ALZHEIMER’S DISEASE Alexa Nash (UIV

ALZHEIMER’S DISEASE

Alexa Nash, UIV

WHAT IS ALZHEIMER’S DISEASE?

Alzheimer’s disease is a type of dementia that accounts for about 70% of all dementia cases. Dementia is an illness that affects the fundamental aspects of a person such as memory and reasoning. As it develops it can interfere with one’s daily tasks and even one’s personality. This disease affects the brain by releasing formations of insidious proteins that cause black stains on the brain also known as amyloid plaques (sticky proteins which fill the spaces between the neurons – which activate the brains thoughts and actions) and tau tangles (deformed proteins which destroy the neurons’ internal transport mechanisms). It takes on average about six to eight years to completely take over and ‘is a pandemic that took us centuries to track down.’ Approximately 57 million people suffer from Alzheimer’s disease globally and by 2050 this is estimated to rise to about 152 million due to the expected growth of an aging population.

HOW WAS ALZHEIMER’S DISEASE DISCOVERED?

Alois Alzheimer 1864 – 1915 first reported the illness we now know as Alzheimer’s on 3 November 1906 after meeting an old (for the time) woman at the aged 56 who had an unusual mental condition which was becoming progressively worse as time went on. Initially she was observed to be making mistakes around the kitchen, but this progressed to her believing that their carriage driver was trying to break in and hiding things around the house. The woman passed away on 6 June 1906, and Alois Alzheimer had her brain sent to him so he could study what had happened to her as part of the post-mortem investigation. Whilst doing this he noticed straight away just how small her brain was compared to the average person. This had resulted in a significant loss of nerve cells (neurons) within her brain. He also identified protein tangles and plaques around many of the remaining neuron cells. Alois Alzheimer showed his findings to his friend and colleague Kraepelin, who was a researcher and pathologist, who met Alois Alzheimer when they were both working at a psychiatry clinic in Germany. Together they prepared to show Alois Alzheimer’s results at the South-West German Psychiatrists meeting which was to happen in November of that year. The meeting went extremely well and in 1910 the term ‘Alzheimer’s disease’ was first used in a psychiatry textbook written by Kraepelin. Since the discovery in 1906 there has been no identified disease modify treatment for Alzheimer’s disease.

HOW DOES ALZHEIMER’S DISEASE AFFECT PEOPLE:

Alzheimer’s disease attacks the brain starting at the hippocampus which is the part of your brain mainly controlling short-term memory, hence it is the first thing to be affected by Alzheimer’s disease. The build-up of amyloid plaques and tau tangles, which accompany Alzheimer’s disease, unravel the brain’s neurons on a massive scale. When this happens the brain’s immune system is activated but unfortunately an irreversible amount of damage has been done so the immune system has very little effect on the disease and in only a few years the disease will have reached other parts of the brain such as the frontal lobe, cerebral cortex and will be destroying them affecting a person’s mood, spatial awareness, facial recognition and long-term memory. Sadly, Alzheimer’s disease often leads to an early death with the brain reduced to about the weight of an orange (about three times smaller than a healthy brain at the time of death). Alzheimer’s disease affects people mainly over the age of 65 but some individuals with genetic characteristics can suffer Alzheimer’s disease at an earlier age.

MEDICAL PROGRESS BEING MADE FOR ALZHEIMER’S DISEASE:

A lot of medical progress has happened in understanding Alzheimer’s and whilst a cure is not yet available the knowledge of the disease has moved on vastly since it was discovered in 1906.

FACTORS THAT AFFECT ALZHEIMER’S:

Projects such as the Human Genome Project which was formally set up in 1990 and has discovered thousands of genes and DNA patterns have substantially advanced research into Alzheimer’s disease. On 11 April 1986 a 30-year-old woman from Nottingham wrote to St Mary’s Hospital in London where a group of scientists were based looking into the factor of genetics linked to Alzheimer’s disease. She informed them that three of her aunts, one uncle and recently her father were all victims of Alzheimer’s disease, backing up theory that the disease runs in genes. This idea had attracted more attention after a physician in Minnesota published some work on their observation of over 2,000 brain samples from post-mortems done in the Minnesota state hospitals. His discoveries showed that many relatives of middle-aged Alzheimer’s patients were more likely to then themselves develop the disease when they reached that age as well. By gaining more knowledge on the causes of Alzheimer’s disease, such as links to genetics, we move closer and closer to a potential cure. After dedicating the

REFERENCES

In Pursuit of memory – Joseph Jebelli

A short guide to Brain Imaging – Richard E. Passinham and James B. Rowe next 30 years of her life to researching Alzheimer’s in honour of her father, the woman who wrote to St Mary’s Hospital in 1986 was diagnosed herself with Alzheimer’s at the same age her father was when he himself to was diagnosed. Genes only impact a small proportion of the cases and there are many factors which contribute to Alzheimer’s disease from genes to lifestyle factors.

SOCIAL IMPACT OF ALZHEIMER’S DISEASE:

A major part of Alzheimer’s disease effects not only the patient but also the ripple effect it has on friends and family; in many ways it can be as hard for them as it is for the patient. It can be very difficult to know the best way to help the person and witnessing them slowly forget the people around them, meaning the relationship they had is slowly lost as the sufferer loses their recognition and memory of who they are. The patient can become very temperamental and upset, so it is a very hard time for every one involved and therefore has a massive social impact. Looking forward with the increased number of people expected to develop Alzheimer’s disease, this significant social burden will increase substantially. The associated cost to health care bodies worldwide will also run to trillions of pounds.

WHAT CAN YOU DO TO HELP MINIMISE YOUR CHANCE OF GETTING ALZHEIMER’S DISEASE?

Really it is the classics that help to reduce the chance of Alzheimer’s disease. They can’t completely prevent it, but they help, with the first being ‘stress’. You need to try and minimise your stress as much as you possibly can as it has been shown that people with chronic stress have less grey matter in their prefrontal cortex. This goes hand in hand with modern life stress causing depression, anxiety and a higher risk of heart diseases and people who suffer ‘post-traumatic stress disorder’ are almost twice as likely to suffer from dementia, with a stress-prone person being 2.7 more times likely to develop Alzheimer’s; so it is no surprise that the less stress you have the better.

The next major thing that helps is your diet, with studies showing that a Mediterranean diet can help prevent Alzheimer’s with Mediterranean people being 52% less likely to develop Alzheimer’s disease compared to global average. With a connection known as the microbiome connecting what you eat to your brain, there are also dietary factors that impact likelihood of Alzheimer’s disease. Then of course the next factor to help is exercise – anything from stretching to running a marathon helps. The final thing is brain training as once again it keeps you brain working well. Brain imaging is a technology that has advanced significantly across the last 20 years. It enables detailed views to be taken of the brain without the necessity of having access to the brain itself.

What this means is that scientists are now able to investigate what happens in the brain when someone develops a disease such as Alzheimer’s rather than only being able to do so post-mortem. This has brought the opportunity to objectively measure the progress of Alzheimer’s disease whereas previously the disease could only be measured using subjective tests such as a test of cognition or metal capability. This has introduced a new era of neurological disease research.

HOW BRAIN IMAGING IS SUPPORTING A CURE FOR ALZHEIMER’S:

There are three key types of imaging used to looking into Alzheimer’s disease and these are:

Structural imaging, such as Magnetic Resonance Imaging (MRI), which looks at aspects such as the shape, position and volume of the brain tissue. Scientists have standardised values that can be measured over time which can indicate the presence and rate of development of a disease such as Alzheimer’s. This allows scientists to assess the impact of a potential new medicinal drug by comparing the progress with Alzheimer’s when a patient is taking that drug compared to when a patient is not.

Functional imaging, often referred to as functional MRI, is another form of imaging that, rather than looking at the physical aspects of the brain such as shape like structural imaging does, looks at how well the cells in the different brain regions are working and responding by analysing the blood flow in the brain. This is useful as lots of research suggests that those with Alzheimer’s disease have brains which have reduced cell activity in particular regions of the brain (which is also associated with reduced blood flow).

Positron Emission Tomography (PET), is one of the most commonly used versions of imaging as it helps identify Alzheimer’s disease in its very early stages and potentially uncover biological clues that enable the detection of the disease before it takes an irreversible toll on the memory. It does so by enabling the tracking of a radiological tracer which is injected into the spine and then is taken into the brain and is attracted to the build-up of sugars and other markers of Alzheimer’s disease, which can then be read by the imaging technology.

Together these technological developments are supporting scientists to find new approaches to dealing with Alzheimer’s disease which continues to cause millions of lives to be impacted or cut short every year.