 50 and 60 years old, the risk of developing Alzheimer’s, according to a study to be published in October 2010, has doubled)

Some studies indicate that the same factors for the development of heart disease contribute to the onset of Alzheimer’s disease. These factors include:

– High cholesterol

– high blood pressure

– Sedentary lifestyle and lack of exercise

– uncontrolled diabetes

These factors may be linked to vascular dementia, a condition that is commonly associated with Alzheimer’s disease.

Symptoms

Alzheimer’s disease evolves through different stages and makes it difficult to diagnose, especially at the beginning. However, one of the recurring problems is memory loss. All people, with age, can forget some words or events, but in Alzheimer’s, there is forgetting simple words (such as “home”), there is forgetting recent events, there is loss of sense of direction, there is forgetting of familiar smells (like lemon, for example). Only a doctor, through examinations and analyses, will be able to confirm whether it is just simple forgetfulness or Alzheimer’s disease.

As the disease progresses, the patient loses other cognitive abilities, presenting difficulties in:

– Spatial orientation

– Ability to speak and write

– Ability to think and reason

– Ability to make judgments and decisions

– Ability to plan and carry out household chores

– Personality and behavior changes. In this case, the patient may experience depression, anxiety, social dullness, mood swings, stubborn behavior, irritability, changes in sleep pattern, wandering from place to place without direction, and aggression.

Alzheimer’s patients also suffer from psychological disturbances as a consequence of the disease. Not being able to remember something simple can be very distressing and also favors depression, as a person suffering from Alzheimer’s has moments of lucidity and can have a critical eye on their state. Therefore, family members and people around them must be willing to help and support the patient.

– Difficulty knowing what day, season or year it is.

The life of a person suffering from Alzheimer’s

In the United States, it is estimated that a patient lives an average of 8 years after signs of the first symptoms of the disease (eg memory loss). During these 8 years, on average, the patient progressively loses his memory and becomes, in the end, unable to perform some simple tasks.

Diagnosis

The diagnosis of Alzheimer’s disease is always made by a physician. We emphasize that it is very important that the disease is diagnosed as early as possible, so that drug treatments have the best effect.

The doctor may perform physical and neurological examinations on the patient. In this case, reflex tests, measurement of muscle tone, coordination and balance are indicative of the patient’s situation.

Tests to assess mental status are also employed. These exams involve several types of tests applied to the patient by the doctor. Some of the required activities are:

– Draw a clock with hands indicating a specific time;

– Indicate the correct date of the day;

– Follow three different commands;

– Remember and repeat three words spoken by the examiner;

– Count backwards from 100, subtracting 7.

The patient’s mental status can also be assessed by more detailed neuropsychological examinations using more extensive forms. These tests help the doctor to establish which level of Alzheimer’s disease the patient is in – an early or advanced stage – and also help to correctly diagnose which type of dementia is associated with the symptoms presented.

Imaging tests are increasingly being used by doctors as a tool to check for conditions that may be linked to Alzheimer’s disease, such as strokes, tumors and trauma. In addition, imaging allows brain changes caused by Alzheimer’s to become visible. Among the tests, we can highlight:

– Computed tomography;

– Magnetic Resonance Imaging;

– Positron Emission Tomography.

Attempts have been made to identify Alzheimer’s disease before symptoms are apparent. In this sense, lines of research have focused on the identification of disease marker proteins. More specific and sensitive mental tests are also a viable alternative. In addition, more accurate brain imaging tests can help diagnose the disease earlier.

Also note a new study published in July 2011 which shows that the fall of an elderly person who is not otherwise predisposed to falling may be a tip for a diagnostic evaluation for Alzheimer’s disease. [Source: International Conference on Alzheimer’s (AAIC)].

The doctor may also perform a lumbar puncture in order to measure beta-amyloid (an important molecule for the development of the disease), a peptide of 40 to 42 amino acids.

Olfaction and Alzheimer’s disease
Olfactory losses are often an early sign of Alzheimer’s disease. For example, a person with this dementia may be unable to identify the smell of gasoline or lemon. For more than 30 years, scientists have explored the connections between memory loss and Alzheimer’s patients’ difficulty identifying different odors. At the physiological level, scientists have observed that the olfactory bulb, which is involved in the sense of smell, and the entorhinal cortex, involved in memory and naming of odors, are among the first structures in the brain to be affected by Alzheimer’s disease. An odor recognition test seems to be a good way to identify the disease early before more typical symptoms such as memory loss appear.

Complications

Alzheimer’s disease is a disease for which there is still no cure available, however, it is possible to slow down its evolution through drug treatments. Alzheimer’s can, therefore, in several cases, lead to death after many years, or it can also trigger serious psychiatric complications such as depression, schizophrenia, anxiety, anguish, among others. A 10% weight loss has also been reported.

As the disease progresses, the patient’s cognitive abilities are impaired and the patient can become increasingly dependent on the caregiver. As a result, functions such as balance, ability to swallow and swallow, and control of smooth muscles, such as the bladder and intestines, are impaired. The patient becomes more vulnerable to some infectious diseases, such as pneumonia and respiratory tract infections, since the ability to swallow is compromised. Loss of bladder control can lead to the need for a catheter to collect urine and this also increases the risk of urinary tract infections.

The loss of balance and tone of skeletal muscles can lead the patient to suffer falls that cause serious damage to health.

As we can see, this is a serious disease, but one that is being taken more and more seriously by pharmaceutical laboratories (research for new drugs), by political authorities and by doctors. “disease of the century”.

When to consult a doctor in case of memory problem?

As we saw earlier, Alzheimer’s is a serious disease that in all cases requires a medical consultation. Only a doctor can make an exact diagnosis of this pathology.

Everyone above a certain age should regularly consult a doctor for a complete check-up, but if you notice any signs of disorientation, frequent forgetfulness of simple words (home, street, eating, etc.), quickly consult a doctor and get used to going to him more often.

Treatments

Before detailing the drugs that exist to treat Alzheimer’s disease, here are some important points about drug therapy:

– It is important to start drug treatment as soon as possible, so regular medical follow-up is necessary.

– Currently, drugs do not treat the cause, but they alleviate the symptoms and delay the development of the disease, and in certain cases severely limit it.

– Medicines do not work for all patients, some may experience a positive effect and others may not feel any difference.

Here are the main medications used to treat Alzheimer’s disease, all of which can be purchased with a prescription:

cholinesterase inhibitors
– based on donepezil
– based on galantamine
– based on galantamine
NMDA receptor antagonists
– based on memantina

Observation the combination of two treatments (eg memantine and donepezil) in some cases increases the effectiveness of the treatment.

In case of psychic symptoms, the doctor may also prescribe antidepressants, anxiolytics or neuroleptics.

New treatments
On November 23, 2016, the American pharmaceutical company Eli Lilly communicated that the molecule on which they were working to fight Alzheimer’s disease, solanezumab, did not show satisfactory results. In a clinical study, the molecule was remarkably unable to slow cognitive decline in people suffering from this type of dementia. Solanezumab was a great hope for the pharmaceutical industry to finally find an effective drug.

Alternativa Alzheimer

Some natural treatments can slightly improve the patient’s condition or even prevent Alzheimer’s disease.

Medicinal plants:

– The use of ginkgo biloba, due to its antioxidant properties, is associated with improved memory. This plant can be used in the prevention and early treatment of dementia caused by Alzheimer’s disease, in addition to conventional treatments.

However, a French study published in 2012 showed that the use of Ginkgo biloba extracts was not effective in treating Alzheimer’s disease.

– Huperzine A is an extract from a Chinese plant that has shown similar effects to acetylcholinesterase inhibitors. However, further studies are needed to establish the efficacy of this compound.

– Regular consumption of coffee over a long period may have a preventive effect on Alzheimer’s disease, as demonstrated in rats by a French-German study from the Universities of Bonne and Lille, published in April 2014.

– Turmeric ( Curcuma longa ) , which can be found in curry or consumed as a food supplement, according to several studies, seems to prevent Alzheimer’s disease (more information about references, on our special page about turmeric).

– Cinnamon ( Cinnamomum verum ) may have a favorable effect in preventing Alzheimer’s disease, as demonstrated by the scientific work of Richard Anderson of the United States Department of Agriculture.

Food supplements:

The use of certain food supplements can help in the treatment of Alzheimer’s disease, they are:

– B-group vitamins

– Evening primrose oil (rich in essential fatty acids)

– Antioxidants (which we find, for example, in ginkgo biloba or in fruits)

– Folic acid

– Vitamin E

Tips

Generally, the person suffering from Alzheimer’s is not aware of his condition, therefore, he needs assistance. Here are some tips aimed at the patient’s family or medical environment that can help improve the patient’s life:

– Even if the patient has difficulty communicating verbally, this does not mean that he is no longer able to communicate, so it is important to always give him attention, show affection, touching him, looking at him and showing kindness.

– The emotional and physical load that must be devoted to a patient suffering from Alzheimer’s disease can be very heavy, so do not hesitate to talk to your doctor about a possible total or partial hospitalization of the patient, if you are not able to cope with it. he.

– It is important to know that people suffering from Alzheimer’s change a lot and in advanced cases of the disease, they may not remember their own children, which in turn implies a very strong emotional charge for them, as all memories of the childhood and the past are forgotten. Some people say these stages are like a “little death”, so it may be necessary to seek help from a health professional (doctor, psychologist) or family and friends if the situation becomes untenable.

– High doses of vitamin B can reduce brain atrophy by 30 to 50% in people affected by moderate cognitive decline, which delays the progression of Alzheimer’s disease.

– Patients with Alzheimer’s disease often forget to eat. Provide them with healthy foods that are high in protein and calories, such as food supplements and protein milkshakes.

– Make sure the Alzheimer’s patient drinks plenty of fluids throughout the day, preferably water, fruit juices and healthy drinks. Avoid caffeinated products, as these increase agitation and may interfere with the patient’s sleep.

– Physical exercises are indicated for patients with Alzheimer’s disease. They improve joint and muscle health and the patient’s sleep profile, help prevent constipation, and improve heart health. Patients with walking problems can use stationary bicycles or chair exercises.

– For caregivers: it is important that the environment is modified for the patient with Alzheimer’s disease. Try to remove excess furniture and objects, install adequate devices to facilitate patient movement, make sure that floors are not slippery and provide non-slip footwear for the patient.

– Decrease the number of mirrors in your home: the patient with Alzheimer’s disease may find the image in the mirror confusing or frightening.

Prevention

– Some studies have shown that maintaining intellectual activities such as reading, games that exercise the brain such as crossword puzzles, as well as exercising some physical activity (walking, etc.) has a strong positive effect on Alzheimer’s Disease.

– Treating high blood pressure is the most effective way to prevent dementias like Alzheimer’s [source: France Info, Dec 16, 2008]

– Regularly taking non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen prevents Alzheimer’s disease. However, it is unlikely that a doctor will prescribe a chronic treatment based on ibuprofen to a person who does not need NSAIDs, as these can have various side effects (ulcers, kidney problems,…). The risk-benefit ratio is not guaranteed, but this subject must still be followed, as all preventive treatments for Alzheimer’s Disease deserve attention. The use of statins (medicines against cholesterol) also has a preventive effect.

– Maintaining a diet rich in fruits helps prevent Alzheimer’s disease. Fruits contain numerous antioxidants, which help in prevention. Red wine is also rich in antioxidants and can also help prevent the disease.

Having a balanced diet is a great way to prevent Alzheimer’s disease. This notably includes avoiding junk food, ie excessive consumption of fast sugars and saturated fatty acids. As seen in the causes part, Alzheimer’s disease can result from insulin resistance in the brain. That is, in Alzheimer’s disease, the brain is unable to fully assimilate glucose. Therefore, it is about preventing diabetes.

– Stop smoking! Especially if you are a smoker between the ages of 50 and 60, your risk of suffering from Alzheimer’s disease 20 years later will be doubled (see below for Alzheimer’s causes as well).

– Vitamin D can prevent Alzheimer’s disease. Indeed, a correlation has been observed between vitamin D deficiency and Alzheimer’s as shown by several studies, including a British study published in August 2014. According to the British study, the risk of suffering from Alzheimer’s increased by 69% in participants with moderate vitamin D deficiency and rose to 122% in participants with severe deficiency. Note that this is an observation and not necessarily a cause and effect link.

A very interesting study published in July 2011, on the occasion of the International Conference of the Alzheimer’s Association (AAIC) showed that in a mathematical model built by researchers at the University of California (San Francisco), a 25% reduction in these modifiable risk factors could prevent over 3 million cases of Alzheimer’s disease worldwide.

– One should avoid consuming benzodiazepines (medicines used against anxiety and insomnia) for long periods, that is, more than 3 months. A study published in September 2014 showed an increased risk of developing Alzheimer’s disease of up to 51%.

These risk factors, in part mentioned above are:

– A low level of education (19%), in this case, intellectual activity seems to have a protective effect. See below:

– Smoking (14%)

– Physical Inactivity (13%)

– Depression (11%)

– Hypertension (5%)

– Obesity (2%)

– Diabetes (2%).

As you can see, to prevent Alzheimer’s disease it will be necessary to minimize seven of these mentioned risk factors.

Jeanne Kenney
 | Website

I’m a stylist trainer, a content creator, and an entrepreneur passion. Virgo sign and Pisces ascendant, I move easily between my dreams, the crazy world I want, and my feet on the ground to carry out my projects.

Leave a Reply

Your email address will not be published. Required fields are marked *