Every September 21st, World Alzheimer’s Day is commemorated. It is no wonder that this disease has its own day to be remembered, since it is estimated that of the nearly 55 million people who suffer from dementia in the world, 60% to 70% have Alzheimer’s type.
Alzheimer’s dementia, described by the German neuropsychiatrist and pathologist Alois Alzheimer in 1906, is the most common neurodegenerative disease in the world. This can be expressed in two different ways; sporadic, responsible for 96% to 98% of cases in the world, and hereditary, which affects between 2% and 4% of patients.
Leonardo Palacios Sánchez, professor of neurology at the School of Medicine and Health Sciences of the Universidad del Rosario.
According to the World Alzheimer Report (2022), every 3 seconds a person develops some type of dementia in the world. For Leonardo Palacios Sánchez, professor of neurology at the School of Medicine and Health Sciences of the Universidad del Rosario, “this figure continues to increase, largely due to the trend towards greater longevity of people, which is known as population aging. This situation is present throughout the planet and particularly affects developing countries in Latin America, like ours.”
“From the beginning of the disease to the most serious stages, 8 to 10 years can pass, but there is individual variability,” commented the neurologist.
How does the illness emerge?
From the point of view of its clinical manifestations, Alzheimer’s disease is characterized by a gradual deterioration in mental functions. Frequently, the first to be compromised is memory, presenting forgetfulness of recent events or conversations. Then, others such as orientation, thinking, judgment, reasoning, mathematical skills and language are compromised, affecting behavior and social skills.
“They can forget passwords for ATMs or to access networks, things that they previously knew how to do very well, such as preparing different dishes, using the computer keyboard, moving around their neighborhood on foot or, those who drive a vehicle through the city where they live, be lost. In more advanced stages, not recognizing known people and even your loved ones,” said Palacios Sánchez.
How do you know if Alzheimer’s runs in your family?
If familial Alzheimer’s dementia is suspected, there are diagnostic tests to study the genetics of the affected person and their close relatives to establish whether they have this condition.
The diagnosis is carried out by specialists in Neurology, Psychiatry or Geriatrics. It requires the preparation of a very good clinical history, a complete physical and neurological examination, and some diagnostic aids, in particular diagnostic images, computed axial tomography of the skull or magnetic resonance imaging of the brain, neuropsychological evaluation, and laboratory tests, which allow ruling out other conditions that produce similar clinical pictures.
“Available medications (rivastigmine, memantine, donepezil and galantamine) can slow the progression of symptoms. There are neurocognitive rehabilitation programs that significantly help patients. Occupational therapists, physiotherapists, neuropsychologists and other professionals intervene,” Palacios noted regarding the treatments available for this disease.
Sometimes, patients present associated conditions such as sleep disorders, agitation, irritability, hallucinations and other changes that require interdisciplinary management with psychiatry and prescription of psychotropic drugs.
In the terminal stages, severe compromise of brain functions can lead to dehydration, malnutrition, infection, seizures and other complications that can lead to death.
“In July 2023, the Food and Drug Regulatory Agency (FDA) in the United States approved a new drug for the treatment of this disease, lecanemab-irmb. However, this product is not yet available in our country,” said the neurologist.
Possible vaccines and protective genes for prevention
According to the expert, it is very important to educate the family members of someone with Alzheimer’s in depth about this condition, warning that frequently one of them will be the caregiver of the affected person. Caregivers may experience psychological and physical exhaustion, which is why they also require support.
“Currently, a lot of research is being carried out on this condition and the future offers different promising possibilities, including having one or more vaccines for its prevention, gene therapy to insert protective genes into the DNA chain or rewriting the genetic code to convert the APOE4 gene (risk gene for Alzheimer’s) into an APOE2 gene (protective gene for Alzheimer’s), medications that aim to reduce accumulations of amyloid beta protein and TAU protein in the brain, and implantation of stem cells into affected patients,” Palacios concluded.
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