More than 5.8 million Americans currently live with Alzheimer’s and dementia, 5.6 million people are living with minds which are gradually erasing things, who memories are eventually crumbling into oblivion and their personalities are ripping apart.
Due to increased lifespans, the total number of people afflicted with this disease is also predicted to rise like never before. In fact, by the time it is 2050, there will be 14.8 million Americans who would be suffering from Alzheimer’s. Can you imagine the unbearable emotional burden, let alone the economic burden?
For several decades now, scientists have been striving to know about the causes of this disease, its cures and tens of billions of dollars have been invested for purposes of research.
Unfortunately, there’s nothing to show for it. There’s no medicine, no treatment and no possible relief from Alzheimer’s. The sole medicine that has been approved treats the symptoms of the disease, that too for just few months!
A breakthrough in combating Alzheimer’s – Is there a faint hope?
In the year 2018, there was breakthrough news that the researchers have successfully found out a brand new way in which they could target the toxic particles which cause damage to the brain cells that are healthy.
Researchers working with the Cambridge University and the Lund University Sweden have devised a strategy where they have to target the ‘cause’ of this degenerative disease, thereby hoping to discover some drugs which could treat the disease, dementia.
One of the scientists involved in this research, Professor Michele Vendruscolo, said that this is probably the first time that they are improvising a systematic method in which they can go after pathogens which cause this disease.
Until now, no scientists agreed on the actual cause of this disease and hence they didn’t have anything common to agree on. But now as the pathogens have been recognized as clumps of proteins called oligomers, they have successfully developed a strategy to devise medicines to target these toxic protein clumps.
How Alzheimer’s creeps into a human brain
There’s no denying the fact that dementia is the biggest reason behind deaths in the UK and the cost is anticipated to double within the next 25 years and might reach 55 billion pounds. The global economy is at a precarious stage with regards to the soaring costs of dementia treatments.
When someone develops Alzheimer’s, the disease leads to loss of tissues and death of nerve cells inside the brain. With time, the brain shrinks and the constant destruction of cells leads to changes in personality, memory loss and difficulties in performing regular activities.
The abnormal deposits of proteins called oligomers are the main suspects that led to dementia. Though proteins are responsible for the vital cell processes yet when people develop this brain disease, these proteins get rough, form clumps and work to kill all the healthy nerve cells.
The proteins should fold into a definite structure in order to be able to function in a desired manner. If there is failure in this folding process, the cell will go through a severe ‘misfolding issue’ and soon there will be harmful deposits which can later on lead to dementia.
These misfolded proteins form unusual clumps which accumulate between the nerve cells thereby barring the proper signalling of the brain. The nerve cells which are dying also comprise of tangles which hamper the cell transport system and this stops the usual supply of nutrients through the cells.
What does the research reveal?
Professor Sir Christopher Dobson said that this interdisciplinary study showed that is not only possible to detect the compounds which target the build up of oligomers but to also boost their potency in a rather rational way.
It is therefore now possible to create different molecules which have definite impacts on the different stages of disorders like Alzheimer’s. They also hope to convert them to drugs that can be applied in a clinical or medical environment.
Previously there have been more than 400 clinical trials for Alzheimer’s but none targeted the actual pathogens which led to the disease. In the UK and US, dementia is the biggest condition among all the other 10 causes of deaths which don’t have any cure or treatment to slow down its progress.
The previous clinical trials which targeted the process of finding drugs to enhance the disease have been unsuccessful. From the successful trials, we have got a handful of medicines which could only treat the few symptoms of Alzheimer’s. So, their new approach to target the protein clumps includes a new ‘drug discovery’ strategy.
What is the Drug Discovery Strategy?
Drug discovery involves screening and testing of chemical libraries, recognizing the most active ingredient, leading to the understanding of the target cause which is protein oligomers in this case. However, development will include clinical trials, further studies and will also need a regulatory approval.
The entire team of researchers believe that their initial drug researchers would reach clinical trials in 2 years. They have created an entire team who have been given the mission of taking those ideas which have been developed in the Cambridge University and transfer them to identifying new methods of diagnosing and curing the disease and other cell misfolding disorders.
Professor Knowles said that they were extremely happy and satisfied about the capability of chemical kinetics for discovering drugs against diseases which developed from protein misfolding.
As the aggregation process is highly dynamic, the kinetics framework lets them approach the issue in a new way so that they could stop the accumulation of toxic proteins.
As there are still no treatments to stop the disease or slow down its progression, it is important that they improve their approaches in a way that could refine the drug discovery progress and find out new ways of treating Alzheimer’s.
Diagnosing dementia – Coming to terms with the disease
It can be challenging to diagnose dementia and decide which type it is. Just as dementia caring can get overwhelming with time, similarly, living with dementia is a tough approach towards life.
In order to be diagnosed with dementia, at least 2 of the core mental functions need to be impaired to such an extent that they interfere with your daily living and regular activities.
Few of these areas are language skills, memory skills, capability of paying attention or focusing on things, problem solving skills, ability to reason and the power of visual perception.
When you visit your doctor, he will review your clinical history and find out the symptoms through few physical examinations. The doctor will probably ask someone close to you regarding the symptoms that you get.
There is no single test which can diagnose this neurodegenerative disease and hence doctors will most likely run through various tests which can help them point out the issue.
Neuropsychological and cognitive tests
The doctor will then evaluate your cognitive and thinking function and there are few tests which measure the thinking skills like orientation, memory, judgment and reasoning, attention and language skills.
What kind of neurological evaluations are done? Doctors will test your language, memory, attention, visual perception, movement, problem solving, balance, senses, reflexes and other areas.
The 2 brain scans which are necessary are CT and PET scans. The MRI or CT scans can check for proof of stroke or tumor or internal bleeding. On the other hand, PET scans show patterns of activity of the human brain and also checks if the amyloid protein is being deposited within the brain.
Psychiatric evaluation of the patient
It is only a mental health professional who can decide whether it is a mental health condition or any form of depression which is leading to the symptoms. Though there is no such treatment of dementia, yet there are few clinical ways in which you can deal with the symptoms.
These are used for improving the symptoms of dementia:
- Cholinesterase inhibitors: Few such medicines include Aricept, Exelon and Razadyne which works to boost levels of the chemical messenger that is involved in judgment and memory. Though these are initially used for treating Alzheimer’s disease, these medicines can also reduce the symptoms of dementia and vascular dementia.
- Memantine: Memantine works in a way where it regulates the activity of glutamate which is nothing but a chemical messenger that is involved in functioning of the brain like memory and learning. Dizziness is one of the most common side-effects of memantine.
- Other medicines: When you meet your doctor, he might also recommend some other medicines to treat other conditions like sleep disturbances, depression and agitation.
There are different symptoms of dementia and behavior issues which can be treated using non-medical approaches like:
- Changing the environment: When you’re involved in home caring for a patient suffering from dementia, you can reduce the noise and clutter so that it gets easier for the person with dementia to pay attention on his own jobs and focus on matters. If there are things which can threaten the safety of the patients like car keys and knives, you should hide them.
- Occupational therapy: It is an occupational therapist that can make your home safer and teach behaviors of coping. The ultimate purpose is to avert the instance of accidents like tripping and falling, managing all sorts of behavior and preparing for the progression of dementia.
- Altering tasks: Being a caregiver, you can also break down tasks into simpler steps and then emphasise on your success and not on your failure. When you follow a routine or a structure, this will reduce confusion among people who are suffering from dementia.
Home & Lifestyle solutions
Mayo Clinic tests new interventions, treatments and tests as a means of detecting, preventing, treating and managing this disease. Here are few suggestions to keep in mind:
- Improve communication: Whenever you speak with your family member, make sure you keep an eye contact with the person. Use simple sentences while speaking and don’t rush to get a response. Make sure you present a single idea and instruction and use cues and gestures.
- Ask him to exercise: If you find your loved one getting idle due to the disease, make sure you plan few activities so that the person gets engaged. Ask him about his interests and plan accordingly. Painting, dancing, cooking, gardening and singing can be few activities which are fun. Make him believe that he is still capable of doing things that he loves.
- Set a night routine: There is something called sundowning syndrome due to which the behavior of a person deteriorates during night. If you can set up few rituals while going to bed, this can calm down his mind. In case there is noise of television of meal clean-ups, make sure the noise is as low as possible. Restrain his caffeine routine, offer him chances of exercising and discourage napping at daytime.
- Set up a plan for the near future: Sit along with your loved one and develop a plan so that he can participate in realizing his goals. He shouldn’t lose his self-belief as this will demotivate him from life. Legal advisers, support groups and family members can be of immense help in rejuvenating his self-confidence.
- Maintain a calendar: If you can maintain a calendar, this can help your family member to remember all the events, daily activities and medicine schedules. Once you create a calendar, share it with the family member so that he too can keep a track on it.
Now that you know about what researchers and scientists have to say about the future of dementia and Alzheimer’s, do you feel safe? They believe that by 2020 or 2025, there will be a treatment for this disease or the most common cause of dementia, Alzheimer’s.
They are also of the opinion that the future is bright and there is enough to be enthusiastic about. The researches that are done are quite exciting now and hence it is unrealistic to say that there won’t be any treatment in the next decade.