Alzheimer's Disease

Although there are many misconceptions, this essay will focus on the facts of Alzheimer's disease. It will explore the difference between early on set and late on set Alzheimers, and the risk factors and treatment options that exist.

If you come across any mistakes or false information, feel free to leave a comment or send me an email. Im always looking to improve my work.

Essay

“Alzheimer’s disease is a neurological condition where amyloid and tau proteins form plaques and tangles in the brain, causing it to shrink.”

Alzheimers is a progressive and neurological disease which results in dying cells and the brain atrophy (Mayo Clinic). It is caused by an unusual protein build up in and/or near to the brain. There are two two types of abnormal proteins that cause Alzheimer’s disease, amyloid proteins and tau proteins. Amyloid proteins form plaques between the nerve cells and brain tissues. They form in the central nervous system and are often specifically located in the hippocampus part of the brain which is responsible for memory. Tau proteins on the other hand, form tangles as they twist due to an additional amount of phosphate molecules attached to them. As the brain cells go bad, it leads to a decrease in neurotransmitters. Acetylcholine is usually particularly low in people with Alzheimer’s (Smith, Yolanda)

The obvious symptom of Alzheimer’s disease that most people would guess is memory loss. This makes it difficult for patients to take in and recall information leading to them losing their possessions or getting lost. However, Alzheimer’s also comes with other symptoms such as behavioral changes. Someone with the diseases is more prone to losing empathy, losing interest and motivation, and mood swings may happen more often. Cognitive deficits are another large part of Alzheimer’s. This creates a difficulty with reasoning, judgements and complex tasks. Spatial awareness problems also make it difficult to do complex tasks but more due to balance than cognition. Two other main symptoms of Alzheimer’s are recognition problems and language problems. With recognition difficulties a patient will not be able to recognize faces or objects. Moreover, language problems include troubles with speaking, reading, and writing.

Alzheimers is one of the most common diseases that affects the whole population, although there still are risk factors that make someone more likely to develop the neurological disease. The main risk factor is age. After the age of 65, a person becomes twice more likely to develop the disease after every 5 years. Despite the fact that most Alzheimer's are not inherited, there is still a genetic variant of the APOE gene on the 19th chromosome which is believed to increase the risk of developing Alzheimer’s. It is important to note that contrary to some beliefs, Alzheimer’s disease does not skip a generation. Another risk factor that many people are unaware of is having Down's Syndrome. This happens because Down’s syndrome also causes amyloid plaques which can lead to Alzheimer’s. Other risk factors include smoking, diabetes, high cholesterol, high blood pressure, untreated depression, obesity and hearing loss (Nhs.Uk)

There are three stages to this degenerative disease; mild, moderate, and severe. With a mild Alzheimer’s it starts with memory problems and cognitive difficulties. The disease then progresses to moderate Alzheimer’s where the part of the brain that is responsible for language, senses, reasoning and consciousness becomes damaged. This part of the brain is called the parietal lobe. The final stage is severe where the brain shrinks because of the plaques and tangles most often resulting in complete memory and communication loss (MacGill, Markus). In addition to this, people can have either early onset Alzheimer’s or late onset Alzheimer’s. Only 1 in 20 people with Alzheimers have early onset Alzheimer’s. The main difference between the two is that with early onset Alzheimer’s patients develop the disease around their 30’s or 40’s while late onset Alzheimer’s happens after the age of 65. Another difference is that early onset can be either familial or sporadic but late onset can only be sporadic. Familial means that the Alzheimer’s is inherited while sporadic means it happens because of the tangles and plaques (John Hopkins Medicine)

The only treatment available for Alzheimer’s is medication because cures and surgeries have not yet been discovered. The medications help temporarily reduce the symptoms of the disease. Aricept for instance is used to increase the acetylcholine levels in the brain by preventing them to break down. This helps increase the communication between the healthy nerve cells that are left in the brain. This medication is the only FDA approved treatment for all three stages of Alzheimer’s.

Razadyne is also a cholinesterase inhibitor like Aricept except it can only be used for patients with mild to moderate alzheimer.

Exelon is the third type of medication that also blocks functions of the acetylcholinesterase. It is used for mild to moderate Alzheimer’s and it is useful as it can be given through skin patches.

Memantine or Namenda, changes the amounts of a brain chemical called glutamate in the brain. Glutamate is used for learning and memory. Namenda is able to reduce the level of glutamate by blocking the receptors. This medication is often combined with any of the cholinesterase inhibitor medications.

In addition to these, Namzaric is a medication which is essentially a mix of Namenda and Aricept. It is only used for moderate to severe Alzheimer’s conditions.

The final medication that will be discussed to treat Alzheimer’s disease is Aducanumab - Arwa, or, more simply, Aduhelm. This medicine reduces the amount of amyloid beta plaques in the brain. Even though it has been FDA approved, Aduhelm is still a controversial treatment as it may cause swelling and bleeding in the brain (Melinosky, Christopher)

To conclude, Alzheimer’s disease is a neurological condition where amyloid and tau proteins form plaques and tangles in the brain, causing it to shrink. Patients with Alzheimer’s experience progressive memory loss and cognitive difficulties which grow from mild to moderate and finally to severe. No cure currently exists but cholinesterase inhibitors, Namenda, or Adulhem are medications currently used to treat the symptoms.

Bibliography

1. "Alzheimer's Disease - Causes". Nhs.Uk, 2021, https://www.nhs.uk/conditions/alzheimers-disease/causes/.

2. Alzheimer's" Disease - Symptoms And Causes". Mayo Clinic, 2022, https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/symptoms-causes/syc-20350447.

3. "Early-Onset Alzheimer's Disease". Hopkinsmedicine.Org, 2022, https://www.hopkinsmedicine.org/health/conditions-and-diseases/alzheimers-disease/earlyonset-alzheimer-disease.

4. MacGill, Markus. "What To Know About Alzheimer’S Disease". Medicalnewstoday, 2020, https://www.medicalnewstoday.com/articles/159442#stages.

5. Melinosky, Christopher. "Alzheimer's Disease Treatment: Medications And Therapies". Webmd, 2021, https://www.webmd.com/alzheimers/guide/alzheimers-disease-treatment-overview.

6. Smith, Yolanda. "Alzheimer’S Tangles And Plaques: What’S The Difference?". News-Medical.Net, 2019, https://www.news-medical.net/health/Alzheimers-tangles-and-plaques-whats-the-difference.aspx.