Alzheimer's not curable

Scientists warn: Alzheimer's not curable. Experts call for better care of patients

13/01/2011

Although Alzheimer's research has brought in recent years, a large increase in knowledge, it is unclear from a scientific perspective, if and when an Alzheimer's drug to cure the most common form of dementia will be available, stressed the experts in a symposium of the brain league e.V..

Several experts presented and discussed the current state of research on Alzheimer's disease during the symposium of the brain league in Frankfurt am Main on Tuesday. They pointed out that despite intensive research, Alzheimer's will not be curable in the longer term, which is why emphasis should be placed on the possibilities for early detection and treatment. The opportunities must be harnessed to delay the outbreak and progression of the disease for as long as possible, rather than continuing to hope to research a patent remedy, the experts said. Not only do the scientists keep an eye on the health of every individual, but they also see a growing threat every year in the sharp increase in Alzheimer's disease „our social security systems“.

27 million Alzheimer's diseases worldwide
The number of Alzheimer's diseases has increased rapidly worldwide in recent years. According to the deputy brain league chairman Hans Gutzmann, around 27 million people worldwide are currently affected. Currently, around one million people in Germany suffer from Alzheimer's disease, with around 200,000 people added every year, according to the expert. Recent studies suggest that the number of Alzheimer's patients in Germany could double or even triple by 2050. However, a large number of illnesses remain unrecognized and are therefore not treated, Gutzmann explained. Thus, only about ten percent of those affected in the course of their disease would be examined by a specialist.

Alzheimer's burden on the entire family
The director of the Department of Psychiatry, Psychosomatics and Psychotherapy of the Frankfurt Goethe University, Harald Hampel, explained the Alzheimer one „highly complex and chronic“ ongoing disease is characterized by progressive memory loss and the loss of other higher brain functions to complete loss of autonomy. The patients are often dependent on care around the clock in the later stages of the disease, which usually affects the entire family, Gutzmann added. According to the expert, the high physical and emotional burdens are hardly sustainable for the relatives in the long term, so that about one third of the family caregivers suffer from depression, burnout and similar disorders.

Better care of Alzheimer's patients called for
As part of the brain-league symposium, the experts also called for the improvement of the care of Alzheimer's patients. The scientists criticized that dementia patients often received inappropriate medication. The gerontopsychiatrist Ralf Ihl emphasized at the symposium that less than 20 percent of dementia patients who are members of the statutory health insurance fund, get appropriate medication prescribed. At least twice as many among privately insured patients, Ihl explained. The expert also cited from a study that revealed that almost 90 percent of neurologists would prescribe a relatives of the symptoms of an acetylcholinesterase inhibitor, that is, a drug to block the breakdown of nerve cells, a relative. 64 percent of the respondents said they would do so. In the context of his contribution, the gerontopsychiatrist emphasized that in reality, however, only 44 percent of patients with symptoms reported that neurologists prescribed an acetylcholinesterase inhibitor and that GPs actually did so in only nine percent of patients. As a reason, GPs and family physicians in the study mentioned budget constraints as the most important cause.

Alzheimer's early detection improved significantly
The Frankfurt psychiatrist Harald Hampel also emphasized that despite the considerable research successes, Alzheimer's will not be curable for a long time yet. However, significant progress has been made in the diagnosis and identification of risk genes, so that researchers' current efforts are more focused on improving early detection and developing drugs to delay disease progression, Hampel said. It is one of the key research findings of recent years that the pathological processes in the brain, which are considered to be the cause of Alzheimer's disease, have been detectable decades before, stressed the Frankfurt psychiatrist. Thus, early detection is possible, for example, by magnetic resonance imaging and biomarkers.

Numerous risk factors for Alzheimer's Disease known
In addition, a number of genes have been discovered, whose changes one can detect an increased risk of Alzheimer's, explained Hampel. In addition, according to the scientist, current findings point to this, „that fat and cholesterol metabolism as well as the immune system“ in Alzheimer's disease one „play important roles“. Other risk factors for the development of Alzheimer's disease, according to the Frankfurt pharmaceutical researcher Gunter Eckert, including high blood pressure, a high level of the metabolic intermediate homocysteine, diabetes, obesity and smoking. Alzheimer's prevention, however, has been proven to have a healthy, Mediterranean diet and physical and mental activity, said Eckert.

Drug treatment insufficient in Alzheimer's disease
The Krefeld gerontopsychiater Ralf Ihl devoted himself in his contribution several topics. The expert commented on the usual methods of medication and listed, among other things, five substances that can currently be used to treat Alzheimer's disease - such as ginkgo-derived preparations. According to Ralf Ihl, occasionally good results can be achieved with the approved medications if they are combined, but this should not be done without medical approval. The Krefeld Gerontopsychiater criticized in his speech also the unequal treatment of statutory insured and private patients. As shown, only about 20 percent of the statutory insured receive appropriate anti-dementia drugs, private patients would be twice as often adequately treated medically. In essence, the problem is that GPs do not prescribe medication for fear of budget overruns, which could delay expensive home care for up to a year.

Dementia plan and merger of nursing and health insurance required
To the „Mortgage Dilemma“ in the treatment of Alzheimer's disease, Ralf Ihl also called for a merger of the nursing and health insurance fund. For the health insurance companies would consider dementia diseases more as a care problem and less as a medical problem, so the statements at the symposium of the brain league. However, adequate treatment would not only delay the need for care, but ultimately also significantly reduce costs, emphasized Ralf Ihl and therefore called for a national dementia plan, such as those already in use in France or the USA. According to the expert, it is necessary to coordinate all actions against dementia, from the politico-local level to the research level. In addition to drawing up a dementia plan, the necessary financial resources must be provided to successfully counteract the growing number of Alzheimer's diseases. There is also an urgent need for action at European level, emphasized Ihl.

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Picture: Slydgo