Can Alzheimer’s Disease Be Prevented
As the exact cause of Alzheimer’s disease is not clear, there’s no known way to prevent the condition.
But there are things you can do that may reduce your risk or delay the onset of dementia, such as:
- staying physically fit and mentally active
These measures have other health benefits, such as lowering your risk of cardiovascular disease and improving your overall mental health.
Read more about preventing Alzheimer’s disease.
Health Environmental And Lifestyle Factors That May Contribute To Alzheimers Disease
Research suggests that a host of factors beyond genetics may play a role in the development and course of Alzheimers disease. There is a great deal of interest, for example, in the relationship between cognitive decline and vascular conditions such as heart disease, stroke, and high blood pressure, as well as metabolic conditions such as diabetes and obesity. Ongoing research will help us understand whether and how reducing risk factors for these conditions may also reduce the risk of Alzheimers.
A nutritious diet, physical activity, social engagement, sleep, and mentally stimulating pursuits have all been associated with helping people stay healthy as they age. These factors might also help reduce the risk of cognitive decline and Alzheimers disease. Clinical trials are testing some of these possibilities.
Early-life factors may also play a role. For example, studies have linked higher levels of education with a decreased risk of dementia. There are also differences in dementia risk among racial groups and sexesall of which are being studied to better understand the causes of Alzheimers disease and to develop effective treatments and preventions for all people.
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Role Of Oxidative Stress
Cognitive impairment has been attributed to oxidative stress, inflammatory reactions and changes in the cerebral microvasculature. The exact impact of each of these mechanisms in affecting cognitive aging is unknown. Oxidative stress is the most controllable risk factor and is the best understood. The online Merriam-Webster Medical Dictionary defines oxidative stress as, “physiological stress on the body that is caused by the cumulative damage done by inadequately neutralized by antioxidants and that is to be associated with aging.” Hence oxidative stress is the damage done to the cells by free radicals that have been released from the oxidation process.
Compared to other tissues in the body, the brain is deemed unusually sensitive to oxidative damage. Increased oxidative damage has been associated with neurodegenerative diseases, mild and individual differences in cognition in healthy elderly people. In ‘normal aging’, the brain is undergoing oxidative stress in a multitude of ways. The main contributors include protein oxidation, lipid peroxidation and oxidative modifications in nuclear and mitochondrial DNA. Oxidative stress can damage DNA replication and inhibit repair through many complex processes, including shortening in DNA components. Each time a replicates, the telomeric DNA component shortens. As telomere length is partly inheritable, there are individual differences in the age of onset of cognitive decline.
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Immune Cells Suggest New Alzheimer’s Treatment Possibilities
Brain cells called microglia have different effects as the neurodegenerative disease progresses
In 1907 German psychiatrist Alois Alzheimer published a case report of an unusual illness affecting the cerebral cortex. A 51-year-old woman living in an asylum in Frankfurt am Main exhibited symptoms that are all too familiar to the millions of families affected by what is now known as Alzheimers disease. There was memory loss, confusion and disorientation.
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How Is Alzheimer’s Disease Diagnosed
There is currently no single test to identify Alzheimer’s disease. The diagnosis is made only after careful clinical consultation.
The clinical diagnosis might include:
- A detailed medical history
- Lumbar puncture for cerebral spinal fluid tests
- Medical imaging
These tests will help to eliminate other conditions with similar symptoms such as nutritional deficiencies or depression. After eliminating other causes, a clinical diagnosis of Alzheimer’s disease can be made with about 80% to 90% accuracy if the symptoms and signs are appropriate. The diagnosis can only be confirmed after death by examination of the brain tissue.
It is important to have an early and accurate diagnosis to determine whether a treatable condition other than Alzheimer’s disease, is causing the symptoms. If Alzheimer’s disease is diagnosed, medical treatment and other assistance can be discussed.
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Our Approach To Alzheimer’s Disease
UCSF is an international leader in Alzheimer’s disease research and care. We offer advanced imaging techniques to identify specific dementia disorders, including the amyloid PET scan, which can reveal brain changes characteristic of AD. Our team of neurologists, neuropsychologists, geriatricians and other specialists works closely with patients, family members and referring providers to provide the best possible treatments.
Because caring for someone with AD can be challenging, we work to connect caregivers as well as patients with a network of support services.
Epigenetic Age Analysis Of Different Brain Regions
The is the youngest brain region in centenarians according to an epigenetic biomarker of tissue age known as : it is about 15 years younger than expected in a centenarian. By contrast, all brain regions and brain cells appear to have roughly the same epigenetic age in subjects who are younger than 80. These findings suggest that the cerebellum is protected from aging effects, which in turn could explain why the cerebellum exhibits fewer neuropathological hallmarks of age related dementias compared to other brain regions.
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Fda Grants Breakthrough Therapy Designation To Gantenerumab
Now, a pair of scientists at the Center for the Biology of Chronic Disease in the U.S. have proposed a possible mechanism. In their paper, the teams goal was to connect seemingly unconnected observations reported in the literature to build the molecular dynamics that lead from HSV1 infection to Alzheimers, they wrote.
At times, HSV1 infections can be lytic thats when sores appear. However, most of the time, HSV1 infections are latent essentially, the virus lingers in nerve cells without causing overt damage. The researchers think this phase of viral infection is mainly responsible for the link to Alzheimers.
Although HSV1 doesnt really cause overt damage in the latency phase, the virus is still active. In other words, its DNA is being constantly read in infected cells.
When a cell reads a gene, the process requires certain proteins called transcription factors, which bind to the cells DNA and help to coordinate the reading. When a cell reads a viral gene, it also requires transcription factors, including some of the same proteins needed to read the cells own DNA.
In their paper, the researchers specifically highlight that certain transcription factors particularly one called GABP are used to read certain HSV1 genes during latent infection.
Disrupted autophagy and mitochondrial function, as well as impaired nerve health, are well-established biological hallmarks of Alzheimers.
How Alzheimers Disease Is Treated
Theres currently no cure for Alzheimers disease, but medicines are available that can help relieve some of the symptoms.
Various other types of support are also available to help people with Alzheimers live as independently as possible, such as making changes to your home environment so its easier to move around and remember daily tasks.
Psychological treatments such as cognitive stimulation therapy may also be offered to help support your memory, problem solving skills and language ability.
Read more about treating Alzheimers disease.
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Suzanne M De La Monte
1Department of Pathology, Rhode Island Hospital and the Warren Alpert Medical School at Brown University, Providence, Rhode Island
2Department of Clinical Neuroscience, Rhode Island Hospital and the Warren Alpert Medical School at Brown University, Providence, Rhode Island
3Department of Medicine, Rhode Island Hospital and the Warren Alpert Medical School at Brown University, Providence, Rhode Island
History Of Dr Alois Alzheimer
Dr. Alzheimer went on to publish his descriptions of several similar patients though his work was not welcomed with much enthusiasm. Since Auguste D was not an elderly woman, her condition was termed as pre-senile dementia. However, in the late 60s, the British psychiatrists Tomlinson and Roth questioned this classification.
Today, Alzheimers is the leading cause of dementia and death among the elderly. Unfortunately, the cause and cure for the deliberating disease is yet to be found. But thanks to Dr. Alzheimer scientists and researchers know where to start and which direction to follow.
Devoted Guardians’ Response to COVID-19
Devoted Guardians is actively monitoring the progression of the coronavirus, COVID-19, to ensure that we have the most accurate and latest information on the threat of the virus. As you know, this situation continues to develop rapidly as new cases are identified in our communities and our protocols will be adjusted as needed.
While most cases of COVID-19 are mild, causing only fever and cough, a very small percentage of cases become severe and may progress particularly in the elderly and people with underlying medical conditions. Because this is the primary population that Devoted Guardians serves, we understand your concerns and want to share with you how our organization is responding to the threat of COVID-19.
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Early Onset Alzheimers Disease
Although age is the main risk factor for Alzheimers disease, this is not just a condition that affects older adults.
According to the Alzheimers Association, early onset Alzheimers disease affects around 200,000 U.S. adults under the age of 65 years. Many people with this condition are in their 40s or 50s.
In many cases, doctors do not know why younger people develop this condition. Several rare genes can cause the condition. When there is a genetic cause, it is known as familial Alzheimers disease.
Neuritic Plaques And Neurofibrillary Tangles
The presence of neuritic plaques and neurofibrillary tangles in the brain are used to diagnose Alzheimer disease in autopsy. Neuritic plaquesalso called senile, dendritic, or amyloid plaquesconsist of deteriorating neuronal material surrounding deposits of a sticky protein called amyloid beta . This protein is derived from a larger molecule called amyloid precursor protein, which is a normal component of nerve cells. Neurofibrillary tangles are twisted protein fibres located within nerve cells. These fibres consist of a protein, called tau, that normally occurs in neurons. When incorrectly processed, tau molecules clump together and form tangles.
Both neuritic plaques and neurofibrillary tangles, which also may be found in smaller amounts in the brains of healthy elderly persons, are thought to interfere in some way with normal cellular functioning. However, it is not known whether the plaques and tangles are a cause or a consequence of the disease. Research in animals suggests that amyloid-beta plaques form naturally in the brain in response to infection, serving to entrap microorganisms. The idea that amyloid beta serves as a natural antibiotic implies that Alzheimer disease may be in some way linked to brain infection, plaque formation being either excessive in older individuals or abnormal in some other way in persons who eventually develop Alzheimer disease.
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Key Points About Early
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Alzheimer disease commonly affects older people, but early-onset Alzheimer disease can affect people in their 30s or 40s.
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It affects memory, thinking, and behavior.
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Although there is no known cure, early diagnosis and treatment can lead to better quality of life.
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Stay healthy with a good diet and regular exercise.
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Avoid alcohol and other substances that may affect memory, thinking, and behavior.
What To Do If You Experience These Symptoms
“Life is a gifteven with Alzheimer’s,” tweeted Bennett. But remember: “Memory loss that disrupts daily life is not a typical part of aging,” says the CDC. If you experience any of these symptoms, contact a medical professional. “More than half of people with memory loss have not talked to their healthcare provider, but that doesn’t have to be you. Get comfortable with starting a dialogue with your medical provider if you observe any changes in memory or an increase in confusion, or just if you have any questions.” And to get through this pandemic at your healthiest, don’t miss these 35 Places You’re Most Likely to Catch COVID.
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How Many Americans Have Alzheimers Disease
Estimates vary, but experts suggest that more than 6 million Americans age 65 and older may have Alzheimers. Many more under age 65 also have the disease. Unless Alzheimer’s can be effectively treated or prevented, the number of people with it will increase significantly if current population trends continue. This is because increasing age is the most important known risk factor for Alzheimers disease.
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.
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The Basics Of Alzheimers Disease
Scientists are conducting studies to learn more about plaques, tangles, and other biological features of Alzheimers disease. Advances in brain imaging techniques allow researchers to see the development and spread of abnormal amyloid and tau proteins in the living brain, as well as changes in brain structure and function. Scientists are also exploring the very earliest steps in the disease process by studying changes in the brain and body fluids that can be detected years before Alzheimers symptoms appear. Findings from these studies will help in understanding the causes of Alzheimers and make diagnosis easier.
One of the great mysteries of Alzheimers disease is why it largely affects older adults. Research on normal brain aging is exploring this question. For example, scientists are learning how age-related changes in the brain may harm neurons and affect other types of brain cells to contribute to Alzheimers damage. These age-related changes include atrophy of certain parts of the brain, inflammation, blood vessel damage, production of unstable molecules called free radicals, and mitochondrial dysfunction .
Alzheimer’s Other Contributions To Science And Medicine
Alzheimer was unique in this era for several reasons.
First, he was an excellent scientist, taking detailed notes and using the latest research techniques. In addition to identifying Alzheimer’s disease, his research also included specific findings of brain changes in Huntington’s disease, arteriosclerosis, and epilepsy.
Alzheimer also placed much importance on speaking and dialoguing with his patients at a time when many physicians interacted very little with those in their care.
Alzheimer also is credited for implementing policies at the asylum against restraining patients. He required that his staff treat patients humanely, interact and frequently talk with them, and provide therapeutic baths for them. Previously, patients in an asylum received little care, and the isolation room was utilized frequently. In this way, Alzheimer made a significant contribution to the medical world by impacting how physicians viewed and treated patients as individual persons.
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Thinning Of The Cortex
Advances in MRI technology have provided the ability to see the brain structure in great detail in an easy, non-invasive manner in vivo. Bartzokis et al., has noted that there is a decrease in volume between adulthood and old age, whereas volume was found to increase from age 19â40, and decline after this age. Studies using have identified areas such as the and superior parietal gyri as being especially vulnerable to age-related losses in grey matter of older adults. Sowell et al., reported that the first 6 decades of an individual’s life were correlated with the most rapid decreases in grey matter density, and this occurred over dorsal, frontal, and on both interhemispheric and lateral brain surfaces. It is also worth noting that areas such as the , and surrounding the appear exempt from this decrease in grey matter density over time. Age effects on grey matter density in the posterior temporal cortex appear more predominantly in the left versus right hemisphere, and were confined to posterior language cortices. Certain language functions such as word retrieval and production were found to be located to more anterior language cortices, and deteriorate as a function of age. Sowell et al., also reported that these anterior language cortices were found to mature and decline earlier than the more posterior language cortices. It has also been found that the width of not only increases with age, but also with cognitive decline in the elderly.
What Is The Outlook For People With Alzheimers Disease
Alzheimers disease gets worse over time and is ultimately fatal. Persons with Alzheimers disease live, on average, four to eight years after diagnosis. Some patients can live as long as 20 years after diagnosis. The course of the disease varies from person to person.
Last reviewed by a Cleveland Clinic medical professional on 03/18/2019.
References
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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.