Alzheimer's Disease: Exploring Causes, Symptoms, and Emerging Treatments.

Alzheimer’s disease (AD) is a devastating neurodegenerative disorder that primarily affects older adults and is the leading cause of dementia worldwide. It is characterized by a progressive decline in cognitive function, memory, language, and reasoning abilities, ultimately leading to the inability to perform basic tasks and severe impairment of daily life. Alzheimer’s disease not only impacts individuals with the condition but also imposes immense emotional, physical, and financial burdens on families, caregivers, and healthcare systems. Although AD was first identified in 1906 by Dr. Alois Alzheimer, the complex nature of the disease is still not fully understood, and there is no cure. However, advancements in research have shed light on its pathology, risk factors, and potential treatment approaches.

The hallmark of Alzheimer’s disease is the buildup of two types of abnormal protein structures in the brain: amyloid plaques and tau tangles. Amyloid plaques are formed when fragments of a protein called amyloid-beta accumulate between neurons. In healthy brains, these proteins are broken down and eliminated, but in Alzheimer’s, they form clumps that interfere with cell communication. Tau tangles, on the other hand, are twisted fibers of the tau protein that accumulate inside neurons, disrupting their internal support and transport systems. These abnormalities lead to the death of brain cells and a reduction in brain mass, particularly in areas critical for memory and cognition, such as the hippocampus.

The exact causes of Alzheimer’s are not fully understood, but it is believed to result from a combination of genetic, environmental, and lifestyle factors. Age is the most significant risk factor, with the prevalence of the disease increasing sharply after the age of 65. However, younger-onset Alzheimer’s can develop in people under 65, and while rare, it is often linked to specific genetic mutations. Individuals with a family history of Alzheimer’s are at higher risk, especially if they carry genetic variations such as the APOE-e4 allele, which is associated with an increased likelihood of late-onset Alzheimer’s. Having one copy of this gene variant increases the risk, while having two copies (one from each parent) further amplifies it.

Beyond genetics, cardiovascular health plays an important role in Alzheimer’s risk. Conditions such as hypertension, diabetes, obesity, and high cholesterol can damage blood vessels in the brain, leading to reduced blood flow and oxygen supply, which may accelerate the onset of cognitive decline. This connection suggests that what is good for the heart is also good for the brain. Poor lifestyle choices, including physical inactivity, smoking, and a diet high in saturated fats and sugars, are linked to higher risks of Alzheimer’s. Conversely, engaging in regular physical exercise, maintaining a healthy diet, and staying mentally and socially active may help reduce the likelihood of developing the disease.

Alzheimer’s disease typically progresses through three stages: early, moderate, and severe. In the early stage, memory problems, particularly with recent events, are common. Individuals may struggle to recall conversations or forget the location of everyday items. As the disease progresses to the moderate stage, memory loss worsens, and additional symptoms such as confusion, difficulty with language, disorientation, and impaired judgment become more prominent. Behavioural changes, including anxiety, depression, aggression, and wandering, are also common during this phase. In the severe stage of Alzheimer’s, individuals lose the ability to communicate effectively, recognize loved ones, or perform basic tasks like eating or dressing. At this point, round-the-clock care is often required.

Diagnosing Alzheimer’s can be challenging because the symptoms overlap with other forms of dementia and cognitive disorders. A diagnosis typically involves a thorough evaluation of medical history, cognitive tests, and brain imaging scans such as MRI or CT to rule out other conditions. In some cases, positron emission tomography (PET) scans can detect amyloid plaques in the brain, providing a more definitive diagnosis. Emerging research into biomarkers—measurable substances in blood or cerebrospinal fluid that indicate disease—may offer earlier and more accurate diagnostic tools in the future.

Currently, there is no cure for Alzheimer’s disease, but treatments are available to manage symptoms and slow cognitive decline. The most commonly prescribed medications are cholinesterase inhibitors, such as donepezil, rivastigmine, and galantamine. These drugs work by increasing levels of acetylcholine, a neurotransmitter that supports memory and learning. For moderate to severe Alzheimer’s, memantine is often prescribed, which regulates the activity of glutamate, another neurotransmitter involved in memory function. While these medications can help manage symptoms, they do not stop the underlying progression of the disease.

Beyond pharmacological treatments, non-drug interventions are increasingly important for managing Alzheimer’s disease. Cognitive stimulation therapy (CST), which involves mentally engaging activities like puzzles, discussions, and memory games, has been shown to improve cognitive function and mood in individuals with dementia. Behavioural interventions, such as creating structured routines and using cues to reduce confusion, can also help manage the symptoms of Alzheimer’s and improve the quality of life for both patients and caregivers.

The emotional and physical toll on caregivers is significant, as caring for a person with Alzheimer’s often involves managing challenging behaviours, providing full-time care, and coping with the emotional loss of the individual’s personality and abilities. Caregivers frequently experience high levels of stress, burnout, and even depression. Support groups, counselling, and respite care services are essential resources for caregivers, offering them emotional support and practical advice on managing the challenges of Alzheimer’s care.

In recent years, research has focused on developing disease-modifying therapies that target the underlying causes of Alzheimer’s rather than just managing symptoms. One promising area of research is immunotherapy, which aims to reduce amyloid plaques in the brain. In 2021, the U.S. Food and Drug Administration (FDA) approved aducanumab, the first drug designed to target amyloid plaque buildup. However, its approval has been controversial due to mixed clinical trial results and questions about its efficacy in slowing cognitive decline. Despite these challenges, the development of such therapies represents a potential breakthrough in the treatment of Alzheimer’s.

Prevention strategies for Alzheimer’s are also a major area of focus. Evidence suggests that addressing modifiable risk factors—such as maintaining a healthy diet, exercising regularly, managing cardiovascular health, and staying mentally and socially active—may reduce the risk of developing Alzheimer’s later in life. The Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets, both rich in fruits, vegetables, whole grains, and lean proteins, have been associated with a lower risk of cognitive decline. Regular physical activity, especially aerobic exercise, is also thought to protect against Alzheimer’s by improving cardiovascular health and promoting neuroplasticity.

(The Writer is Editor in Chief of the Assamese E-Magazine SAMPROTIK. Email: himangshur1989@gmail.com)