Alzheimers and Memory
Alzheimer’s Disease (AD),
originally described by Alois
Alzheimer
in 1906, is a chronic degenerative
disease, which is progressive. The cause is unknown until now. It is the most
common form of dementia in the US, followed by vascular or senile dementia. Symptoms may appear as early as the sixth
decade and more commonly at 85 years of age onward.
The hallmarks of AD are:
-Forgetfulness; places,
dates, circumstances. As it progresses, this can extend to persons, faces,
names and the main characteristic is that the patient who suffers the disease
doesn’t realize that this is occurring. Victims of AD usually don’t try to
recall except for the in the beginning of the disease. Other manifestations include changes in
behavior and mood swings.
The phases of AD are divided
into
Pre-dementia, Early, Moderate
and Advanced. The symptoms and mental
deterioration progress in each phase.
-AD tends to run in families,
but no specific hereditary pattern has been established.
-Another finding is the
accumulation of Beta Amylase and neuronal death (brain cells) around small vessels forming a cobweb pattern
(Neurofibrillary tangles) 1.
Abnormal Phosphorylation of
Tau Proteins.
-Normal neurons are
substituted by beta amyloid thus decreasing the amount of healthy neurons and
Synapsis (Neuron connections).
-Clinical depression is often
associated to AD
The Diagnosis should be made
by a qualified professional such as Neurologist, General Practitioner,
Psychiatrist or other qualified physicians.
Diagnostic tools include
CT Scan (Computed tomography)
Magnetic resonance imaging (MRI)
SPECT (Single Photo emission computed tomography)
PET (positron emission tomography)
Magnetic resonance angiography (MRA)
Psychometric exams such as
the mini-mental state exam MMSE
Biopsy (most specific but
impractical and rarely done)
Spinal Tap with measurement
of Beta Amyloid and Tau protein in both its Phosphorylated and non
phosphorylated forms yield a sensitivity of >94% for establishing the onset
of AD3
Once diagnosed, AD has no
cure currently as such. However, several substances have been found to be
useful in slowing progression of the disease, mainly by increasing the
production of a substance that connects one neuron with the neighboring neurons
known Acetylcholine (Ach).
Amongst these substances are:
-Donepezil Hcl
-Tacrine
-Galantamine
-Rivastigmine (Exelon)
-Selegiline
-Memantine
The combination of the above
mentioned, depends on the patient and the stage of the disease as well as the
age of presentation. These medications, in general, help to preserve or increase
the availability of Ach from the decreasing number of Ach producing Neurons.
Only Donepezil is approved
for the advanced form of Alzheimer’s disease.
Mematine blocks receptors
(NMDA) on which Glutamate works. In theory, this decreases neuronal death due
to overexciting the glutamate receptors, slowing the process of mental decline.
Adjuvant supplements include:
-Nifedipine (Unknown Mechanism of action)
-Statins 1 (eg.
Lipitor, Crestor)
-Pentoxyphiline (Trental)
- Haloperidol (Haldol)
-Sodium Valproate
* The aforementioned
medications work as palliative medications, but their mechanism of action is
not fully understood.
Methods to decrease
forgetfulness in Alzheimer’s disease.
-Intellectual exercises that
is unrelated to their original career or occupation.
-Scrabble
-Monopoly
-Chess
-Sudoku
-Cross word puzzles
-N-Back test
-Counting back wards in 7’s
or 4’s from 200
-Simple Math problems in
general without paper and pencil
-Change in daily routine
-Supplements such as a combination
of Huperzine and Gingko5 as found in supplements MC2
-Listening to classical music
*Always consult with your
physician if you have queries or doubts regarding decreasing or loss of memory.
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Bibliography
1.
-"Neurofibrillary Tangles." Wikipedia. Wikimedia Foundation,
19 Feb. 2014. Web. 22 Mar. 2014.
2.
- Landes AM, Sperry SD,
Strauss ME, Geldmacher DS. Apathy in Alzheimer's Disease. J Am Geriatr Soc.
2001;49(12):1700–7. doi:10.1046/j.1532-5415.2001.49282.x. PMID 11844006.
3.
- De Meyer G, Shapiro F,
Vanderstichele H, Vanmechelen E, Engelborghs S, De Deyn PP, Coart E, Hansson O,
Minthon L, Zetterberg H, Blennow K, Shaw L, Trojanowski JQ. Diagnosis-Independent Alzheimer
Disease Biomarker Signature in Cognitively Normal Elderly People. Arch Neurol.. 2010;67(8):949–56. doi:10.1001/archneurol.2010.179. PMID 20697045.
4.-
Li J, Wu HM, Zhou RL, Liu GJ, Dong BR (2008). "Huperzine A for Alzheimer's
disease". In Wu, Hong Mei. Cochrane Database of Systematic Reviews
(2): CD005592. doi:10.1002/14651858.CD005592.pub2. PMID 18425924.
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