It is extremely important that our population be aware of the efforts and hard work being done by the scientific community and industry related to neurodegeneration around the world to advance early diagnosis and more effective treatments for Alzheimer’s disease and dementia in general.
Conscientious work is underway to develop new drugs, more modern and effective biomarkers that are easy to use, and new neuroimaging methods that facilitate early preclinical diagnosis in accordance with modern criteria for diagnostic studies.
Of course, the medical world as a whole, at various levels of care, takes an active part in the fight against this terrible disease, known for its high incidence and prevalence as the “epidemic of the 21st century”, therefore, based on a summary of the most relevant aspects discussed during the congress, we structure today’s article .
Alzheimer’s disease was first described in 1907 as a condition with mental symptoms, to which were added cognitive impairment. Gradual advances in the study of neurodegenerative diseases have changed the criteria for its diagnosis over time.
The medical world at various levels of care is actively involved in the fight against this terrible disease.
The interest of scientists dealing with this issue in the diagnosis at ever earlier stages is very relevant, which motivated the research and development of specific biomarkers of the pathophysiology of the Alzheimer’s type, which facilitated diagnosis at an earlier time.
For many years, the names popularly known as “senile” and “presenile” dementia, used depending on the age of the onset of the clinical picture, were preserved as differentiated nosological forms.
In the 1960s, Blessed’s group demonstrated that patients with senile dementia were neuropathologically and clinically indistinguishable from younger patients described as Alzheimer’s disease.
While the original descriptions of the disease did value the coexistence of psychiatric and cognitive symptoms, in the later years of the 20th century, the “cognitive paradigm” of Alzheimer’s disease dominated the scientific literature. In view of this, central to this disorder is the early onset of a cognitive deficit that is progressive and may be complicated by mental symptoms that are not part of the core of the disease.
Philip Sheltens during the presentation.
C7
Subsequently, the International Psychogeriatric Association drew attention to the importance of what has since been called the “Psychological and behavioral symptoms of dementia”, emphasizing their significance in the clinical symptoms of the disease and as a cause of suffering for the patient and his relatives.
Advances in neuroscience have made it possible to investigate and advance the origin of dementia, although there is still a long way to go as new discoveries emerge.
The study of amyloid deposits in senile plaques (extracellular) and TAU protein in neurofibrillary tangles (inside neurons) in Alzheimer’s disease have been two preferred lines of research in recent years.
Maria C. Carrillo with René de Lamar.
C7
It is estimated that 30% of cognitively normal people have a burden of Alzheimer’s disease, and a fraction of them meet the neuropathological criteria for Alzheimer’s disease without showing symptoms.
There is a gap between the appearance of the first foci in the brain tissue and the appearance of symptoms, that is, there is an Alzheimer’s type pathology in the absence of dementia for a number of years, a period that can be defined as preclinical. period.
Biomarkers have gained strength in the context of preclinical diagnosis of Alzheimer’s disease.
Biomarkers are detected at different points in the pathophysiological process of the disease and indicate progressive milestones in its progression.
Brain atrophy in the medial temporal lobe, prelimbic, and temporoparietal cortex, as assessed by structural MRI, is a marker of neuronal loss.
Practical Data
*First of all, it should be made clear that this Congress of the International Association for the Study of Alzheimer’s (AAIC) is the world’s largest gathering dedicated to advances in all aspects of research and development in what can be defined as the science of dementia.
* The Scientific Committee has developed an impressive program with plenary sessions, presentations on various topical issues and the presentation of over 4,000 posters from around the world.
*An interesting exchange of knowledge with the participation of the world’s leading figures involved in research on dementia, aging and neurodegeneration in general.
*We are at an important juncture in which there is ongoing work to develop new diagnostic criteria and therapeutic options with mechanisms of action different from those currently available.
*Based on currently available scientific knowledge, new diagnostic criteria have been developed that improve upon previous criteria and are ahead of the times for detection and treatment of the disease.
*Diagnosis of Alzheimer’s disease at the preclinical stage is possible through the use of biomarkers detected at different stages of the pathological process.
* Lecanemab (Leqembi) is a monoclonal antibody approved by the US FDA for the treatment of early stage Alzheimer’s disease, treatment candidates must have an amyloid pathology confirmed by PET (positron emission tomography) or cerebrospinal fluid examination, indicating the disease (given intravenously every 2 weeks )
*Aducanumab (Adulhelm) is another FDA-approved amyloid monoclonal antibody for the treatment of early-stage Alzheimer’s disease with the same profile as the previous one.
*Donanemab is another drug under investigation that may slow the progression of early symptomatic Alzheimer’s disease.
* Important aspects of the diagnosis and prevention of risk factors for Alzheimer’s disease and other dementias were considered.
* Undoubtedly, improvements in the ever-earlier diagnosis of the disease that causes dementia must go hand in hand with the advent of new treatments that can change its course, so that all this has a clinical, applied and practical meaning.
Dr. René de Lamar. Specialist in geriatrics and gerontology, medical advisor to CANARIAS7. Comprehensive medical diagnostics, c/ Diderot, 19 bajo. Phone: 928 220 474.