Neurology and Neurorehabilitation

Alzheimer's Disease: Quick Overview

Paul Tuite^{* *}Correspondence: Paul Tuite, Editorial Office, Neurology and Neurorehabilitation, Germany, Email:

Author info »

Introduction

Alzheimer's Disease (AD) is the leading cause of dementia in the world. According to the 2019 World Alzheimer Report, about 50 million people worldwide suffer from Alzheimer's disease. Long-term investigations have revealed the multi-factorial nature of illnesses, which adds to the disorder's complexity. Initially, Alzheimer's disease was thought to be an uncommon ailment, and subsequently, it was thought to be a natural part of ageing. The stigma connected to ageing and other causes has stifled vigorous study into and treatment of persons with Alzheimer's disease, but these misunderstandings are dispelling, and medicines, while ineffective at first, are becoming available. In the case of neurodegeneration, like with other conditions, early detection is critical for effective therapy. As a result of the non-specific nature of the earliest AD symptoms, an additional difficulty arises [1]. Symptoms of Alzheimer's disease are comparable to persistent fatigue and memory problems in the early stages. Regrettably, this period is portrayed as being critical to therapy effectiveness. Alzheimer's disease is a disease whose aetiology is unknown. Its development is linked to a number of environmental and genetic risk factors. An allele of the APOE gene is the most powerful genetic risk factor [2]. AD has become a serious public health issue as a result of greater life expectancy in the general population and a better understanding of the disease's socioeconomic repercussions. There are no therapies that can stop or reverse the disease's course, while some can temporarily alleviate symptoms. Affected people become more reliant on others for help, which puts a strain on caregivers. Social, psychological, physical, and economic stresses might all be present. The earliest signs are frequently misdiagnosed as age or stress. Up to eight years before a person meets the clinical criteria for Alzheimer's disease diagnosis, detailed neuropsychological testing might indicate moderate cognitive impairments. These early signs can have an impact on even the most sophisticated everyday tasks [3]. The most obvious weakness is short-term memory loss, which manifests as difficulties recalling previously learned knowledge and an inability to learn new material.

Alzheimer's Disease Symptoms and Causes

Alzheimer's disease is thought to develop when abnormal amounts of amyloid beta, which accumulates extracellularly as amyloid plaques, and tau proteins, which accumulate intracellularly as neurofibrillary tangles, form in the brain, affecting neuronal functioning and connectivity and resulting in a progressive loss of brain function. Alzheimer's disease, according to scientists, is caused by a mix of hereditary, behavioural, and environmental factors that damage the brain over time. Alzheimer's disease is caused by certain genetic abnormalities that nearly guarantee a person will acquire the condition less than 1% of the time. This deterioration in protein clearance capacity is age-related, controlled by brain cholesterol, and linked to other neurodegenerative illnesses. Disturbances in memory and language, visuospatial orientation, and higher executive function are clinical indications of Alzheimer's disease [4]. Personality changes, impaired judgement ability, wandering, psychosis, mood instability, agitation, and sleep disorders are examples of noncognitive alterations. Some examples of issues are: Memory lapses. poor decision-making leads to poor judgement, absence of spontaneity and initiative, it is taking longer to conduct routine everyday duties, questioning over and over, having difficulty managing money and paying expenses, wandering and being disoriented, losing or misplacing items in unusual places. The aetiology for most Alzheimer's cases is still mainly unclear, save for 1-2 percent of instances where deterministic genetic abnormalities have been detected. Several conflicting ideas seek to explain the fundamental aetiology, with the amyloid beta theory and the cholinergic hypothesis dominating.

Treatment for Alzheimer's Disease

Alzheimer's disease presently has no cure. However, there is medication available that can temporarily alleviate the symptoms. There is also aid available to help people with the illness and their families manage with day-to-day living. Modifications to the living environment and lifestyle during the early and moderate phases can promote patient safety and minimise caregiver strain. Adherence to simplified routines, the installation of safety locks, the labelling of home things to alert the person with the condition, or the usage of adapted daily life objects are examples of such adaptations. The therapy aims are to enhance cognitive and to reduce behavioural problems (depression, psychosis, agitation, and insomnia) [4]. Psychosocial therapy includes environmental modification, family support, and the avoidance of other medical comorbidities can all help AD sufferers operate better. In order to keep patients with Alzheimer's disease in their homes for as long as possible, various adjustments to the patient's surroundings are required [5]. Cognitive enhancers for the therapy of cognitive deficit14 and mood stabilisers, antipsychotics, antidepressants, and hypnotics for the treatment of behavioural disturbance are now accessible to doctors treating AD [6].

Conclusion

Current dementia therapy options are based on varying degrees of scientific evidence, indicating an insufficient grasp of the core pathophysiology of AD. Alzheimer's disease is the most frequent cause of dementia, and its incidence is growing globally. Pathology of disease begins years before symptoms appear. Neuropsychological, imaging, and spinal fluid studies can all be used to get a precise diagnosis. Cholinergic deficiencies have been widely reported, and data is sufficiently consistent to make cholin-esterase inhibitors (donepezil, tacrine, rivastigmine, and galantamine) the recommended therapy of cognitive disruption in Alzheimer's disease patients. Antioxidants, anti-inflammatories, and hormone replacement treatment are remain contentious, despite the fact that scientific research investigating their efficacy are underway. Symptomatic therapy of behavioural disturbances includes antidepressants, antipsychotics, mood stabilisers, anxiolytics, and hypnotics.

References

1. American Psychiatric Association. “Diagnostic and statistical manual of mental disorders 3 Washington, DC.” Am Psychiatr Assoc (1980).
   Google Scholar      Cross Ref
2. Khan, MC., et al. "Clinical diagnosis of Alzheimer's disease: Report of the NINCDS-ADRDA work group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease." Neurology 34.7 (1984): 939-939.
   Google Scholar      Cross Ref
3. Small., et al. "Diagnosis and treatment of Alzheimer disease and related disorders: consensus statement of the American Association for Geriatric Psychiatry, the Alzheimer's Association, and the American Geriatrics Society." Jama 278.16 (1997): 1363-1371.
   Google Scholar   Cross Ref
4. Poorkaj, P.,  et al. "Tau is a candidate gene for chromosome 17 frontotemporal dementia." Ann neurol 43.6 (1998): 815-825.
   Google Scholar   Cross Ref
5. Mooser, V.,  et al. "Interactions between apolipoprotein E and apolipoprotein in patients with late-onset Alzheimer disease." Ann intern Med 132.7 (2000): 533-537.
   Google Scholar    Cross Ref
6. Andersen, K., et al. "Gender differences in the incidence of AD and vascular dementia: The EURODEM Studies." Neurology  53.9 (1999): 1992-1992.
   Google Scholar      Cross Ref