Taking advantage of the anniversary of World Alzheimer’s DayOn September 21, we consulted with Quirónsalud professionals to learn more about the disease.
Alzheimer’s disease is the most common cause of neurodegenerative dementia. It is characterized by progressive neuronal loss, which also leads to a decline in cognitive abilities. In Spain alone, 800,000 people suffer from the diseaseIn addition, the number of cases is expected to increase, so the health system must be prepared to deal with the situation.
Jesus Romero Imbrodahead of the Neurology Service of the Quironsalud Malaga Hospitalgives more information about the symptoms of the disease: “The main initial symptom is memory lapses for recent events, which progressively worsen. In addition, language disorders, mood disorders, spatial and temporal disorientation, difficulty performing usual tasks, need for help with self-care, and behavioral disorders may appear.”.
It is a complex disease, since it is unknown how it begins, although it is clear that it influences “Age, together with genetic aspects, as well as the prevalence of vascular risk factors, environmental factors and factors related to previous cognitive development. Alterations occur in the brain caused by the deposit of insoluble proteins, which lead to neuronal death and neurodegeneration, causing brain atrophy and deterioration of cognitive function”explains Imbroda.
But at what point should I start to worry? Imbroda clarifies the following, “Sometimes it is others who can notice that we are distracted more than usual, although distractions are part of normality, and they also appear when we are stressed, do not rest well or take certain medications that negatively affect cognition. If these distractions lead to failures in daily activities (even at work), or increase progressively, it is best to consult a Neurologist”.
Main diagnostic tests
The Dr. Erika Torreshead of the Advanced Neurosciences Unit of the Quirónsalud Torrevieja Hospital and Quirónsalud Alicanteprovides information on the data obtained from the diagnostic tests available to us: “As for nuclear medicine tests, depending on which one we request, they tell us whether there is abnormally folded β-amyloid (Aβ) protein accumulated in the brain, following a typical pattern of this neurodegenerative disease, or whether there is less neuronal activity in these areas. And the lumbar puncture shows us the existence of the disease’s biomarkers in our cerebrospinal fluid.”.
Torres also clarifies that we are not dealing with a hereditary disease in the vast majority of cases, since “Between 0.1% and 0.5% of cases are genetically determined, that is, a specific genetic alteration is the cause of the disease. Therefore, genetic Alzheimer’s disease is a minority and rare in the population.”. It also clarifies that “There is a slightly higher incidence in women than in men”.
The annual incidence of the disease in Spain is 2-4 cases per 1,000 inhabitants per year and increases with age.
Torres also provides important statistical data, “The relationship between age and incidence is evident in all the studies carried out. From 60-64 years of age, the incidence is 1-8 cases per 1,000 inhabitants per year, however, from 90 years of age onwards, the incidence increases to 60-100 cases per 1,000 inhabitants per year. According to data from the World Health Organisation, the disease and other dementias affect 47 million people worldwide, and it is expected to increase to 75 million people in 2030 and 132 million in 2050. On the other hand, in Spain, according to data from the National Institute of Statistics (INE), there is a prevalence of about 800,000 people and in 2050 it will approach two million people.”.
How is the disease treated?
He Dr. Ernest Balaguer and the Dr. Joan Izquierdoneurologists of the General University Hospital of Catalonia They explain that it is a disease that is still being worked on continuously, since unfortunately, as of today, there is no cure: “Currently, we do not have a curative therapy. Decades ago, treatments were started that tried to protect neurons from death (neuroprotectors), or that tried to improve their level of neurotransmitters. All of them had a finite effect over time. In recent years, trials have been started with new lines of drugs that attack abnormal proteins found in these patients, called amyloid and tau. Only one of them is currently marketed, currently in the United States and in other countries (not in the European Union), and its effectiveness is limited.”.
They are effective in reducing abnormal amyloid protein, but can cause brain inflammation and require MRI monitoring. The benefits “They slow down clinical progression by 37%, but their application in real life is still little known, since these results have been obtained through clinical trials with highly selected patient populations” in the words of Dr. Balaguer. Although there are also other advantages, since “There have been improvements in symptoms such as anxiety or hallucinations, as well as in responses to the evolution of the degree of dependency and the burden that this implies for the caregiver”explains Dr. Izquierdo. And a clear advantage is that the treatments “Both orally and transdermally, they are generally well tolerated by patients”clarifies Izquierdo.
Current treatments only allow stop the progression of the disease, so we are facing a work in constant developmentand that is “In order to have a truly effective therapy, we must learn much more about this disease. Trials are being conducted with new anti-amyloid therapies, and also another therapeutic target, the TAU protein. In addition, there are other avenues that focus on neuroprotection, as well as the study of risk factors in order to have a prevention plan. We trust that in the coming years the noose will be tightened against this fearsome pathology, which so affects the world’s population.”.
Emotional management of illness
Considering that Alzheimer’s is a degenerative disease, for which there is currently no curative treatment, the emotional management of patients and caregivers becomes of paramount importance. Explains the effects caused by knowledge of the disease Dr. Oriol Franchhead of the Neurology Service of the Ruber International Hospital: “The diagnosis of Alzheimer’s disease has a considerable impact because it alters all aspects of the patient’s life and that of his or her family. Feelings of uncertainty, worry or sadness appear. In addition, there will be progressive difficulties in carrying out personal projects and/or professional activity. And as the disease progresses, the level of dependency will become progressively greater. Symptoms of depression or anxiety may frequently appear, both in the patient and in family members and caregivers. This aspect must be addressed appropriately.”.
According to Dr. Franch, it is important for the doctor to explain clearly to family members and caregivers that what is happening to the patient is a consequence of an illness, “to know that brain alterations are the cause of changes in behavior, memory lapses, repeated questions, or not being aware of mistakes made. It helps the caregiver a lot to know the difficulties the patient has in order to treat him correctly, not to constantly correct him or avoid showing impatience.”. Similarly, it is possible to carry out routines to improve, “such as keeping the house tidy with important objects always in the same place, ensuring that the patient has objects that may be emotionally significant in sight or removing dangerous objects with which he could hurt himself, which can be combined with healthy routines such as walks, good nutrition, visits from friends”.
Everyday life can also be made easier with aids such as “a notebook or sticky notes to write down what you need to remember, a calendar to write down appointments, an identification bracelet in case you get lost or need help, and other measures that help you cope with the disease as best as possible”.
It is also possible to count on the help of “Patient Associations, which are non-profit entities, formed by individuals or legal entities that usually group together around the problems arising from a pathology or illness that affects them. They are a great support in terms of information, accompaniment and emotional support. Usually, the entities have specialized medical advice”.
Some of the existing entities are:
CEAFA – Spanish Alzheimer’s Confederation, Queen Sofia Foundation Alzheimer’s Center, Afadema, Pascual Maragal Foundation, AFARABA, AFAPARLA – Alzheimer’s Patients Association of Parla, AFADE – National Alzheimer’s and Other Dementias Association, AFAMSO – Association of Relatives of Patients with Alzheimer’s and Other Dementias, Madrid Southwest.