Spain, July 3, 2023.
Alzheimer’s is a neurodegenerative disease that causes deterioration of cognitive abilities, mainly affecting memory, as well as language, behavior and executive functions, among other disorders. It is the most common form of dementia in older people.
Unfortunately, it is a much more common disease than you might think: one in two people has a direct or indirect relationship with it. Thousands of new Alzheimer’s patients are diagnosed every day around the world. In Spain alone, it is estimated that there are 1.2 million people with Alzheimer’s disease, according to data from the Spanish Alzheimer’s Confederation (CEAFA). A figure that, given the growing aging of the population and the greater diagnostic capacity, could double in the next 20 years if a definitive treatment is not achieved to stop its progress.
In usual clinical practice, the diagnosis of the disease, -since it is treated in connection with ageing-, is frequently delayed several years after the onset of symptoms. The role of the geriatrician in early detection can be of vital importance for early access to the necessary pharmacological and non-pharmacological therapies.
The terrible thing about this disease is that it does not only affect the sick person. The physical, psychological and social impact also affects their relatives, and it is tremendous due to the physical and emotional burdens that it entails. The need to resort to professional caregivers, such as those who make up Brunimarsa, -an expert company in social and health care at home and specialized in the care of patients with Alzheimer’s, Parkinson’s and Stroke-, is also vital to provide care not only to the patient but to the entire family unit.
“Knowing how to manage all the burden of caring for a sick person is difficult. Alzheimer’s patients need very specific attention and very special affection, since, in many cases, in addition to needing the same physical assistance on a day-to-day basis as other older people, they add the characteristics that this disease entails: the loss memory, disorientation and psychological disorders such as depression or apathy” explains Enrique Aguilar, founder of Brunimarsa.
Given the growing number of people affected, concern arises in the population about the genetic factors that can influence its development. A hot topic as a result of the news related to the genetic predisposition of actor Chris Hemsworth to develop the disease due to the identification of two copies of the ApoE4 gene, inherited from his mother and father, which unlike its other two common forms (APOE e2 and APOE e3) increases the risk of Alzheimer’s disease and is associated with the onset of the disease at a younger age.
The apparent truth is that not all people who have 1 or 2 APOE e4 genes suffer from this disorder, and that many who do not have this type of gene do, so genetic factors are not determinant for the onset of Alzheimer’s, but that are added to other causes such as age, health and living conditions of each individual.
“Alzheimer’s disease (AD) is a disease, from the genetic point of view, very heterogeneous. Only 0.5 to 0.1% of cases, AD is genetically determined. Due to this fact, genetic Alzheimer’s disease is considered a “minority or rare” disease at the population level (ORPHA1020)”, confirms Dr. Jara Velasco García-Cuevas, a geriatrics specialist at the Hospital de Guadarrama (Madrid). Dementia expert and Master in geriatric rehabilitation.
The presence of APOE e4 can therefore be considered a genetic risk factor that generates a higher relative risk, explains Dr. Velasco, although, by itself, it is not the cause of the disease, since up to 50% of carriers of APOE have not developed symptoms by age 85.
And it is that, in addition to the genetic component, there are other factors that can intervene in the development of Alzheimer’s disease. Growing evidence, says Dr. Velasco, suggests that the health of the brain is closely related to the health of the heart and blood vessels. And therefore the risk of developing dementia appears to increase as a result of high blood pressure, heart disease, stroke, diabetes, and high cholesterol.
Despite this outlook, in recent years the progress associated with Alzheimer’s has been important. Current treatments temporarily improve symptoms of memory loss and thinking problems. However, these treatments do not stop the underlying deterioration and death of brain cells, so the disease continues to progress, says Dr. Velasco, an expert in dementias.
However, little by little, the changes that occur in the brain are being better understood, which helps to find strategies that promise to alleviate the consequences of the disease, slow down its course, and ultimately improve the quality of life of patients. affected. Some of these tactics are aimed at mimicking antibodies (which our immune systems naturally produce) to rid the brain of beta-amyloid plaques, a hallmark of Alzheimer’s.
“Lecanemab has shown promise for people with mild Alzheimer’s and mild cognitive impairment due to the disease,” says Dr. Velasco. The FDA approved the drug in 2023. A phase 3 clinical trial found that Lecanemab reduced cognitive decline in people with the early disease by 27%.
Also a drug initially developed as a potential cancer treatment, Saracatinib, is now being tested with Alzheimer’s as well.
Other pathways aim to avoid tangles, proteins twisted into tiny fibers, which cause another common change in the brains of people with Alzheimer’s. Some studies are also exploring how insulin changes in the brain may be related to the disease. And it is also being investigated whether blood pressure medications can benefit.
“There is no doubt that progress is being made towards a future cure for the disease, although there is still a long way to go,” says Dr. Velasco.
The importance of cognitive stimulation in the early stages of the disease is also stressed. Hence the importance of early diagnosis and the need for professional care. If the current pharmacological treatments are aimed at stabilizing the disease, the non-pharmacological ones must be aimed at getting the patient to adapt to the problems that the loss of neurons can cause.
“It is about maintaining mental abilities as much as possible through cognitive stimulation, concentration and memory exercises, and physical activity” to thus slow down cognitive deterioration, reports Enrique Aguilar from Brunimarsa.
Based on their experience, among the strategies they have found useful is psychotherapy, -with the aim of treating loss of control and feelings of anxiety and depression-. “Physiotherapy also offers various treatments for Alzheimer’s patients, whose objective is to preserve mobility, autonomy and the ability to perform activities of daily life,” they comment in Brunimarsa. “The important thing is to have a professional caregiver focused on the specific needs of each patient with Alzheimer’s disease” concludes the CEO of Brunimarsa.
Contact
Contact name: Brunimarsa
Contact description: Enrique Aguilar Santamaría
Contact phone: 617474275
