Alzheimer's Month

On September 21, World Alzheimer’s Day is commemorated, in the context of World Alzheimer’s Month. 

Amarin joins this international campaign coordinated by the World Health Organization in 1994, to raise awareness and publicize the problems faced by people affected by dementia, helping them, their families and caregivers to go through this silent disease.

Alzheimer's statistics

Alzheimer’s disease is the most common cause of dementia, accounting for 60-70% of cases worldwide, although not the only one. In Argentina, it is estimated that 1 in 8 adults over 65 years old suffer from it 1. It affects more than 50 million people in the world, and this number is expected to double every 20 years. This is why today Alzheimer is considered one of the most significant health issues of the 21st century.

What is Alzheimer's?

Alzheimer’s is a neurological disease in the group of neurodegenerative ones.

Although the causes of Alzheimer’s are not yet fully understood, in the brains of people affected by the disease, abnormal deposits of two proteins forming aggregates and inclusions have been identified (senile or amyloid plaques) in and between cells, preventing communication between neurons 2 3. These proteins are called beta-amyloid and tau protein. It is a slow process, in which these denatured proteins begin to accumulate in the hippocampus, triggering neuronal death and the reduction of neurotransmitters such as acetylcholine, that are the key to the proper functioning of the synapse. This process can begin 10-20 years before diagnosis. Over time, the size of the brain is significantly reduced, affecting almost all of its functions

What are the symptoms?

The first symptoms of Alzheimer’s disease are generally mild, but as neuronal damage progresses, they get worse and begin to interfere with daily life. The disease can manifest itself differently in each person, but the most frequent indicators are 4:

  • Memory, in particular, difficulties remembering recent events and learning new information. This is because in the early stages of Alzheimer’s disease, damage occurs in the hippocampus, associated with short-term memory. The memory for events that happened a long time ago is usually not affected in the early stages.
  • Speaks: difficulties in following a conversation
  • Visuospatial skills
  • Concentration, planning or organization: may have difficulty making decisions, solving problems, or carrying out a sequence of tasks (such as cooking)
  • Orientation: they may become confused or lose track of the date.
  • Character: they often have mood swings.
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These signs may be more obvious to family and close friends. As the disease progresses, problems with memory loss, language, reasoning, and orientation become worse, and the patient will need daily care and help.

Some people begin to have delirium or hallucinations. They exhibit atypical behaviors (yelling, repeating the same question, having disturbed sleep patterns, or reacting aggressively).

In the later stages of Alzheimer’s disease, people may become much less aware of what is going on around them. They may find it difficult to eat or walk without assistance, and they become increasingly fragile.

How quickly the disease progresses and the life expectancy of a person with Alzheimer’s vary from person to person.

Treatments

Today there is no cure for Alzheimer’s disease, but there are approved pharmacological treatments 5, which delay its progression and the appearance of symptoms, although they do not reverse it.

The drug Rivastigmine is an example of them. This acts on the neuronal communication process, slowing down the breakdown of the neurotransmitter acetylcholine, which allows nerve cells to communicate. This can be done by blocking the enzymes that break down acetylcholine: acetylcholinesterase and butylcholinesterase. Rivastigmine can be administered orally, either as capsules or tablets, or by applying a patch to the skin.

The advantages of using the Rivastigmine transdermal patch over other routes of administration are the following 6:

  • By entering directly into the bloodstream, it avoids passing through the liver and being metabolized.
  • Fewer side effects (nausea, vomiting, and other gastrointestinal problems) were reported.
  • Delivers a constant drug level over a long period of time.
  • It can be given even when the ability to swallow is affected by the disease.
  • They can be withdrawn immediately if adverse effects occur.

It is important to mention that cognitive stimulation, although it has not shown significant efficacy in preventing or slowing the progression of the disease, exerts a beneficial effect on patients and caregivers, not only of a cognitive nature but also of a behavioral nature. it is recommended as a complement to pharmacological therapies. 

The World Health Organization has issued the guide “Risk reduction of cognitive decline and dementia” 7 published by PAHO, which analyzes the risk and worst-case factors related to dementia. It proposes the early detection of the disease as a useful tool to delay the appearance of disabling symptoms due to the adoption of hygienic and therapeutic behaviors similar to those recommended for cardiovascular diseases.

 

References

1https://www.osinsa.org/2019/10/15/alzheimer-1-de-cada-8-adultos-mayores-lo-padece-en-la-argentina/

2https://alzheimertierradebarros.es/index.php/component/k2/1-noticias-de-alzheimer/953-no-es-solo-la-acumulacion-de-la-toxina-amiloide

3https://www.alz.org/alzheimer-demencia/que-es-la-enfermedad-de-alzheimer?lang=es-MX#Placas%20y%20ovillos

4https://www.alzheimers.org.uk/about-dementia/types-dementia/alzheimers-disease-symptoms#content-start

5https://www.alz.org/alzheimer-demencia/tratamientos

6https://www.argentina.gob.ar/noticias/apostar-al-desarrollo-de-productos-transdermales

7https://iris.paho.org/bitstream/handle/10665.2/52426/9789275322574_spa.pdf?sequence=1&isAllowed=y

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