Understanding Alzheimer's disease

2024-01-02

September 21 this year is the 30th World Alzheimer’s Day. According to data provided by Yu Jintai of Huashan Hospital, the incidence of dementia among people aged 60 and above in China is about 6.19%, of which about two-thirds are caused by Alzheimer's disease. Currently, there are about 10 million Alzheimer's patients in China. Dementia patients.

As the population ages and life expectancy increases, the incidence of Alzheimer's disease continues to increase. According to a report by the World Health Organization, without effective intervention and control, the incidence of Alzheimer's disease will double in 20 years.

At the same time, with changes in the environment and lifestyle, the incidence of vascular risk factors such as hypertension, hyperlipidemia, hyperglycemia, and reduced exercise is increasing, and vascular diseases such as diabetes and stroke are becoming younger. Alzheimer's disease is also trending at younger ages.

If you have the following symptoms, it is recommended to go to the hospital as soon as possible:

1. Memory loss or short-term memory impairment: What just happened is quickly forgotten, lost, and what has just been said or done
2. Difficulty performing familiar activities, being confused about time and place, often failing to handle matters on time, and misplacing things
3. Difficulty finding words when speaking, words that do not convey the meaning: forgetting simple words, speaking or writing sentences that are incomprehensible
4. Decreased judgment
5. Sleep disorders: changes in circadian rhythm, decreased time orientation, inability to remember dates, and even the inability to distinguish between day and night
6. Mood swings and personality changes: mood swings for no reason, rapid mood changes, moodiness, prone to anxiety, depression or indifference, personality changes from lively and active to depressed, from unhappy to chattering
7. Disturbances in vision and spatial awareness

Alzheimer's disease drug treatment

There won't be enough treatments for Alzheimer's disease until 2022. Treatment of Alzheimer's disease is the most difficult mountain to climb among common diseases. In the past two or three decades, relevant institutions have continuously discovered and tried new targets and new mechanisms of action. However, Alzheimer's disease is like the "Valley of Death" in the pharmaceutical research and development community. From Lilly to Pfizer to Bogen, many large clinical trials have ended in failure.

Until June 2021, aducanumab (trade name: Aduhelm), a new Alzheimer's disease drug jointly developed by Biogen and Eisai, was approved for marketing by the U.S. Food and Drug Administration (FDA) under a fast-track approval pathway ( Conditions attached). This is the first Alzheimer's-related drug approved by the FDA since 2003.

But Aduhelm also caused an uproar because of insufficient evidence of its effectiveness and its high price. It was even called “the most bottom-breaking approval in history.” One of the reasons is that in clinical practice, Aduhelm's use of Aβ plaque reduction as a surrogate endpoint is considered to lack theoretical support. The essential reason behind this is that it is still unclear whether plaque A is a causative factor, and there is no definite connection between it and improved cognition. (Science conducted a 6-month investigation and published an article in July 2022 exposing the fraud of the pioneering paper on Alzheimer's disease. However, this fraudulent pioneering paper touted Aβ*56. Other researchers Little attention has been paid to this. Therefore, the Aβ plate theory cannot be completely rejected because of the fake article, but it is not reasonable to completely affirm it.)

Until June 9, 2023, an independent advisory panel of the U.S. Food and Drug Administration unanimously approved Lencanide, a drug for the treatment of Alzheimer's disease produced by Eisai Co., Ltd. and Biogen, by a vote of 6:0. Monoclonal antibodies, this research that lasted for 20 to 30 years and invested hundreds of billions of dollars, led to the first marketed drug.

The experimenters recruited a total of 856 Alzheimer's disease patients, and 854 patients were eventually accepted into the trial. However, the drug may have serious side effects. 17.3% of the patients in the experimental group had signs of brain hemorrhage and 12.6% had brain edema, while only 9% of the patients in the control group had brain hemorrhage and 1.7% had brain edema. Relevant researchers also warned that the drug is most effective for people in the early stages of the disease, and further trials are needed to determine its efficacy and safety.

Therefore, although lencanezumab has its unique therapeutic value, the treatment of Alzheimer's disease does not only rely on drugs, but also requires comprehensive intervention and care and other multi-faceted management, so that problems can be treated as early as possible.

Non-drug modulation of Alzheimer’s disease

In addition to drug treatment, Alzheimer's disease can also be managed in other ways, and these ways can improve patients' quality of life and delay disease progression. Since Alzheimer's disease mainly affects the patient's cognitive ability, cognitive training can Enhance patients' brain function and improve their ability to function in daily life.

Memory games, simulation tasks, daily living skills, and social interactions are important in mitigating the negative effects of Alzheimer’s disease. Social interaction can boost brain function and improve patients' self-esteem and emotional well-being.

Nutritional regulation is also indispensable, and diet is very important for the health of patients with Alzheimer's disease. Nutritional balance keeps the body healthy and improves brain function.

Exercise can have many benefits for people with Alzheimer’s disease. Exercise can improve sleep, reduce anxiety and depression, and improve cognition and memory.