Alzheimer’s Disease: Causes, Diagnosis, and Modern Approaches to Treatment
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Causes, Diagnosis, and Modern Approaches to Treatment
Alzheimer’s disease (AD) is a progressive neurodegenerative disorder that leads to the decline of cognitive functions, including memory, attention, orientation, and other mental abilities. It is one of the most common diseases in the elderly, and the number of patients increases every year. According to the World Health Organization, there are currently around 50 million people worldwide suffering from dementia, with approximately 60-70% of them having Alzheimer’s disease.
Causes of Alzheimer’s Disease
The exact causes of Alzheimer’s disease remain unclear, but there are several factors that may contribute to the development of the disease.
- Genetics։ One of the key factors is genetic predisposition. In some cases, Alzheimer’s disease arises due to mutations in specific genes, such as the apolipoprotein E (APOE) gene. There are three variants of this gene: APOE-ε2, APOE-ε3, and APOE-ε4. The latter is most strongly associated with the development of the disease. People who inherit two copies of APOE-ε4 have a significantly higher risk of developing the disease. However, not all cases of Alzheimer’s disease are linked to genetic mutations. Genetics play a role in the development of the disease but are not the sole factor.
- Advanced Age։ Alzheimer’s disease primarily affects individuals over the age of 65. As the body ages, the ability of cells to repair themselves decreases, and metabolism deteriorates, which can lead to the accumulation of harmful substances in the brain. Changes in the aging brain can contribute to the development of neurodegenerative diseases.
- Environment and Lifestyle։ Environmental factors such as pollution, lack of physical activity, stress, and poor nutrition can contribute to the onset of the disease. Problems with circulation, high blood pressure, diabetes, and obesity also increase the risk. Additionally, a lack of social activity and intellectual engagement, as well as insufficient communication with others, can raise the likelihood of developing dementia.
- Disruptions in Brain Activity։ At the molecular level, Alzheimer’s disease is associated with the accumulation of amyloid (a protein) that forms plaques in the brain, and tau protein, which forms neurofibrillary tangles. These processes lead to damage to nerve cells and disrupt their connections. These pathological changes are the primary cause of neurodegeneration.
Diagnosis of Alzheimer’s Disease
The diagnosis of Alzheimer’s disease is a complex process that requires a multidisciplinary approach. It is important to differentiate Alzheimer’s disease from other forms of dementia, such as vascular dementia, dementia with Lewy bodies, and others.
2.1 Clinical Symptoms։ The main symptoms of Alzheimer’s disease include:
- Memory impairment (initially, recent events are forgotten, followed by older memories).
- Problems with spatial and temporal orientation.
- Speech difficulties (trouble finding the right words, problems with constructing sentences).
- Behavioral changes (depression, anxiety, irritability, aggression).
- Loss of decision-making ability and difficulty performing everyday tasks. The diagnosis is based on observing symptoms and excluding other diseases that may cause similar symptoms.
2.2 Neurological Examination։ A neurologist conducts a series of tests to assess the patient’s cognitive functions, including memory, attention, problem-solving ability, and information processing. The most common tests include:
- Mini-Mental State Examination (MMSE) – evaluation of cognitive abilities.
- Montreal Cognitive Assessment (MoCA).
- Memory tests.
2.3 Laboratory Tests and Neuroimaging։ To confirm the diagnosis, the following may be used:
- MRI or CT scans of the brain to detect structural changes, such as cortical atrophy.
- Positron Emission Tomography (PET) to assess amyloid deposits in the brain.
- Laboratory tests to exclude other diseases, such as infections, vitamin deficiencies, and hormonal disorders.
2.4 Genetic Testing։ In some cases, genetic testing may be recommended to diagnose Alzheimer’s disease and identify genetic predispositions (e.g., a test for the presence of the APOE-ε4 gene). However, this is not a mandatory procedure and is applied only in specific cases.
Modern Approaches to Treatment of Alzheimer’s Disease
Currently, there are no treatments that can fully cure Alzheimer’s disease. Treatment focuses on slowing the progression of the disease and improving the patient’s quality of life.
3.1 Pharmacological Treatment։ Modern medications used in Alzheimer’s disease include:
- Acetylcholinesterase inhibitors, such as donepezil, rivastigmine, and galantamine. These drugs increase the level of acetylcholine in the brain, helping to improve cognitive functions.
- NMDA receptor antagonists, such as memantine. This drug regulates the activity of glutamate, a neurotransmitter that can damage brain cells if it becomes overly active.
- Antidepressants and anxiolytics for treating behavioral symptoms, such as depression and anxiety, may be prescribed.
3.2 Neurological Approaches։ In addition to pharmacological treatment, an important component is neurological rehabilitation aimed at improving cognitive functions and slowing disease progression. This may include:
- Cognitive-behavioral therapy.
- Memory and attention training.
- Development of self-care skills and adaptation to the environment.
3.3 New Treatment Methods։ Scientific research on Alzheimer’s disease treatment is ongoing. In recent years, particular attention has been paid to the following areas:
- Immunotherapy – the development of vaccines and antibodies aimed at eliminating amyloid plaques.
- Gene therapy – research aimed at correcting genetic mutations that may lead to the development of the disease.
- Stem cells – studying the use of stem cells to restore damaged neurons.
3.4 Psychosocial Support։ In addition to pharmacological treatment, psychosocial support is crucial for both the patient and their family. Psychotherapy, support groups, and caregiving programs for dementia patients can significantly improve their quality of life.
Conclusion
Alzheimer’s disease is a complex condition that affects cognitive functions and the quality of life of the patient. Although there is currently no universal cure, modern approaches allow for significant slowing of disease progression and improvement in the lives of those affected. An important aspect is early diagnosis and comprehensive treatment, which includes not only pharmacological therapy but also neurorehabilitation, psychosocial support, and ongoing scientific research that continues to open up new possibilities for treating this disease.
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