Alzheimer's - causes, symptoms and therapy

Alzheimer's: causes, course of disease, prevention

Alzheimer's disease is a disease in which sufferers suffer from a marked lack of memory, language and orientation function of the brain as well as disorders of reasoning and judgment. Many people also experience illness-related personality changes. Most sufferers are over 65 years old.

contents

• Alzheimer's: causes, course of disease, prevention
• disease
• Seven warning signs indicating Alzheimer's disease
• The early stage of the disease: mild dementia
• The second stage of the disease: moderate dementia
• The advanced stage of the disease: severe dementia
• causes
• Alzheimer's Research
• risk factors
• How to protect yourself from Alzheimer's?
• Drug treatment of Alzheimer's dementia
• history
• What is the difference between dementia and Alzheimer's??

Alzheimer's disease (AK), also known as Alzheimer's disease or Alzheimer's dementia, is a brain organic or neurodegenerative disease. About 60 percent of all dementias are due to Alzheimer's disease. It is named after the German neurologist Alois Alzheimer, who scientifically documented the disease in 1906 for the first time. Even though the disease has been known for over 100 years, it is still considered to be insufficiently understood and the underlying symptoms are currently untreatable.

Alzheimer's is mainly characterized by increasing memory lapses or difficulties in retrieving memories. (Image: Robert Kneschke / fotolia.com)

disease

Alzheimer's dementia is developing slowly, but progressing steadily. As a rule, there is a constant decline in cognitive performance. With a worsening of the condition of the patients decreases in most cases, the independence in everyday life and the patient needs more and more support.

The course of the disease is subdivided into different stages depending on the severity. Each phase focuses on other mental and physical impairments that require other measures.

Alzheimer's disease is divided into three disease states: mild, moderate and severe dementia. (Image: Ocskay Bence / fotolia.com)

Seven warning signs indicating Alzheimer's disease

According to the National Institute on Aging, there are seven warning signs indicating the onset of Alzheimer's disease. Families of the person concerned should seek advice from a physician if several of these characteristics apply. As a feature counts when a person

• more often answers with the same question that was asked to him,
• repeatedly asking the same question,
• very often tells the same story,
• increasingly neglected its outward appearance,
• Everyday things that he or she originally mastered, such as cooking, playing cards or operating household appliances,
• Difficult to handle money, forgets to pay bills or make money transfers,
• frequently misplaced things of everyday life or placed them in unusual places and suspected others of having stolen the items they were looking for.

The early stage of the disease: mild dementia

The first signs of Alzheimer's disease are short-term memory disorders. Those affected often can not remember conversations, have difficulty finding words, forgetting where to put things such as their keys or glasses, and have reduced planning, organizational and orientation skills.

In this phase, those affected often remember their own forgetfulness. Depending on the individual, patients may respond aggressively, afflicted, defensive, depressed or with complete withdrawal when confronted with the symptoms. Many Alzheimer's sufferers try to preserve the semblance of normality as long as possible.

For the most part, patients can handle everyday tasks such as shopping, household maintenance, preparing food, and taking care of their personal hygiene while still on their own. In addition, they can still make limited judgments and solve problems. However, more complex activities such as contracting, banking, and the use of buses, trains, or planes (especially on unknown routes) may require help.

In the case of mild dementia, those affected can for the most part manage their own lives on their own. (Image: highwaystarz / fotolia.com)

The second stage of the disease: moderate dementia

In this phase of the disease, the symptoms reach a level that largely does not permit independent everyday coping. The cognitive performance of the patients decreases so much that they can no longer accomplish simple everyday tasks alone. Also the language ability is formed back. Many sufferers can no longer complete sentences at this stage.

Even long-term memories begin to fade. As part of this phase, Alzheimer's sufferers may forget how old they are, what the spouse or children are called, what profession they did, or similar basic things. In addition, many sufferers are no longer aware of their illness and, for example, suddenly want to go to work or visit the deceased

For relatives, this phase can be very stressful, as the Alzheimer's patients also show increasing behavioral abnormalities. These can include a strong restlessness, aggressiveness, apathy and depression. Often the nerves of the relatives are strained by the constant repetition of the same question or the execution of the same activity.

Patients with Alzheimer's disease in the intermediate phase are often disoriented in public spaces. (Photo credits: Jana Krupik / pixelio.de)

The advanced stage of the disease: severe dementia

In the most severe phase, those affected experience a massive loss of cognitive and muscular performance and control. The patients are now completely dependent on the help of others in all areas. Often, patients can no longer maintain their posture, control bladder and bowel functions and no longer go their own way. It can also cause seizures, limbs and dysphagia at this stage. Many patients are bedridden or require a wheelchair at this stage.

Although Alzheimer's dementia does not directly lead to the death of patients, it increasingly increases susceptibility to infections. Accordingly, infectious diseases are the leading cause of death in Alzheimer's patients.

With severe dementia it often comes to loss of control of many body functions. (Image: Ocskay Mark / fotolia.com)

causes

The causes of Alzheimer's dementia are not fully understood today. There has been no significant progress in research for a long time. Scientists suggest that the protein amyloid-beta (beta-amyloid) plays a key role in Alzheimer's disease. The protein is suspected as a trigger and its presence is considered a symptom of the disease. The beta-amyloid clumps and forms insoluble deposits called amyloid plaques. These deposits disturb the communication of nerve cells.

Another responsible person seems to be the tau protein. It is located inside the nerve cells and ensures the stability of the cells. In addition, the tau protein allows the exchange of information between the nerve cells. In Alzheimer's disease, an incorrectly altered tau protein was detected, which accumulates in the nerve cells and forms the so-called tau fibrils. These have the consequence that the cells lose stability and decay.

The death and dysfunction of nerve cells is considered to be the cause of Alzheimer's disease. (Image: Kateryna_Kon / fotolia.com)

Researchers believe that the combination of these two protein deposits disturbs and destroys neurons over many years, ultimately leading to cognitive impairment in memory, thinking, language, gestures, and orientation. Whether and how the two protein deposits interact and the reasons for these processes have not yet been conclusively clarified. In the course of the disease, up to 20 percent of all nerve cells die. To make matters worse, a part of the surviving cells is disturbed in function.

Alzheimer's Research

All previous drug candidates to stop Alzheimer's disease have failed in clinical trials. Many pharmaceutical companies have given up and stopped the field of research, although there is a significant increase in dementia.

The events suspected to be the cause can begin as early as 20 years before the onset of the first symptoms. So far, however, there is no reliable way to identify people in the pre-stage of the disease. Most clinical studies have looked at people in whom the clinical symptoms are already evident and brain damage has already occurred.

Many areas and relationships of Alzheimer's disease are not fully understood and understood. (Image: goa novi / fotolia.com)

So far, costly and expensive methods are needed to identify amyloid-β in the brain. In addition, the procedures are very uncomfortable for the patients, since they require, for example, a removal of the spinal fluid. While imaging studies such as magnetic resonance imaging (MRI) and computed tomography (CT) can detect advanced Alzheimer's disease, it is usually undetected early in the disease.

A new Alzheimer's blood test will revolutionize the early detection of the disease. The developers of the test hope that it can be used to identify people with Alzheimer's early, before irreversible damage to the brain occurred. This could bring about the long-awaited breakthrough in disease research and the development of appropriate drugs. At the moment the blood test is still in development.

risk factors

Contrary to the uncertainty surrounding the causes of Alzheimer's, scientists are largely in agreement as to which factors favor the development of the disease. Recently, a recent study identified nine risk factors for dementia. According to the researchers, a good third of all illnesses could be prevented by a healthy lifestyle.

The glyphatic system
The glyphatic system can be seen as a disposal system of the central nervous system. This flowing cycle picks up and removes excess and harmful material. The research team led by the Danish neurobiologist Maiken Nedergaard was able to scientifically document this system as a unit for the first time in 2013.

Increasing age
The biggest risk factor is age. Most sufferers are over 65 years old. With age, the risk of developing Alzheimer's dementia increases. Again, the researchers suspect that this is related to the glyphatic system, as the system's performance decreases with age and more pollutants remain in the nervous system. Women are more frequently affected by Alzheimer's disease than men, which is associated with the increased life expectancy of the female sex.

According to the German Alzheimer's Association (DAlzG), around one million people in Germany today live with Alzheimer's dementia. This number is steadily increasing. For the year 2050, the number of cases is estimated at two million unless new therapies are developed. More and more young people are affected.

Sleep disorders are considered to be a risk factor for the development of Alzheimer's dementia, as the detoxification process accelerated during sleep is reduced. (Image: Sven Vietense / fotolia.com)

Risk factor sleep disorders
The previously mentioned deposits of beta-amyloids and the defective tau proteins are transported away by the glyphatic system. During sleep, this system works twice as fast as when awake. During sleep, the brain detoxifies and sleep disturbances reduce this process. Researchers have already discovered that people with sleep disorders are at an increased risk of developing Alzheimer's, Parkinson's and amyotrophic lateral sclerosis (ALS).

Risk factor inheritance
In five to ten percent of the investigated cases of Alzheimer's a familial accumulation was found. Scientists suggest that a variant in the gene for a protein called apo-lipoprotein might be responsible for an increased risk of Alzheimer's disease through heredity. Apo-lipoprotein is present in all humans. It is needed for the transport of cholesterol in the blood. The protein underlying the protein exists in three variants, one variant seems to protect against Alzheimer's and another seems to promote the disease.

Excessive alcohol consumption
People who regularly drink too much alcohol and alcoholics have an increased risk of Alzheimer's disease.

traumatic brain injury
People who have suffered a traumatic brain injury seem to be more likely to be affected by Alzheimer's. The reasons for this have not yet been scientifically clarified. Inflammatory processes in the brain and hormone influences are suspected in this context as factors involved in the development of the disease.

air pollution
Scientists at the Leibniz Institute for Environmental Medical Research have shown a connection between environmental pollution and the development of Alzheimer's disease. Perhaps the ever increasing air pollution is an Alzheimer's cause.

Air pollution caused by particulate matter apparently increases the risk of contracting Alzheimer's disease. (Image: Ralf Geithe / fotolia.com)

Vascular risk profile
Various vascular diseases and conditions increase the risk of developing Alzheimer's disease. This includes:

• High blood pressure (hypertension),
• Arrhythmia,
• Poorly adjusted blood sugar in diabetes (diabetes mellitus),
• High cholesterol levels (hypercholesterolemia),
• Obesity (obesity),
• Smoke,
• Vascular calcifications (arteriosclerosis),
• already suffered strokes.

How to protect yourself from Alzheimer's?

There are a number of preventative measures that can help reduce the risk of illness.

Spermidine and resveratrol
Great potential against mental degradation, current studies attribute spermidine. This is an endogenous cell metabolite and important role in the maintenance of cell processes. Spermidine supports the so-called autophagy processes. These self-cleaning processes digest and destroy the pollutants in the cells, for example the aforementioned protein deposits.

Boosting these processes could thus prevent these diseases. Spermidine in food also seems to be good for the brain. Thus, the effect of natural spermidine, which was obtained from wheat germ, to improve the memory performance after three months of use tends to improve.

Also for Resveratrol positive effects on the memory performance could be proven. This can be obtained for example from grapes and occurs, inter alia, in red wine. Resveratrol is also found in green tea extract. These food substances are said to protect against Alzheimer's disease.

Healthy eating
A Mediterranean diet, such as Mediterranean diets, provides the brain with important nutrients and strengthens its preparedness. Fruits, vegetables, nuts and fish such as salmon, cod or mackerel are on the menu. Extra virgin olive oil also reduces Alzheimer's risk. In addition, red meat should be avoided. In addition, you should regularly drink plenty of fluids, such as water and tea - at least two to three liters a day.

Healthy diet, such as the Mediterranean diet can protect against dementia. (Photo: exclusive-design / fotolia.com)

Spiritual training
It has been observed that a high level of education and mentally demanding activities can reduce the risk of illness. In addition to solving puzzles, music, learning a new language or some games as a mental fitness. In contrast, frequent television is suspected to increase the risk of Alzheimer's. Certain video games may protect against dementia as they stimulate mental activity. Also, impressions that are gained during a vacation can keep the brain fit.

Move
Exercise keeps you healthy and fit and has a variety of positive effects. Exercise can also reduce the risk of Alzheimer's dementia. The brain is better supplied with blood and the nerve cells are strengthened and even new ones are formed. The brain becomes more efficient overall and better protected from the disease.

Folic acid and other B vitamins
Scientific studies have shown that the toxic amino acid homocysteine ​​plays a crucial role in the development of arteriosclerosis. In addition, homocysteine ​​causes the brain to age faster. People with too high levels of this amino acid are twice as likely to get Alzheimer's. In contrast, folic acid as well as vitamins B6 and B12 help to break down toxic homocysteine.

Antioxidants of black and green tea
Several studies have already looked at the antioxidant epigallocatechin gallate found in green teas. There are indications that this antioxidant can prevent and even dissolve the formation of protein deposits in the nerve cells. The same effect is suspected in theaflavin components of black tea.

Antioxidants from black and green tea are supposed to protect against Alzheimer's. (Image: photocrew / fotolia.com)

Drug treatment of Alzheimer's dementia

Currently, there is no drug that can cure the disease. The approved drugs are more effective against individual symptoms and can not stop the progression of the disease. In addition, promising drugs failed in clinical trials and were not approved for treatment or had only minor effects.

Acetylcholinesterase inhibitors
For mild to moderate dementia so-called acetylcholinesterase inhibitors are approved, which are intended to slow down the death of neurons. These inhibitors include galantamine, donepezil, rivastigmine and the active substance huperzine A. Treatment with acetylcholinesterase inhibitors is considered controversial, as different studies have come to different conclusions.

insulin
Insulin administered as a nasal spray was able to positively influence the course of the disease in test persons. Scientists at the Wake Forest Baptist Medical Center in the US reported in the Journal of Alzheimer's Disease that giving a given insulin helps reduce the cognitive impairment of mild to moderate Alzheimer's disease.

history

The symptoms are named after the German psychiatrist and neuropathologist Alois Alzheimer (1864-1915). He was the first to describe the disease in 1901 in the case of the patient Auguste Deter. In 1910, the name after Alzheimer was officially introduced by the German psychiatrist Emil Kraepelin (1856-1926).

Alzheimer's is the most common dementia disease. (Image: Osterland / fotolia.com)

What is the difference between dementia and Alzheimer's??

Dementia is Latin and means "lack of understanding". Dementia itself is not a medical condition, but a pattern of symptoms in which cognitive abilities such as memory and thinking are impaired and can alter the person's behavior. These symptoms can occur in several diseases, which are summarized among dementia. Alzheimer's disease is the most common disease in this group and accounts for around 60 percent of all dementias. (tf, vb; updated on 14.02.18)
Specialist supervision: Barbara Schindewolf-Lensch (doctor) Sources:

• The Lancet Commission on Dementia Report
• The Journal of Alzheimer's Disease (JAD)
• The Alzheimer's Association (2017 facts and figures)
• National Institute on Aging (NIA)
• The information portal neurologists and psychiatrists in the network
• Guideline of the German Society for Psychiatry and Psychotherapy, Psychosomatics and Neurology (DGPPN) and the German Society of Neurology (DGN)
• Alzheimer Research Initiative e.V. (AFI)
• German Alzheimer Society e.V. (DAlzG)
• and linked studies and articles in the text