Alzheimer’s is a progressive condition that affects one’s memory, learning ability and organizing skills. It is a neurodegenerative condition where brain cells are damaged eventually. Alzheimer’s is thought to be the most common form of dementia that contributes to 60-70% of the cases. In India, more than 4 million individuals are thought to live with some form of dementia; globally, it accounts for more than 44 million cases [1].
Alzheimer’s Disease Causes buildup of amyloid plaque and tau protein tangles around the brain cells. The accumulation of these proteins damages neurons and disrupts brain signalling. The article explores causes, symptoms, and comprehensive treatment to manage Alzheimer’s.
What Causes Alzheimer’s Disease?
Alzheimer’s disease causes includes factors like change in cognition, genetic factors or environmental risks. These includes:
Genetic/Hereditary
- Existing family history increases 10-30% chances of developing Alzheimer’s
- APOE ε4 gene increases the risk
Brain Changes
- Amyloid-beta protein sticks to the brain, forms clumps or plaque
- Tau protein tangles in fiber-like stands
- Blocks neural ability to deliver electrical/ chemical signals
- The hippocampus (an area of the brain that controls memory) is affected
Lifestyle/Environmental Risk Factors
- Aging
- Co-morbidity existence like CVD, diabetes, obesity, hypertension, hyperlipidemia
- Trauma or head injuries
- Smoking, alcohol, or substance use
- Chronic stress, insomnia
Alzheimer’s Disease Symptoms
Alzheimer’s disease symptoms vary among individuals depending on disease stage and co-morbid conditions. The symptoms include
Early Stage
- Forgetfulness
- Concentration problem
- Difficulty in finding a word
- Misplacing objects
Progressive/Moderate stage
- Memory loss or confusion, trouble in remembering names, facts or faces
- Spatial understanding, bumping into furniture, unable to pick something, struggling with delicate hand motion
- Difficulty in performing daily life activities
- Increases agitation, paranoia or hallucination
- Loss of independence
Advanced Stage
- Severe memory impairment
- Difficulty in recognising people
- Communication disability (aphasia)
- Serious physical health complications like trouble breathing, swallowing, seizures, pneumonia
How Alzheimer’s is Diagnosed?
The Alzheimer’s disease diagnosis involves a series of medical examinations including physical, and laboratory technique. Clinicians recommends diagnostic tests including:
- Physical Examination: Reflexes, mobility, muscle tone or strength, balance, coordination
- Laboratory Examination: Blood test, Urine test
- Neurological Examination: Cognitive test, psychiatric/mental health evaluation
- Imaging: CT Scan, MRI, PET scan
What Is The Current Treatment For Alzheimer’s?
Alzheimer’s Disease Treatment currently intends to manage symptoms and slow down disease progression. Beginning treatment at the early diseased state produces better success.
Currently, Alzheimer’s Disease Treatment Involves:
Medications
- Cholinesterase inhibitors (Donepezil, Galantamine, etc.) block enzymes
- IV infusion (Lecanemab, Donanemab) enables the immune system to target amyloid proteins. Lecanemab targets amyloid fibers before they sticks, donanemab targets amyloid plaque that is already clumped together
- NMDA receptor antagonists (glutamate, memantine). NMDA receptor antagonist binds to the NMDA receptor
- For other symptom management, antidepressants, antipsychotics, and antiseizure medications are recommended
Non-Drug Therapies
- Creating routine habits and restricting tasks that involve memory
- Keep keys, wallets, and other valuables in the same place
- Install alarm sensors on the door/window
- Use a whiteboard or a calendar to highlight the schedule
- Unclutter the space, introduce non-slippery shoes
- Occupational therapy helps the patient perform their daily routine tasks
- Dietary intervention ensures the nutritional needs of the patient and manages other symptoms
*NOTE: Currently, there is no definitive cure for Alzheimer’s; scientists and clinicians are continuously working on advanced stem cell therapy to support and reverse the neuronal damage
Can Regenerative Medicine Change Alzheimer’s Care?
Regenerative medicine holds potential in regeneration and reversal of the neuronal loss. Scientists believe it to be a groundbreaking approach that not only promises symptom management but also halts disease progression. Currently, Stem Cell Therapy for Alzheimer’s is rigorously explored through advanced research and clinical trials to develop transformative solutions. Mesenchymal stem cells (MSCs) sourced from umbilical cord tissue/blood, adipose tissue, or bone marrow are widely explored.
Preclinical and Clinical Evidence Showed Key Benefits, Including:
- Improved memory function and cognitive abilities of the patient
- Neuronal regeneration and enhanced brain function
- Overall functional recovery of the patient is supported by replacing damaged cells with healthier ones
- Safety and tolerance of the stem cell therapy [2]
*NOTE: The current evidence is based on early-stage trials.
How Does Stem Cell Therapy for Alzheimer’s Work?
Stem Cell Therapy for Alzheimer’s targets altered cellular and molecular function in the brain. They triggers multiple mechanisms including:
- Tissue Repair: MSCs can potentially differentiate into distinct cell types, including neurone-like cells. It aids in the regeneration and replacement of damaged or lost neurons in the brain. The mechanism is likely to restore cognitive function
- Amyloid Plaque Buildup Reduction: MSCs aid in reducing amyloid beta protein accumulation. It aids in slowing down disease progression and boosts cognitive function
- Anti-Inflammation: MSCs release various anti-inflammatory molecules. They aid in reducing chronic low-grade neural inflammation and slow disease progression
- Immunomodulation: MSCs possess immunomodulatory properties. They mitigate the risk of immune rejection by introducing stem cells to Alzheimer’s patients. It supports an anti-inflammatory environment
- Neuroprotection: MSCs release various neurotrophic factors that create a healthier microenvironment surrounding neural networks. It supports repair mechanisms and helps the survival of surrounding neurons.
What Are The Key Considerations?
Currently, stem cell therapy is at an early stage as a Treatment for Alzheimer’s Disease in India and globally. Clinicians are actively coordinating with stem cell researchers/scientists to introduce supportive treatment (combined with conventional treatment). The outcome differs among individuals. The key considerations in the success of the therapy include:
- Individual factors, including disease state, severity, and overall health status
- Quality of the stem cell therapy, isolation procedure, and administration protocol
- Expertise of the clinicians and a renowned clinic that ensures safe outpatient procedures
- Strict supervision during the stem cell therapy for Alzheimer’s
*Advancells, India, is a leading stem cell-based laboratory that isolates and delivers clinical-grade stem cells. The cells undergo strict quality checks and come with a Certificate of Authenticity (CoA).
Can Alzheimer’s Disease Be Prevented?
In medical science, prevention plays a crucial role and with early preventive measures disease progression can be checked. The key strategies to prevent Alzheimer’s in later life include:
- Maintaining physical health, performing regular exercise
- Intake of healthy and nutritious diet
- Maintain adequate sleep cycle
- Manage co-morbid conditions, including cardiovascular disease or metabolic disorder
- Maintain mental health, uphold healthy social engagement
- Prevent trauma or injuries, undertake regular health checkups
Conclusion
Alzheimer’s disease causes complex developmental processes. Early diagnosis and a comprehensive treatment plan remain the cornerstone of effective management. The current conventional therapies focus on symptom management, while the emergence of stem cell therapy opens new avenues for a curative approach. Continuous research and well-structured clinical trials are desirable for optimizing stem cell therapy potential and role in curative care.
References
- Alzheimer’s Association. Alzheimer’s and dementia in India. Chicago (IL): Alzheimer’s Association. Available from: https://www.alz.org/in/dementia-alzheimers-en.asp
- Karvelas N, Bennett S, Politis G, Kouris NI, Kole C. Advances in stem cell therapy in Alzheimer’s disease: a comprehensive clinical trial review. Stem Cell Investigation. 2022 Feb 21;9:2.
FAQ’s
Q- What are the Main Causes of Alzheimer’s Disease?
Alzheimer’s disease causes accumulation of the amyloid proteins and formation of tau protein tangles. These conditions lead to plaque formation in the brain and interfere with the neuronal signals.
Q- What are the Early Symptoms of Alzheimer’s Disease?
Alzheimer’s early symptoms include forgetfulness, misplacing objects, difficulty finding words to express feelings, physical exhaustion, or compromised mobility.
Q- What is Stem Cell Therapy for Alzheimer’s Disease?
Stem cell therapy for Alzheimer’s disease involves injection of clinical-grade stem cells. MSCs support regeneration of lost neurons and boost repair mechanisms. Stem cells reduce neuroinflammation, modulates immune response, and provides neural protection.
Q- Is Stem Cell Therapy Approved for Alzheimer’s Disease?
No, currently, stem cell therapy is under investigation and at an early stage of clinical trials. The early investigation reported the safety and tolerance of stem cell therapy.
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