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Alzheimer’s disease is the most common cause of dementia in old age. With no cure available, it is emerging as a growing cause of deaths worldwide. Scientists are focusing their attempts on developing diagnostic methods and treatments to prevent dementia.

Alzheimer’s disease it is the most common cause of dementia. It causes progressive brain damage, affects memory and ability to perform day-to-day activities.

More than 36 million people worldwide are suffering from this disease.

Multiple studies have investigated risk factors and causes of this pathology but till date there is no definite cure for this condition.

What happens to the brain in Alzheimer’s disease?

Studies on the brains of people with Alzheimer’s disease show the deposition of β-amyloid protein plaques in between the nerve cells, as well as formation of so-called neurofibrillary tangles made of tau proteins within the neurons of the brain. These protein deposits disrupt the cell to cell communication in the brain and cause neuronal degeneration resulting in dementia.

While amyloid deposition in the brain is entirely pathological, the tau proteins is normal cell component which assist the brain cell communication and transport of substances in and out of cells. The abnormal and excessive deposition of tau proteins in the form of tangles disrupts the transport mechanism and cause dementia. The deposits also stimulate the immune system and initiate inflammatory changes which set up a cascade of reactions leading to the degeneration of the brain cells.

These are the commonly accepted theories that explain the pathology of Alzheimer’s disease. However, the definite cause of the disorder is yet to be established. Studies demonstrate that many people with amyloid deposits in the brain do not show any cognitive impairment even in their old age. Thus it proves that the mere presence of amyloid proteins does not cause the learning and memory problems although all patients diagnosed with Alzheimer’s disease have these deposits in their brain. Some studies implicate the soluble oligomers (the smaller components of β-amyloids) that float freely in the brain fluid and not the amyloid plaques in the pathogenesis of of Alzheimer’s disease. Researchers speculate that these oligomers can be bound to the plaques and the plaques tie down the oligomers until certain level is reached. When this level is exceeded, oligomers are set free to float in the cerebrospinal fluid resulting in brain cell damage.

Why is it difficult to treat Alzheimer’s disease?

There is no specific test that can detect the presence of this condition. It is actually a diagnosis of exclusion. The slow and gradual course of the disease and its multifaceted presentation makes the diagnosis of Alzheimer’s disease difficult. When dementia is observed in a patient, the next step involves ruling out various causes of dementia to narrow down the diagnosis to Alzheimer’s disease. 

By the time the diagnosis of Alzheimer’s disease is confirmed, the patient would have undergone considerable and irreversible brain damage.

What treatment strategy is presently available for this disorder?

Currently available FDA-approved drugs aim to ease the symptoms and improve the quality of life in the patients with this debilitating disorder. Some herbal products and dietary supplements for controlling or preventing the disease are available on the market but they are not sufficiently studied and their safety and efficacy is still questionable. Though a lot of novel drugs to control the disease progression are now under clinical investigations, they are either in the early stages of development or do not perform up to the mark in the large scale trials. The main treatments at present time include support therapies provided by health care workers and care givers.

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