Alzheimer’s Disease – Paths for Treatment

The world’s leading Alzheimer diseases is accounting for 60-70% of cases of dementia typically represent the progressive memory decline. Initially, Alzheimer is accompanied by cognitive dysfunctions such as visuospatial abnormalities, language disturbance, executive problems and navigation difficulties. These conditions are making life problematic even behavioural psychological symptoms of dementia (BPSD) has been seen during disease progression.

There are several risk factors associated with AD including age, diabetes, obesity, hypercholesterolemia, low education level or traumatic situations. Cummings et.al, 2018 has said, a mutation in gene presenilin 1 (PSEN1) and presenilin 2 (PSEN2) are linked with the autosomal recessive disorder. 

Since the 19th century, researchers have been focused on discovering new pathways for its treatments as the number of AD cases is growing exponentially. According to Salzberg, more than 5 million people are managing their life with Alzheimer’s in the US, costing $300 billion in 2020. As the population becomes older, this condition becomes worse. In this review, we are going to discuss and try to recognize the most important treatment currently utilized and studied in i-iii trials.

Introduction

AD is a complex, most prevalent subtype, neuropathologically disorder which is the main concern of dementia. It is differentiated by extracellular amyloid plaque, nerve cells deaths, and tangles in intracellular fibres. 

In People constantly battling with Alzheimer, beta-amyloid protein accumulation seems to disturb brain function. That means if beta-amyloid protein gets eliminated, the diseases can be treated effectively, however, articulation of three-layer pharmacological pathways for drug approval is needed. 

Alzheimer’s is named after Dr Alois Alzheimer when he noticed changes in brain tissues of a woman who died in 1906 because of persistent mental illness. When the woman died, he examined brain tissues and found abnormal amyloid protein clumps and twisted neurofibrils. 

Another feature identified in Alzheimer patients was a disturbing connection between brain and muscles and damages in Hippocampus areas (Schachter and Davis, 2000). But the real cause of AD is still ambiguous. 

Every year substantial death in the UK, Australia, and the United States is linked with pathogenesis. Solely in the United State, the mortality rate has crossed 38.5% between the year 2000 and 2018. Many scientists believe the earliest way to cure AD is to take medication as soon as possible.

Stats for a Growing Mortality Rate of AD

With the help of a combination of treatment, doctors, professional have been trying to uproot diseases, even after vigorous medical practices, no permanent cure has been identified. Contempt the growing population with AD is heart-wrenching and requires the immediate attention of the government. 

According to the Statista report, 2018, the mortality rate due to Alzheimer in the old age group has reached 38%. That means 38 persons out of 10000 people will die because of this disorder. There is a hefty amount being allocated in Medicare which is expected to grow by $700 billion by the end of 2030 (National Institute on Aging, 2020). 

Reviewing and meta-analysis of treatment given to AD patients’ forebrain chlorogenic system is affected at the early stage of diseases that enforces loss of acetylcholine neuron functions, degradation, memory loss etc. 

Alzheimer Diseases Management

For treating AD patients, overall four to five treatments are approved by FDA and licenced in the EU over a decade ago. This will include cholinesterase inhibitors, memantine and N methyl galantamine and rivastigmine. For a person having moderate to severe AD, a fifth treatment operation is approved consisting of fixed combined dosage of donepezil and memantine standardly known as donepezil therapy. In the past 15 years, most therapeutic agents were failing due to the complexity of AD (Huang et.al, 2015). 

The main prescription given to a patient with AD are-

Acetylcholinesterase (AchE) inhibitors

This is used to increase the level of acetylcholine which is a substance helping neurons to communicate with each other, but this is prescribed only by a neurologist. 

A person who is at an early stage of AD is given Donepezil, galantamine and rivastigmine which has some side effects like nausea, vomiting and appetite loss.

Memantine

This is not an Ache inhibitor that works by blocking excessive amounts called glutamine. It is suitable or prescribed to those who are allergic or unable to take Ache combination. This is also showing its side effects at early stages, like constipation, dizziness, or headache (Nhs.uk,2020)

Sometimes other medications are also prescribed to treat BPSD under the circumstance. Apart from medicine, cognitive therapies are also used to communicate patiently with AD. As of 2018, Dementia was a subject just a subject of stage iii trials, later on, putative therapies are included allowing exploration of cognitive activities and regulatory guidance driven by FDA, and EU. In essay writer point of view, the most prominent one is-

Cognitive Stimulation Therapy

Under this, an occupational therapist, or relative or friend working as a professional teaches daily tasks activities to patients and tries to achieve them. Cognitive rehabilitation works to helps the brain part which is not functional

Reminiscence

This included talking or telling a story about the pasts to the professionals. It is usually completed with pictures, images or movies. It enforces the patient to recall the memories from past to present and aiming to improve their mood and well being

Future of Alzheimer Treatments

There are several studies that have been carried out to look beyond AD addressing underlying symptoms treatment. In undergoing trials, scientists have been trying to develop immunization therapies, drug therapies, and cardio activities to enhance brain activity (Yiannopoulou & Papageorgiou, 2013).

Conclusion

Despite the complexity of AD, scientists and researchers are trying harder to eliminate AD permanently. This is a major concern as half of the old age population in different parts of the world is living with AD. Under this report, we have discussed the rate at which AD mortality rate is growing as well as discuss the challenges and treatments used by a neurologist. We have first enumerated how age, diabetes, obesity, hypercholesterolemia, low education level or traumatic situations and genetic factors like a mutation in gene presenilin(PSEN1) and presenilin(PSEN2) leads to the development of AD. Then after we have enlisted, statistics contribute to huge cases of AD over the decades.

At last, we have defined the treatment procedures including therapies such as cholinesterase inhibitors, memantine and N methyl galantamine and rivastigmine combined dosage of donepezil is given to patients who have a severe or moderate illness. Also, some treatment like reminisces enforces the patient to recall the memories from past to present and aims to improve their mood.