Those are words that no one wants to hear: Alzheimer’s disease and dementia. As the population ages, more and more older people lose their important memory and thinking abilities, and ultimately even the most basic functions of their daily lives.
Researchers say that dementia is so diverse and complex that there are more questions left than answers on how to prevent them.
“This is a condition with multiple medical conditions,” said Cynthia Remeer, the immediate chair of the Alzheimer’s Association’s Medical and Scientific Advisory Group. “A lot of research is currently being done.”
Although there are many causes of dementia, most of the research revolves around Alzheimer’s disease, which accounts for 60% to 70% of all cases.According to the Alzheimer’s Disease Association, more than 6.2 million people live with Alzheimer’s disease disease, The number expected to double by 2050.
The federal government spends about $ 3.1 billion annually on research on Alzheimer’s disease. An additional $ 250 million comes from the Alzheimer’s Disease Association, and last year the American Heart Association announced a joint brain health research project with Billgates to accelerate early detection and treatment of Alzheimer’s disease and related dementia. We supported the efforts of the global network between the research centers of. ..
Many drugs have been tested. Some are thought to be one of the hallmarks of the disease, some that work by tracking beta-amyloid protein. When this protein accumulates in the brain, it aggregates to form plaques that stick between nerve cells, disrupting the cells’ ability to communicate.
Remeer, an associate professor of neurology at Brigham and Women’s Hospital in Boston and the Anromney Neurological Disorders Center at Harvard University School of Medicine, has been working on aggressive Alzheimer’s disease vaccines and antibodies for the past two decades. Amyloid plaque..
Studies show some possibilities, but it was difficult to obtain enough antibody to cross. Blood-brain barrier, She said. Nonetheless, “there are three or four drugs in this class that come down the pipeline that looks promising.” Drugs targeting amyloid plaques received conditional approval from the Food and Drug Administration this summer and require further testing to validate their benefits.
A new field of research is focused on drugs that stop the spread of a protein called tau, which is needed to stabilize the structure of nerve cells. In the brain of people with Alzheimer’s disease, tau changes its structure and aggregates within the cell to form entanglements. Tangles block nutrients and communication from moving inside cells and eventually die. It is then that the symptoms appear.
“Alzheimer’s disease does not begin when memory loss begins to be seen, but begins 15 to 25 years before these spots and tangles are formed,” Lemere said. “If you have both for a long time, neurodegeneration will begin.”
So far, researchers have seen the best results in patients in the early stages of Alzheimer’s disease, Remea said. “Previous clinical trials have shown that these drugs do not work well in people with moderate to severe Alzheimer’s disease. If someone has already lost 40% of the hippocampal neurons, clear the plaque. But they don’t go back, so we need to continue. To find a way to help late-stage people with illness. “
The cause of beta-amyloid accumulation is unknown in the first place.Some people believe it might be Immune system reaction NS Virus infectionIt may also be associated with periodontal disease bacteria such as herpes.
“We have found that amyloid plays a role in protecting the brain from infection,” said Dr. Mitchell Elkind, a former president of the American Heart Association. He is a professor of neurology and epidemiology at Columbia University Irving Medical Center in New York City.
When an infection attacks the brain, he said, beta-amyloid can be overproduced as part of the immune response. One method of investigation is to prevent antivirals from slowing the progression of Alzheimer’s disease or disease, based on the theory that eliminating the stimulating insults of infection can probably reduce the amount of amyloid. It is hypothesized that it can be done. This is an exciting possibility. “”
According to Elkind, research on COVID-19 may be useful. “For those of us who are interested in the notion that infections can exacerbate dementia, COVID provides a great model because there are so many around it. Viruses can cause long-term cognitive decline. Helps answer the question of whether or not you have sex. I don’t know yet. “
When viruses and bacteria activate the immune system, they also cause inflammation, which researchers believe contributes to plaque development.
“Inflammation is currently a hot button for Alzheimer’s disease research,” Elkind said. Researchers are investigating whether anti-inflammatory drugs can be used to prevent symptoms.
Remeer said he believes that the most promising approach may be a combination of drugs that help immune cells in the brain work while suppressing inflammation.
“It will be a wave of the future,” she said. “Probably an anti-inflammatory drug containing tau antibodies to prevent downstream neurodegeneration.”
However, even if researchers succeed in developing a drug that removes amyloid plaques and tau tangles from the brain, they cannot stop other forms of dementia, said the director of the Alzheimer’s Disease Research Center at Mount Sinai Health System in New York. Said Dr. Mary Sano. city.
About 10% of dementias are vascular and are associated with stroke and poor blood flow to the brain. Others have mixed dementia, which can be a combination of Alzheimer’s disease, vascular dementia and other less common types of dementia.
The Sano Center works with people who often develop dementia associated with risk factors for type 2 diabetes and heart disease. High blood pressure, And these “have very different profiles of cognitive impairment.” For example, people with diabetes start with bigger problems with executive function, such as their ability to plan and organize. You may have less memory loss.
Lifestyle behavior continues to be an important tool for preventing vascular dementia, she said.Control blood pressure, cholesterol, blood sugar and make others Lifestyle changesAll of the indicators AHA calls Life’s Simple 7, such as smoking cessation, exercise, a nutritious diet, and weight loss, have been shown to help maintain brain health over time.
According to Elkind, this needs to start early. “It is not the blood pressure of the 70’s and 80’s that causes dementia, but the blood pressure of the 40’s and 50’s.”
According to Remea, one of the best things people can do is exercise. “Promotes cardiovascular health associated with brain health. It has anti-inflammatory properties and promotes sleep. Sleep deprivation is a risk factor for Alzheimer’s disease, and exercise is the maximum that people can avoid or mitigate risk. Is one of the methods. dementia.. ”
American Heart Association
Quote: What are researchers doing to stop dementia? (August 30, 2021) Obtained August 30, 2021 from https: //medicalxpress.com/news/2021-08-dementia.html
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