Alzheimer’s Day: from new studies to initiatives – iO Donna

Although it is a widespread disease, in Italy alone there are an estimated 500 thousand sick, the triggering causes are not yet fully known as well as, despite the efforts made by science, to date there is no therapy that can cure Alzheimer’s.

To understand where the research is today, we asked a few questions to Cecilia PerinAssociate Professor in Physical and Rehabilitative Medicine e Head of the Clinicalized Complex Operative Unit for Specialized Rehabilitation of Severe Brain Injuries at the Zucchi Clinical Institutes of Carate Brianza.

Alzheimer’s, a disease on the rise

«Alzheimer’s is one today increasingly widespread disease – explains Professor Perin – we are in fact witnessing a increase in the number of cases linked to the fact that life expectancy is higher today. To understand what the incidence of the disease is, we can say that Alzheimer’s represents more than half of all cases of dementia; the prevalence in the population of over 65s is 4.4% and is higher in women, for whom life expectancy is higher, with a gap of about 6/7 years compared to men ».

The hypotheses about the causes

As we said, research has been engaged for years to find out what are the triggering causes of Alzheimer’s, however this is an aspect not yet fully understood.

“To the base we know there is an alteration in the metabolism of a protein that being metabolized in an altered way leads the accumulation in the brain of a neurotoxic substance, beta amyloid – explains Professor Perin – this protein slowly accumulates in the brain carrying to progressive neuronal death. However, it has not yet been clarified what are the triggering causes of this process “.

More factors at play

«The most accredited hypotheses are those according to which the disease is the result of a sum of different factors – continues the expert – Having, for example, a certain genetic heritage can lead to a greater probability of developing abnormalities in the disposal of the protein chain of beta amyloid and tau protein, or the two proteins involved. Then there is what is defined inflammatory hypothesislinked to the correlation between Alzheimer’s and diseases that increase the inflammatory componentas the diabetes and obesity. According to this hypothesis, it would be the increased inflammatory expression of the cells to prevent the proteins from degrading properly ».

Alzheimer’s: first alarm bells

The disease course is slow and often sneaky because you can begin to forget some things, and then get to the point where you can’t even recognize family members anymore.

«The first symptoms in 80% of cases they involve a memory problem – explains Professor Perin – There are three rarer variants with symptoms linked instead to behavior and the loss of the ability to plan thinking and reasoning but the most common symptoms are found in what is defined episodic memorythat of daily action. The patient forgets, for example, things that have just been said to him or he forgets an action he has just taken, such as putting the pot on the fire, realizing that something is wrong precisely because these accidents become frequent ».

How quickly symptoms worsen varies from person to person. In the course of the disease, memory loss can also be associated confusion, mood swings and disorientation.

Early forms and diagnosis

The same symptoms can also occur early. It is estimated today that the 5-10% of all Alzheimer’s cases involve people under the age of 65.

“A distinction is made between cases that occur under the age of 49, which are quite rare – explains the expert – and cases that arise between 50 and 65 years which are more frequent“.

If in most diseases early diagnosis can be important to be able to stop the course promptly, in the case of Alzheimer’s the matter becomes complicated, especially given the fact that there is no therapy that can cure the patient. «The scientific world is moving in this direction – explains Professor Perin – today there are many tools for making a diagnosis. We know that it is possible to present anatomo-pathological alterations of the tissues many years before getting sick, a fact that allows us to assess early if you are at risk. However, there is still no therapy ».

Studies on possible treatments for Alzheimer’s

«From 2000 onwards, the company has gone a long way research into drugs capable of enhancing memory: in fact, the so-called anticholinesterase drugs – continues the expert – which can delay or contain the worsening of symptoms. Now the search is taking a more precise address: it is looking for to develop molecules that can act on the immune system helping the body to degrade the molecules that are not disposed of ».

Encouraging in this regard i results of a recent study carried out by researchers of the IRCCS Carlo Besta Neurological Institute Foundationin collaboration with colleagues from the Institute of Pharmacological Research Mario Negri And published in the journal “Molecular Psychiatry”.

The hope of a new molecule

Research has indeed proving the effectiveness of a new molecule administered intranasally in an animal model. Such a molecule would be able to inhibit the deposition and toxic effects of one of the two proteins which cause the pathology.

“This is certainly an important result – specifies the expert – even if caution is a must: we must in fact take into account that this is a study conducted on animals and that unfortunately often these models do not find applications then in being human”.

Non-drug therapies for Alzheimer’s

Then there are the so-called non-drug therapies that come proposals for the treatment of Alzheimer’s dementia. These include reality orientation therapy

“There ROT therapy it is a conservative therapy, that is, it aims at maintenance of residual cognitive abilities of the patient – explains the neurologist – at the base of the training in which the elements of temporal orientation are stressed: where are you? What day is it? What month is it? So from reinforce basic information of the patient with respect to time and space but also to his personal history “.

Noise pollution is also a risk factor

If the therapy has not yet been defined, one wonders today how important prevention can be. Several studies have pointed out the importance of lifestylepointing out how to follow eating healthy, exercising, consuming little alcohol and not smokingare good habits that can have a protective role against the disease.

Not only that, under accusation as a potential risk factor for Alzheimer’s it’s even over noise pollution. A Danish study, published in the British Medical Journal and conducted on data from 2 million people, has in fact shown that even the noise from cities can increase the risk of dementia. Specifically, out of 8 thousand cases of dementia, one thousand can be attributed to exposure to traffic noise in cities.

Life expectation

“What we know for sure is that life expectancy is around 10 years – explains Professor Perin – because the disease affects several functions but not the motor one. In degenerative diseases, the critical aspect occurs when the patient becomes still, stops swallowing, stops breathing. On the other hand, in Alzheimer’s disease, until a long time, this does not happen because the motor cortex is the last to degenerate ».

The dedicated initiatives

In light of all this, it becomes more and more important today continue to raise awareness and inform about the disease and related problemssupporting research but also associations that have been committed for years to improve the living conditions of those affected from Alzheimer ea support caregivers who live next to the sick every day and take care of them.

On the occasion of World Alzheimer’s Day, in the gallery above we have collected some dedicated initiatives.

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