Can we treat Alzheimer disease?

Hello there.

We all know there is some called Alzheimer disease. Maybe some of us know that it is the number one cause of dementia, mainly seen in elders.

However not all of us know about

  • What is Alzheimer disease
  • Why it occurs
  • How it occurs
  • How to prevent and treat it

Therefore, to get a good idea about it. Let’s begin.

What is Alzheimer disease?

Simply said, it is a neurodegenerative disorder of cortex (outer grey part) of brain.

In this, we have:

  • Atrophy of cerebral cortex and hippocampus
  • Narrow gyri and widened sulci
  • Dilated ventricles
  • Neuritic plaques that surround the beta-amyloid core with neuritic processes.
  • Neurofibrillary tangles that are intracellular aggregates of protein tau.
  • Degenerated cholinergic neurons in the nucleus basalis of Meynert.

Signs:

  • Progressive memory loss from short term to long term.
  • With time, the patient disorients, his/her behaviour and personality changes.
  • Language could be forgotten along with some other learned skills like maths, driving etc.
  • Unable to learn anything new and adapting to changed situation.
  • Patient becomes aggressive, irritated.
  • With time, patient gets lonely, becomes silent and lost interest in people, activities and even eating.
  • Patient falls into depression.

Why it occurs?

More than 95% cases are sporadic and are common above age 65. Whose risk, doubles every 5 years.

It is highly associated with one of the many alleles of APOE i.e. Apolipoprotein E gene.

  • One of the alleles is e4.
  • This protein is needed for forming lipoproteins which is needed for cholesterol packaging.
  • In CNS, it functions as a cholesterol transporter that regulates signalling, growth, development and repair of CNS.
  • Having e4 increases the risk while having e2 allele decreases the risk.

It is also associated with Down syndrome as amyloid forming protein i.e. amyloid precursor protein (APP) is coded on chromosome 21.

  • And Down syndrome is the trisomy of chromosome 21.
  • Hence, it is common to see Alzheimer with Down syndrome by the age of 40.

Some cases of the disease are also associated with familial cases.

  • There is a 25% probability of having Alzheimer disease if a family member has it already.
  • It is mainly linked with presenilin 1 and 2 gene mutations.
  • Presenilin protein is required for digestion of beta amyloid hence mutation causes the risk of its accumulation to form plaques and cause death of brain cells.

How to diagnose it?

One way to diagnose it, is on the basis of clinical signs shown by the patient.

  • By observing his/her mental health condition, behaviour, ability to perform daily routine activities.
  • By testing with maths, memory quizzes, problem solving capability.

By seeing scans of brain imaging such as CT, MRI of brain.

Simply to say, tests are done to exclude other causes of observed symptoms rather than trying to confirm the Alzheimer disease.

One can perform autopsy for confirmation but for that, we need a dead patient. So… it is beneficial for the other members of the family to find out the risk of familial development of the disease but not for the patient itself.

How to prevent it?

There is nothing special to reduce the risk of Alzheimer disease. One has to go through the healthy habits such as:

  • Avoid smoking
  • Drinking alcohol
  • Eating healthy food, fruits
  • Exercising

Mind games are also said to prevent or slow down the Alzheimer’s development.

How to treat it?

Sadly, there is no permanent cure for it.

There are some drugs that could be given but only to delay the death (Q1), not to prevent it.

The first line drugs are:

  • Cholinesterase inhibitors such as Donepezil (Aricept) is approved to treat all stages of the disease,
  • Galantamine (Razadyne) and Rivastigmine (Exelon) are approved to treat mild to moderate Alzheimer.

However, a drug named Aducanumab (Aduhelm) has received approval for treatment as it first drug on the market to remove amyloid and reduce amyloid plaques and lesions in the brain.

Well, this is all about Alzheimer disease for now. I hope you have learned many important things from this.

Don’t forget to like and comment.

Later. 😉

Published by signaturedoctor

I am a doctor-to-be pursuing my medical studies. I want to share my knowledge to fellow medical students and to other interested people.

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