Alzheimer’s Disease (AD) is the most common form of dementia, a neurodegenerative disorder which makes a person lose his or her cognitive abilities slowly but steadily, altering daily functioning, leading to various levels of physical and emotional stress for the patient and family.
Detected most commonly beyond 65 years of age, an early onset of the disease between ages 30 and 60 is also a possibility, cased by a number of conditions, family history, and genetics.
AD begins with short term memory loss problems that later escalate to severe issues, including loss of the identity of the patient to himself as well as those near and dear him. The exact point where AD actually catches up with a person’s nervous system is difficult to diagnose, which presents the main challenge in its diagnosis, as old age normally takes a toll on a person’s memory gradually, even on a natural basis. This poses the greatest challenge in detection and diagnosis of AD, which makes treatment all-the-more difficult. This is probably the reason why a mere 3% of the diagnosed cases manage to have a survival period of a maximum span of 14 years.
Being a progressive disease, it moves from a pre-demential state to a condition of mild cognitive impairment, before proceeding towards severe cognitive damage. It is the transition of the early stages of AD which is often misjudged as normal side-effects of aging, and hence hinders the initiation of treatment process.
Pathologically speaking, two major causes of AD, as observed from brains scan reports, include the formation of senile plaques and neurofibrillary tangles. The tangles are nothing but hyperphosphorylated Tau proteins (abundant in the neurons of the central nervous system), which become defunct and cannot participate in stabilization of microtubules, which in turn become disintegrated within neurons and hence cannot conduct nerve impulses. The senile plaques are formed of deposits of a protein called Beta Amyloid (Aβ), which is enhanced due to mutations in genes responsible for its breakdown and metabolism, and decreased secretion of selective neurotransmitters (namely norepinephrine). It is the formation of a large number of plaques and tangles, which adds to the neurotoxicity of the condition, making it worse.
AD initially affects the memory compartment of the brain, which leads to cognitive impairment that gets severe with time, induces mood swings and behavioral changes, and leads to more confusion. These changes are more severe than normal age-related processes and normally it is the family members of the patient who get an idea of the disease taking root in a family member. A caregiver, often from the family itself, is assigned the task of providing support physically and emotionally, to overcome these changes, but more than often it becomes a difficult and daunting task.
Apart from getting psychologic help from the physician after getting to know the patient’s family history and the sequence of events from family members and relatives, brain scans are necessary to support the diagnosis, along with assessment of the patient’s intellectual functioning. Biochemical tests to detect the levels of Tau and Beta-Amyloid proteins in the cerebrospinal fluid (CSF) are conducted to supplement the information derived upon, thus far. As far as medications are concerned, physicians rely mostly upon anti-depressants, beta blockers, neuroleptics, and cholinesterase inhibitors. Supportive therapy is given to reduce brain inflammation and treatment of symptoms. Practicing a healthy diet and a clean lifestyle also helps overcome the mental stress to some extent.
AD has been the topic of extensive research over the past 15 years, and 90% of what we know about the disease is the result of this most recent research. As of 2012, as many as 1,000 clinical trials have been undertaken in order to understand the pathophysiology of the condition and obtain targets for therapeutic intervention. Recently, as many as 10 proteins in blood have been recognized as possible markers for AD. This comes as good news for patients as the main challenge for AD lies in distinguishing age-related consequences from those pertaining to AD. Globally, AD has been the cause of great economical burden, with the health costs alone in 2011 being as high as $183 billion. In the USA, around 5.4 million people get affected each year, with an estimate of 12 to 16 million getting affected by 2050.