Alzheimer's: Symptoms, treatment, and research

Alzheimer's disease is a brain disorder involving gradual loss of memory, thinking skills, and the ability to carry out simple day-to-day tasks. It has two subcategories based on the age of onset- late and early. The late-onset type occurs more commonly and people start showing initial symptoms in their mid-60s. The early-onset type is rare and occurs in individuals between their 30s and mid-60s. It is the most common reason for dementia in the older population.

Signs and Symptoms

Mild Alzheimer's Disease

●      Memory loss

●      Poor judgment

●      Loss of spontaneity 

●      Repetitive questions

●      Getting lost

●      Misplacing things

●      Personality changes

●      Increased anxiety

●      Increased aggression

 

Moderate Alzheimer's Disease

●      Increased memory loss

●      Confusion

●      Unable to learn new things

●      Language and communication difficulties

●      Issues with logical thinking

●      Short attention span

●      Difficulty coping 

●      Lack of recognition of people

●      Problems with multi-step tasks like changing clothes

●      Hallucinations

●      Paranoia

●      Delusions

●      Anger management issues

●      Impulsive behaviour

●      Anxiety

●      Repetitive movements

Severe Alzheimer's Disease 

●      Unable to communicate properly

●      Weight loss

●      Seizures

●      Skin infections

●      Problems with swallowing

●      Groaning

●      Sleeping more

●      Difficulty in controlling bowel and bladder movements

Treatment

Due to its complex nature, there is currently no proper cure for Alzheimer's disease. However, medicine is available to reduce symptoms and slow disease progression. Thus, these medicines can help improve quality of life and prolong independence.  Usually, medicines are most effective in mild or moderate stages. Approved medications include cholinesterase inhibitors, memantine and aducanumab.

In Alzheimer's, there are reduced levels of acetylcholine- a chemical messenger. This chemical is necessary for alertness, memory, thought, and judgment. Cholinesterase inhibitors prevent the chemical's breakdown and make it more readily available to the nerve cells. However, these medications lose their effectiveness over time as the disease progresses. 

Memantine, alone or with a combination of donepezil, is approved for later stages of Alzheimer's. It helps control the activity of a chemical messenger, glutamate, which is involved in cognitive functions like learning and memory. It helps patients remember things and manage their daily tasks in a better way. 

Aducanumab is the only approved drug that addresses the underlying biology of the disease at the moment. It is a human antibody that targets abnormal beta-amyloid proteins. It helps decrease amyloid plaques- brain lesions linked with Alzheimer's. These plaques have been associated with cell death and tissue loss in the brain.  Its use was indicated for the mild stage of Alzheimer's in clinical trials.

Research 

Developing new cures is a painstaking and slow process. Experts are cautiously hopeful about discovering treatments which may halt, or notably delay, the progression of Alzheimer’s. Numerous studies are underway to find a cure for Alzheimer’s. These include research aimed at targeting plaque in the brain by recruiting the immune system through monoclonal antibodies, preventing destruction by turning off target proteins, and blocking its production by parent proteins. Additionally, there are investigations regarding the prevention of tau proteins from tangling, reducing brain cell inflammation, insulin resistance, connections between the heart and head, and hormonal therapy.