All we know about Alzheimer's disease
It is the most common form of dementia, and you most likely know someone who suffers or has suffered from this disease. These are some of the discoveries that have been made in understanding its symptoms, stages, and treatments.
It was first described by Alois Alzheimer in 1906 and has been known by his name ever since. An unusual honour, naming the most common neurodegenerative disorder, which accounts for between 60% and 80% of dementia cases worldwide. Its main characteristic is the accumulation of amyloid plaques and neurofibrillary tangles in the brain, which interfere with neuronal communication, impairing memory and other cognitive functions.
Previous symptoms
Due to the progressive nature of this disease, its symptoms vary over time, differing in each phase. There are also early stages in which symptoms can already be spotted, so their identification is key to being able to detect the disease and start treating it before it is too late.
This first stage of detection could be divided into two phases, the preclinical phase and the mild cognitive impairment (MCI) phase. Studies such as those by Sperling et al. (2011) for the preclinical phase and Petersen et al. (1999) for mild cognitive impairment have identified biomarkers enabling early detection of MCI. At the same time, it has been established that people with mild cognitive impairment do not always go on to develop Alzheimer's disease, although they are at increased risk.
Phases of the disease
After these initial stages, we reach the disease itself. Depending on the stage we are in, we may see different symptoms, from occasional memory loss to complete loss of independence. We must therefore divide the disease into an early stage, a moderate stage and, finally, an advanced stage.
In the initial phase, there are early signs, including impairment of recent memory, difficulty finding words, and changes in mood and personality. At this stage, people may have problems with the everyday tasks that they used to perform with ease. However, despite these difficulties, they are still able to be autonomous, to a certain degree.
However, as the disease progresses and we enter the moderate phase, the symptoms become more acute. Patients may forget important information, such as their address or the names of close family members. At this point it is common for them to get lost in familiar places and need help with daily activities.
Patients will require increasing amounts of support, until the final stages, where they become completely dependent. Verbal communication is severely affected, and there may also be loss of mobility and control over basic body functions. Long-term memory also deteriorates.
In search of a cure
Despite being known for more than a century and having been studied in depth, there is currently no cure for Alzheimer's disease. However, treatments have been discovered that can alleviate some of its symptoms and improve patients' quality of life.
From a pharmacological point of view, there are certain drugs that, while they may not halt the progression of the disease, can help improve cognitive function and behaviour. Among the drugs approved to treat the symptoms of Alzheimer's we find cholinesterase inhibitors, such as donepezil, rivastigmine or galantamine, and memantine.
However, non-pharmacological treatments such as cognitive-behavioural therapies, cognitive stimulation and occupational therapy are also worth mentioning. These therapies have been proven to result in a very significant improvement in the quality of life of patients.
In this field, it should also be noted that considerable progress has been made in Catalonia. At the national level, we would also like to highlight the work of the Neurodegenerative Diseases Area at the Centre for the Biomedical Research Network (CIBERNED), whose research ranges from the genetics of Alzheimer's to new therapeutic targets. Internationally, significant progress has also been made in understanding Alzheimer's disease. Research such as that by Selkoe (2012) has delved deeper into the molecular pathogenesis of the disease, while global clinical trials are exploring new therapeutic options, including immunotherapies targeting amyloid plaques and tau tangles.
To summarise, Alzheimer's remains a daunting medical and scientific challenge. Although some progress has been made in its treatment and detection, the search for a cure has not yet yielded the results we hope to eventually obtain. Our only option is to keep up the fight.
