The spread of Alzheimer's in the brain is decoded

Hypertension increases the risk of Alzheimer's

02/02/2012

After the former manager of Schalke 04, Rudi Assauer, has made public his Alzheimer's disease, the neurodegenerative disease in Germany is again a much-discussed topic of conversation. „Waves online“ Therefore, in conversation with the experts Prof. Elisabeth Steinhagen-Thiessen from the Berlin Charité, Dr. med. Elisabeth Stechl from the Protestant Geriatric Center in Berlin and the chairman of the Alzheimers Relatives Initiative, Rosemarie Drenhaus-Wagner, who discusses important aspects of Alzheimer's disease. In addition, US researchers in the journal „PloS One“ their findings on the spread of Alzheimer's in the brain.

Around 1.3 million people in Germany suffer from dementia, two-thirds of them suffer from Alzheimer's, according to the 2011 Dementia Report from the Berlin Institute for Population and Development. Different factors play a key role in the development of Alzheimer's disease, with the experts interviewed „World Online“ attributed special importance to hypertension as an Alzheimer's risk factor. As another factor that increases the risk of Alzheimer's, Prof. Elisabeth Steinhagen-Thiessen, for example, named diabetes and elevated cholesterol levels.

Growing proliferation of Alzheimer's and dementia
The professor of the Berlin Charité pointed to the growing prevalence of dementia and stressed that the number of Germans affected today by the year 2050 by the year 2050 could double in the opinion of the experts. However, not only Alzheimer's disease but also other forms of dementia such as vascular dementia, which is triggered by vascular changes in the brain, are included in the mentioned figure. As a typical sign of Alzheimer's disease Prof. Steinhagen-Thiessen describes „World Online“ the deposits of protein called plaques in the brain. These result in the early stages of the disease, so that those affected can remember worse and newer information. „Conversation content, appointments and possibly also taking important medications“ are forgotten according to the Charité professor.

Attention, concentration and memory diminish
In addition to memory, attention and ability to concentrate are also affected, which makes it difficult for Alzheimer's patients to carry out parallel activities in the past without any problems. According to Steinhagen-Thiessen, the ability to think is also affected in Alzheimer's patients. In the beginning, those concerned are particularly difficult to understand in complex contexts; even in an advanced stage of the disease, even simple correlations of meaning are difficult, explained the expert. For example, it is typical for Alzheimer's that sufferers lose track of their finances and business affairs. In addition, with progressive Alzheimer's disease, a temporal and spatial orientation loss follow. Alzheimer's patients find it particularly difficult to find their way in unfamiliar surroundings.

Alzheimer's often associated with depression
According to Professor Steinhagen-Thiessen, when evaluating a possible Alzheimer's disease, it must always be considered what skills the patients used to have and what skills they had lost. This is of particular importance for a correct diagnosis, said the expert. According to Prof. Steinhagen-Thiessen, the Alzheimer-related deficits have been discussed with him „World Online“ This often results in those affected having to cut back on their activities, which is often the case „the outside looks as if these people want to retire.“ Many Alzheimer's patients also react „on her dwindling abilities with depression; some also irritated“, explained the Charité professor. Rosemarie Drenhaus-Wagner added that when the first deficits occur, it is necessary to look closely, „whether they have an everyday relevance.“ Because from the first symptoms to severe dementia, according to the experts „ten years and more pass“, although in the early stage of the disease, it would take three to four years to be able to lead an independent lifestyle with support. „You do not have to give it up all at once just because you have been diagnosed with dementia“, emphasized Drenhaus-Wagner „World Online“.

However, Alzheimer's is considered to be incurable until today, so that with appropriate diagnosis in the patients' sense, only a few years can be gained in which they remain longer-term fitness. „There are medicines that can delay the course of the disease for at least one year, so that the phase of long-term care commences later“, explained Elisabeth Steinhagen-Thiessen. However, early diagnosis is of particular importance. This opens, according to the Charité professor also „the chance to prepare for dementia in good time, for example, to issue precautionary powers.“

To use opportunities for Alzheimer's prevention
When asked about the possibilities for Alzheimer's prevention, Prof. Steinhagen-Thiessen explained that blood pressure „a crucial role in the development of dementia“ games. Several large studies have shown that high blood pressure carries an increased risk of vascular dementia but also an increased risk of Alzheimer's. According to the experts, other risk factors are diabetes and high cholesterol. Most of these Alzheimer's risk factors were well treated, „you just have to do it“, emphasized Prof. Steinhagen-Thiessen. According to the Charité professor, even relatively simple methods can already have a significant effect. For example, Professor Verena Stangl from the Berlin Charité discovered in her studies a dementia preventive effect of green tea. If all preventive measures were used, the risk of Alzheimer's could, according to the experts, be considerably reduced overall. But the spread of risk factors such as high blood pressure, diabetes or high cholesterol levels in the population has been increasing significantly for years, so that even against this background, a strong increase in dementia and Alzheimer's disease must be expected. In addition, the likelihood of a corresponding neurodegenerative disease increases with increasing age, which is why a further increase in dementia is to be expected in the course of demographic change.

Spread of Alzheimer's in the brain
Researchers around Li Liu from the Department of Pathology and Cell Biology at the Taub Institute for Alzheimer's Disease Research at Columbia University in New York have featured in the journal „PloS One“ presented a study, according to which Alzheimer's spread in the brain of those affected along the anatomical networks between neurons. The faulty tau protein responsible for Alzheimer's disease jumped from neuron to neuron. According to US scientists, Alzheimer's disease is spreading from the region of the cortex entorhinalis in the brain. In experiments with genetically modified mice, Li Liu and colleagues were able to show that the non-functioning tau proteins in the brain pass from neuron to neuron, causing the onset of Alzheimer's disease. If it were possible to reduce or even prevent the skipping of neuronal tau proteins, this could, according to the researchers, slow down or possibly even halt the spread of the neurodegenerative disease. Here too, however, an early diagnosis of Alzheimer's disease would be of particular importance in order to prevent the spread of tau proteins in the brain as early as possible. (Fp)

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Picture: Gerd Altmann