What Happens To The Brain Cells With Alzheimer’s

What Can We Do To Minimize Alzheimers Disease

National Alzheimers Month is a perfect time to learn more about what you can do to help reduce your risk of developing Alzheimers disease.

While its true that Alzheimers primarily affects those over 60, there are lifestyle choices we can begin to make earlier in life to minimize the risk of developing it.

Medications To Treat The Underlying Alzheimer’s Disease Process

Aducanumab is the first disease-modifying therapy approved by the FDA to treat Alzheimers disease. The medication helps to reduce amyloid deposits in the brain and may help slow the progression of Alzheimers, although it has not yet been shown to affect clinical outcomes such as progression of cognitive decline or dementia. A doctor or specialist will likely perform tests, such as a PET scan or analysis of cerebrospinal fluid, to look for evidence of amyloid plaques and help decide if the treatment is right for the patient.

Aducanumab was approved through the FDAs Accelerated Approval Program. This process requires an additional study after approval to confirm the anticipated clinical benefit. If the follow-up trial fails to verify clinical benefit, the FDA may withdraw approval of the drug. Results of the phase 4 clinical trial for aducanumab are expected to be available by early 2030.

Several other disease-modifying medications are being tested in people with mild cognitive impairment or early Alzheimers as potential treatments.

Focus On Brain Health This Alzheimers Awareness Month

By 2030, more than 76 million people worldwide will struggle with Alzheimers Disease, and many more will experience some type of brain health issues. National Alzheimers Month 2021 is an opportunity to learn more about Alzheimers disease and to start conversations with those you love about brain health.

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A Step Closer To Understanding How Brain Cells Die In Alzheimer’s Disease

New research from the Australian Institute for Bioengineering and Nanotechnology at the University of Queensland has brought us a step closer to understanding how protein clumps called amyloid plaques contribute to the death of brain cells in Alzheimers disease.

The research, published in the highly regarded journal Stem Cell Reports, shows that an increased production of plaques surprisingly does not lead to an increase in brain cell death, suggesting that they dont kill neurons directly or, if they do, they dont work alone.

Currently, Alzheimers disease effects around a quarter of a million Australians, accounting for more than two-thirds of all dementia cases.

One of the major hallmarks of Alzheimers disease is the accumulation of the so-called beta-amyloid plaques. These plaques are formed when a type of protein in the brain, called amyloid precursor protein , is broken down into smaller fragments. These fragments, which are called beta-amyloid, then clump together to form plaques.

It is widely thought that these amyloid plaques contribute to the death of neurons in people with Alzheimers, either directly, or by causing another protein, called tau, to form toxic neurofibrillary tangles. Thus, reducing amyloid plaques has been the focus of many efforts to treat the condition.

People with Down syndrome have an extra copy of chromosome 21, and therefore carry an extra copy of the amyloid precursor protein gene, says lead author Dr Dmitry Ovchinnikov.

Key Biological Processes In The Brain

Most neurons have three basic parts: a cell body, multiple dendrites, and an axon.

• The cell body contains the nucleus, which houses the genetic blueprint that directs and regulates the cells activities.
• Dendrites are branch-like structures that extend from the cell body and collect information from other neurons.
• The axon is a cable-like structure at the end of the cell body opposite the dendrites and transmits messages to other neurons.

The function and survival of neurons depend on several key biological processes:

Neurons are a major player in the central nervous system, but other cell types are also key to healthy brain function. In fact, glial cells are by far the most numerous cells in the brain, outnumbering neurons by about 10 to 1. These cells, which come in various formssuch as microglia, astrocytes, and oligodendrocytessurround and support the function and healthy of neurons. For example, microglia protect neurons from physical and chemical damage and are responsible for clearing foreign substances and cellular debris from the brain. To carry out these functions, glial cells often collaborate with blood vessels in the brain. Together, glial and blood vessel cells regulate the delicate balance within the brain to ensure that it functions at its best.

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What Will The Doctor Do

It can be hard for a doctor to diagnose Alzheimer disease because many of its symptoms can be like those of other conditions affecting the brain. The doctor will talk to the patient, find out about any medical problems the person has, and will examine him or her.

The doctor can ask the person questions or have the person take a written test to see how well his or her memory is working. Doctors also can use medical tests to take a detailed picture of the brain. They can study these images and look for signs of Alzheimer disease.

When a person is diagnosed with Alzheimer disease, the doctor may prescribe medicine to help with memory and thinking. The doctor also might give the person medicine for other problems, such as depression . Unfortunately, the medicines that the doctors have can’t cure Alzheimer disease they just help slow it down.

What Happens In The Brain In Alzheimers Disease

When Alois Alzheimer examined the brain of Auguste Deter, he noted a few distinct pathological changes. The first was that the brain had undergone significant atrophy. It appeared somewhat shrunken compared to a healthy brain.

This atrophying of the AD brain is due to the death of brain cells that occurs in the disease. AD is what is known as a neurodegenerative disease, which is a classification used to refer to diseases that cause the degeneration and death of neurons. A number of diseases fall into this category , but AD is the most common of the group.

Alzheimer also noted unusual formations both within and surrounding neurons. He remarked that distributed all over the cortexthere arefoci which are caused by the deposition of a special substance, and he also mentioned many fibrils located next to each otherthey appear one by one at the surface of the cell. Alzheimer was describing what today are the two hallmark neurological signs of AD: amyloid plaques and neurofibrillary tangles.

The first of these structures, amyloid plaques, consist of collections of small peptides known as amyloid beta, or A, that form large clusters outside of neurons. Normally, enzymes called proteases can help to get rid of unwanted peptides and proteins in the brain. But amyloid plaques are especially resistant to degradation by proteases. Thus, they build up in the brain as the disease progresses their presence is a defining feature of an AD brain.

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Safety And Supportive Measures

Creating a safe and supportive environment can be very helpful.

Generally, the environment should be bright, cheerful, safe, stable, and designed to help with orientation. Some stimulation, such as a radio or television, is helpful, but excessive stimulation should be avoided.

Structure and routine help people with Alzheimer disease stay oriented and give them a sense of security and stability. Any change in surroundings, routines, or caregivers should be explained to people clearly and simply.

Following a daily routine for tasks such as bathing, eating, and sleeping helps people with Alzheimer disease remember. Following a regular routine at bedtime may help them sleep better.

Activities scheduled on a regular basis can help people feel independent and needed by focusing their attention on pleasurable or useful tasks. Such activities should include physical and mental activities. Activities should be broken down in small parts or simplified as the dementia worsens.

Managing Alzheimer’s Disease Behavior

Common behavioral symptoms of Alzheimers include sleeplessness, wandering, agitation, anxiety, and aggression. Scientists are learning why these symptoms occur and are studying new treatments drug and nondrug to manage them. Research has shown that treating behavioral symptoms can make people with Alzheimers more comfortable and makes things easier for caregivers.

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What Is Brain Shrinkage/atrophy In Dementia

When receiving a diagnosis of dementia, many people hear for the first time the term brain atrophy. The term is usually given by the clinician providing the diagnosis when discussing their brain scan. For example, you have mild atrophy in your brain, suggesting that you might have the early stages of Mild Cognitive Impairment/Alzheimers disease/other forms of dementia. But what is actually meant with this term atrophy and what does it refer to specifically?

Lets find out.

What Causes Alzheimer Disease

Lots of research is being done to find out more about the causes of Alzheimer disease. There is no one reason why people get it. Older people are more likely to get it, and the risk increases the older the person gets. In other words, an 85-year-old is more likely to get it than a 65-year-old. And women are more likely to get it than men.

Researchers also think genes handed down from family members can make a person more likely to get Alzheimer disease. But that doesn’t mean everyone related to someone who has it will get the disease. Other things may make it more likely that someone will get the disease, such as high blood pressure, high cholesterol, Down syndrome, or having a head injury.

On the positive side, researchers believe exercise, a healthy diet, and taking steps to keep your mind active may help delay the start of Alzheimer disease.

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How Do Brain Cells Die In Alzheimers

In Alzheimers disease both of these amyloid plaques and tau tangles happen. The amyloid plaques happen first and the tau tangles happen a little bit later. But eventually the neuron that has tau tangles inside dies.

When the tangle overpowers the brain cell, neural communication processes can slow down and be eventually blocked entirely.

Imagine you are trying to shove something through a small tube and there is a clog in the tube. Quite similar to getting a clog in your house pipes. Once the clog is there, its really hard for the water to go through. And thats exactly what happens to the neurons.

Brain cells like to talk to each other and receive input from each other. Once neurons are unable to communicate, they begin to die.

There are diseases where you only observe amyloid plaques, and diseases where you see only tangles. But Alzheimers disease by definition has both. When you look at an Alzheimers disease patients brain at autopsy you can see both amyloid plaques and tau tangles.

Medications To Maintain Mental Function In Alzheimer’s Disease

Several medications are approved by the U.S. Food and Drug Administration to treat symptoms of Alzheimers. Donepezil, rivastigmine, and galantamine are used to treat the symptoms of mild to moderate Alzheimers. Donepezil, memantine, the rivastigmine patch, and a combination medication of memantine and donepezil are used to treat moderate to severe Alzheimers symptoms. All of these drugs work by regulating neurotransmitters, the chemicals that transmit messages between neurons. They may help reduce symptoms and help with certain behavioral problems. However, these drugs dont change the underlying disease process. They are effective for some but not all people and may help only for a limited time.

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Creating A Beneficial Environment For People With Dementia

What Is Alzheimer Disease

Alzheimer disease, which affects some older people, is different from everyday forgetting. It is a condition that permanently affects the brain. Over time, the disease makes it harder to remember even basic stuff, like how to tie a shoe.

Eventually, the person may have trouble remembering the names and faces of family members or even who he or she is. This can be very sad for the person and his or her family.

It’s important to know that Alzheimer disease does not affect kids. It usually affects people over 65 years of age. Researchers have found medicines that seem to slow the disease down. And there’s hope that someday there will be a cure.

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How Does Alzheimer’s Disease Affect The Brain

Scientists continue to unravel the complex brain changes involved in Alzheimers disease. Changes in the brain may begin a decade or more before symptoms appear. During this very early stage of Alzheimers, toxic changes are taking place in the brain, including abnormal buildups of proteins that form amyloid plaques and tau tangles. Previously healthy neurons stop functioning, lose connections with other neurons, and die. Many other complex brain changes are thought to play a role in Alzheimers as well.

The damage initially appears to take place in the hippocampus and the entorhinal cortex, which are parts of the brain that are essential in forming memories. As more neurons die, additional parts of the brain are affected and begin to shrink. By the final stage of Alzheimers, damage is widespread and brain tissue has shrunk significantly.

How Alzheimer’s Disease Impacts The Brain

November 26, 2019Neurology

One condition becoming all too common today is Alzheimers disease, a brain condition that is the 6th leading cause of death in the United States. The Alzheimers Association defines the disease as a type of dementia that causes problems with memory, thinking, and behavior.

Alzheimers doesnt happen all at once. In fact, the symptoms may at first be dismissed as simply getting older, if doctors and family members arent vigilant. Early symptoms include relatively small issues like trouble learning new things or remembering details. Eventually, the symptoms grow to the point of inability to care for oneself or understand ones surroundings. So, where does the brain with Alzheimers disease go wrong?

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How Is Alzheimers Disease Treated

Alzheimers is complex, and it is therefore unlikely that any one drug or other intervention will successfully treat it in all people living with the disease.

Scientists are exploring many avenues to delay or prevent the disease as well as to treat its symptoms. In ongoing clinical trials, scientists are developing and testing several possible interventions. Under study are drug therapies aimed at a variety of disease interventions, as well as nondrug approaches such as physical activity, diet, cognitive training, and combinations of these. Just as we have many treatments for heart disease and cancer, we will likely need many options for treating Alzheimers. Precision medicine getting the right treatment to the right person at the right time will likely play a major role.

Current approaches to treating Alzheimers focus on helping people maintain mental function, treating the underlying disease process, and managing behavioral symptoms.

Behavior Disorders In Alzheimer Disease

Because people are less capable of controlling their behavior, they sometimes act inappropriately or disruptively . These actions are called behavior disorders.

Several effects of Alzheimer disease contribute to this behavior:

• Because people with Alzheimer disease have forgotten the rules of proper behavior, they may act in socially inappropriate ways. When hot, they may undress in public. When they have sexual impulses, they may masturbate in public, use off-color or lewd language, or make sexual demands.

• Because they have difficulty understanding what they see and hear, they may misinterpret an offer of help as a threat and may lash out. For example, when someone tries to help them undress, they may interpret it as an attack and try to protect themselves, sometimes by hitting.

• Because their short-term memory is impaired, they cannot remember what they are told or have done. They repeat questions and conversations, demand constant attention, or ask for things they have already received. They may become agitated and upset when they do not get what they ask for.

• Because they cannot express their needs clearly or at all, they may yell when in pain or wander when lonely or frightened. They may wander, yell, or call out when they cannot sleep.

Whether a particular behavior is considered disruptive depends on many factors, including how tolerant the caregiver is and what sort of situation the person with Alzheimer disease is living in.

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Icipating In Alzheimer’s Disease Clinical Trials

Everybody those with Alzheimers disease or MCI as well as healthy volunteers with or without a family history of Alzheimers may be able to take part in clinical trials and studies. Participants in Alzheimers clinical research help scientists learn how the brain changes in healthy aging and in Alzheimers. Currently, at least 270,000 volunteers are needed to participate in more than 250 active clinical trials and studies that are testing ways to understand, diagnose, treat, and prevent Alzheimers disease.

Volunteering for a clinical trial is one way to help in the fight against Alzheimers. Studies need participants of different ages, sexes, races, and ethnicities to ensure that results are meaningful for many people.

NIA leads the federal governments research efforts on Alzheimers. NIA-supported Alzheimers Disease Research Centers throughout the U.S. conduct a wide range of research, including studies of the causes, diagnosis, and management of the disease. NIA also sponsors the Alzheimers Clinical Trials Consortium, which is designed to accelerate and expand studies and therapies in Alzheimers and related dementias.

To learn more about Alzheimers clinical trials and studies:

• Talk to your health care provider about local studies that may be right for you.

Watch videos of participants in Alzheimers disease clinical trials talking about their experiences.