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Sep 14, 2017 in Medicine
Alzheimer's disease is an incurable degenerate disease of the central nervous system, being characterized as a gradual loss of mental capacities (memory, speech, logical thinking). The risk of Alzheimer's disease development increases after 65 years old. In spite of the fact that a few people suffer from this disease, it is one of the main reasons for the weak-mindedness at elderly people. This disease is a substantial problem and a heavy psychological loading for the members of the family of a patient.
The exact reasons of Alzheimer's disease are unknown, but usually, it is connected with the destruction of a large number of nerve cells, insufficiency of substances, necessary for the transfer of nervous impulses, heredity (genetic predisposition), poisoning with toxic metals, injury of the head, brain tumor and hypothyroidism.
The medical treatment of Alzheimer's disease practically does not make a success.
How Alzheimer's Disease Begins
Alzheimer' disease is "a disease at which cells of a brain perish that leads to heavy disorders of memory, intelligence, others cognitive functions, as well as to serious problems in the emotional and personal sphere and behavior." (Ziesel, 2009).
Today, Alzheimer's disease is recognized as one of the most common causes of senile dementia (up to 40% of all cases). On the average, 5% of elderly people suffer from it at the age of 65-80 years old and about 25% aged after 80 (Sarlin, 2012).
The number of patients is constantly growing. In recent years, it has increased from 24 million (2001) to almost 36 million (2012) people (Sarlin, 2012). According to the most conservative forecast, the diagnosis "Alzheimer's disease" will have been put to more than 100 million patients around the world by 2050 (Ziesel, 2009) (See Figures 1,2,3).
The main reason of the growth of patients' number with Alzheimer's disease is an increase in the life expectancy in developed and the majority of developing countries. Statistically, "the risk to develop Alzheimer's disease in the people of the retirement age increases twice every five years of life" (Newport & Hirsh, 2011). There is a dependence that the older people grow after reaching 65 years old, and the longer these people live, the more the Alzheimer's disease distribution is.
This disease affects people irrespective of their nationality or their social and economic status. The earliest beginning of this disease was recorded in a person aged 28, but usually, it is shown after 40-50 years old. Though Alzheimer's disease often remains unknown, it takes the fourth place among the causes of death: in the USA, more than 100 thousand people die of it a year, which influences negatively on the society. (Newport & Hirsh, 2011).
Mechanism of Alzheimer's Disease Development
According to the modern scientific research, Alzheimer's disease is caused by the fact that proteinaceous deposits, which prevent the connections of these neurons with other cells, are formed around neurons and inside them, which leads to their death. When the quantity of nerve cells and connections between them decrease critically, the brain ceases to cope with its habitual functions that affect both the behavior and general condition of a person to a considerable degree. From this point, Alzheimer's disease is shown in external signs. As scientists have not found any effective ways to prevent the formation of proteinaceous plaques yet, the main method of medicamentous fight against Alzheimer's disease is an impact on work of the mediators, providing connections between neurons. In particular, inhibitors of acetylcholinesterase influence acetylcholine, and memantine medicine influences a glutamate.
Alzheimer's Disease Symptoms
Though the clinical record and its external manifestations can significantly vary in different patients, experts allocate the main stages of the disease, connecting them with the emergence of certain symptoms of Alzheimer's disease—frustration in cognitive, emotional, communicative and other spheres.
Such cognitive frustrations as memory violations, attention instability and disorientation in time are considered typical of an initial stage of Alzheimer's disease. The illness quite often has an effect on changing the patient's character. He or she becomes rough and reserved. In certain cases (no more than 20%), "the patients observed suffer from the attacks of unmotivated jealousy or suspicion in evil intention of close people" (Newport Hirsh, 2011).
The patients and their relatives are inclined to explain all these changes as an over-fatigue, depression, combination of circumstances or misunderstanding. The glasses left at home, not turned off light, differences in mood are perceived as "nothing unusual" and "they do not connect it with Alzheimer's disease" (Brackey, 2008). This period can proceed from several months to several years, depending on a set of the factors, defining the course of disease. However, the time passes and it becomes impossible to ignore essential memory blackouts and significant changes in the identity of patients anymore. It is necessary to ask for the doctor's help, and it is only necessary to regret not doing so earlier. According to the experts' opinion, "the treatment of Alzheimer's disease is more effective at an early stage" (Newport Hirsh, 2011).
At the following stage of the disease, the symptoms are aggravated. Forgetfulness progresses: the patient forgets the names of close people and their appearance. It is more difficult for him or her to remember the names of habitual subjects; the failures in own speech and problems with understanding of written and oral messages become more and more significant.
At this stage of Alzheimer's disease, the symptom is inertness of the patient. His or her reactions become stereotypic and sample. The loss of spontaneity leads to the indifference. The professional activity of a patient can proceed only in those spheres, where the stereotyped actions are used, which have been developed for many years.
The following stage in the development of the illness is its developed form when the signs shown earlier reach their maximum. The patient ceases to understand the speech addressed to him or her and makes senseless shouts or a flow of unclear incoherent words (logorrhea) instead of phrases, depending on the affected zones. The disorder of speech actions is shown both in oral speech and writing. It is not better with understanding of drawings, which ceases to be perceived by the patient as a whole. Only separate elements are isolated in them that act as a symptom of spatial agnosia the impossibility to define the position of subjects in space.
All other symptoms also progress. The patient ceases to be guided in time and space: he or she can call neither a current date nor a month, nor even a year; the patient forgets the age, can easily be lost in the place earlier well-known to him or her and ceases to recognize acquainted and close people. At this stage, there is quite often "a shift in the past": the patient starts considering himself or herself as a child or a teenager (Sarlin, 2012).
The care of the patient becomes seriously complicated as he or she loses elementary skills of using the household devices; furthermore, the patient is not able to look after himself or herself, as well as adhere to elementary rules of hygiene. Such skills of a person as standing, sitting and walking are subjects to the disintegration. Gluttony and hypersexuality can also develop.
All these changes are quite often accompanied by noticeable changes in the emotional status. The apathy typical for patients with Alzheimer's disease can be replaced by the irritability from time to time. Probably, the emergence of epileptic seizures, as well as delirium and hallucination, are found. The latter has no phantasmagoric character; they are made of freakish combinations, household scenes well familiar to the patient and proceed on a negative background of the damage expectation.
The final stage of the disease is a deep general weak-mindedness, the loss of all acquired skills and preservation of only basic reflexes (respiratory, chewing and swallowing), supporting an organism's life.
There is no test, which would allow diagnosing Alzheimer's disease unmistakably. Therefore, the doctor needs to exclude other defiant symptoms of dementia of the disease, especially those, which can be treated: traumas, tumors, infections, metabolic disorders, an overdose of medicines, as well as mental disorders such as a depression or disturbing syndromes. Even after an exception of other diseases, the diagnosis of Alzheimer's disease remains presumable. It is possible to confirm it with only a microscopic research of the brain tissue, which is usually made after death. Only occasionally, this research is conducted at the live person by taking a biopsy or small samples of brain tissue.
According to numerous supervisions, people with a high education level and intelligence have Alzheimer's disease less often, and in case they get sick, they keep cognitive abilities much longer. Possibly, it occurs so because "the people with a good education and high I.Q. have more associative connections in a cerebral cortex and their compensatory opportunities are higher" (Hurd, 2012).
Medical treatment of Alzheimer's disease practically does not make a success. However, after the development of a regenerative pharmacology based on the stem cells transplantation, patients suffering Alzheimer's disease can hope to recover. After executing the transplantation of early neural stem cells against the simultaneous intravenous injection of hemopoietic cells, Alzheimer's pathological processes can be stopped at the expense of the replantation of the transplanted neurons, beta-amyloid and tau-protein, synthesis of which is not broken. At the early stages of the development of Alzheimer's disease, such a treatment is the most effective.
The Institute of Cellular Therapies has an experience of the treatment of Alzheimer's disease at the stages of early dementia and pre-dementia. As an example, there can be given the results of treatment of the patient with an accurately established diagnosis of Alzheimer's disease.
The patient, aged 54 years old, arrived on a treatment with complaints to progressing job activity violation that was shown in a pathological obliviousness. The patient could carry out the same elements of actions 5-6 times for a working day, whereas he forgot each time that this work had already been performed. Besides, he frequently forgot, almost instantly, the assignment given to him. Due to that fact, he had serious troubles at work. The patient was apathetic, did not show any interest to the process of treatment and treatment methods. He arrived on the treatment with his personal physician, who reported the statement of the diagnosis of Alzheimer's disease in the country of accommodation. The diagnosis was confirmed at the research of spinal liquid on a beta-amyloid and tau-protein.
In the clinic of the Institute of Cellular Therapies, the patient underwent a transplantation of neural stem cells, simultaneously changing hemopoietic cells. Then, the patient was returned to his country, receiving a special diet (vegetables, fruits, fish, olive oil, red wine), vitamin therapy (C, B3, B12, and folic acid) and pharmacotherapy (memantine "Akatinol" +donepezil) (Brackey, 2008).
Three months later, the patient passed a special test on the NINCDS-ADRDA Alzheimer's Criteria complex, psychological test and neuropsychological MMSE test on depression have shown positive results. Six months later, hemopoietic and neural stem cells were transplanted to the patient again. As a result of the treatment, progressing of the disease was blocked, short-term memory was restored, the patient was under the supervision, but he could continue to work successfully.
Now, the numerous researches, directed at the clarification of the role of a virus infection, heredity, pathological immune reactions, environmental factors and toxic substances in the disease development, are conducted (Hurd, 2012).
The group of the scientists of the Harvard University came to a conclusion that the risks of the development of Alzheimer's disease increase considerably at a regular and enormous usage of the food, rich with saturated fats, first of all, red meat and animal oil. In general, it was known long ago that saturated fats harm people's health. Concerning their influence on the memory, scientific researches were not conducted before. The development and existence of the problems with memory in elderly people is "the first disturbing thing that reminds about Alzheimer's disease" (Pattee, 2001).
The scientists from the University of Pennsylvania defined a positive influence of an almond diet on the brain work of mice with Alzheimer's disease. The leading authority on the topic is Jason Karlawish, an associate professor of medicine, who is sure that almonds contain natural stimulating substances, which allow developing an effective system of treatment for patients at an early stage of Alzheimer's disease in the near future (Vaughn, 2009). Jason Karlawish is an expert on research ethics and nursing decision makings dealing with memory disorders. He has published a substantial number of medical studies and researches on dementia care, and he got lots of awards and prizes for his contribution to the disease treatment and medicine.
It is also possible to suspend temporarily or slow down the disease progressing by means of the preparation "Takrin", but a full healing is impossible now. Therefore, the treatment mainly is symptomatic. Patients and their families are assisted to adapt to the illness. It is necessary to aspire the patient to lead an active way of life as much as possible. The medicinal therapy is appointed at the emergence of nonsense, excitement or other changes in behavior.
The U.S. President Barack Obama reported about the initial investments of 100 million dollars into the project directed at studying of the work of a brain and the best understanding of such diseases as epilepsy and Alzheimer's disease (Putton, 2012). Obama declared that the previous initiatives, similar to the "human genome" project, completely changed the understanding of genetics of a person (Putton, 2012). Now, Obama wants to make the same in the field of studying of a person's brain. The project received the name BRAIN that is deciphered as Brain Research through Advancing Innovative Neurotechnologies. The work on the project will begin in 2014, and the National Institute of Health Care (NIH), the Agency of Perspective Research Defensive Projects (Darpa) and the National Scientific Fund (NSF) will take part in it. The creation of new technologies for studying of the way how billions of cells of a human brain interact with each other will be the purpose of investments of 100 million dollars. The scientists will also study how the human brain uses, stores and processes the information, as well as how the functioning of a brain is connected with a person's behavior.
Alzheimer's disease should be studied further and deeper as nowadays, there is no finally confirmed way of the treatment, which helps to prevent or to slow down significantly its progressing. As the existing therapy of this pathology does not give desirable results, researchers of the whole world are engaged in the development of new methods of treatment. Fundamental researches gradually open some links of dementias pathogenesis of Alzheimer's disease in order to create a theoretical basis for the development of new methods of therapy.