Abigail Witman (Neal)
PY 301
Prof. Cindy Nelson
Term Paper
11/27/2018
ALZHEIMER’S/DEMENTIA CURE
“God damn bitch!” Said JoAnn Holton to her daughter after not receiving a diet Pepsi quickly enough. A sentence her daughter would have never heard six years prior, before her mother was diagnosed with Alzheimer’s, now holds more weight than a curse word ever would have. These kind of episodes happen almost daily for JoAnn along with continual repetition of simple phrases and frequently confusing family ties. Her degenerative disease is turning a once quick-witted, strictly religious and undoubtedly kind woman into a grumpy, forgetful potty mouth, as described by her daughter. These are the kind of struggles JoAnn and her family, as well as nearly 5.7 million other Americans, experience daily. By 2050 it is projected that a staggering 14 million Americans will be diagnosed with Alzheimer’s dementia (Alzheimer’s Association, 2018). This disease is currently the 6th leading cause of death in America, killing more than breast cancer and prostate cancer combined (Alzheimer’s Association, 2018).
Merriam Webster defines Alzheimers as a degenerative brain disease of unknown cause that is the most common form of dementia. It usually starts in late middle age or old age, that results in progressive memory loss, impaired thinking, disorientation, and changes in personality and mood, and that is marked histologically by the degeneration of brain neurons especially in the cerebral cortex and by the presence of nerofibrillary tangles and plaques containing beta-amyloid. Alzheimer’s affects not only those diagnosed, but it also affects the estimated 16.1 million Americans that provide unpaid care for people with this disease (Alzheimer’s Association, 2018). Not only are these personal effects staggering but the disease affects the whole of America’s economic infrastructure costing the nation $277 billion not including the 18.4 billion hours of unpaid care provided by loved ones (Alzheimer’s Association, 2018).
Alzheimer’s starts in the brain about ten years before symptoms start showing up. The two abnormal proteins that show up are beta-amyloid and tau which becomes toxic to the brain by forming tangles inside neurons and forming plaques between neurons. Research also suggests that other factors may play a role including vascular conditions or metabolic conditions like diabetes. Eventually neurons lose their ability to communicate due to the plaques and tangles and they die. As they die the brain shrinks beginning in the hippocampus. People will start experiencing memory loss as the hippocampus is killed. The ability to create new memories is destroyed. Simple recollections of the past hours or days are simply not there. From there, the plaques and tangles spread to other regions of the brain responsible for language processing where it becomes tougher and tougher to find the right words. As more neurons continue dying those afflicted with Alzheimer’s lose the ability to logically make decisions, problem solve and conceptualize new plans due to death in the front of the brain. Next the plaques and tangles move to the part of the brain where emotions are regulated. The patient gradually loses control over moods and feelings. After that the disease moves to where the brain makes sense of everything it hears, sees and smells. In this stage the disease can cause hallucinations and wreaks havoc on a persons senses. Eventually Alzheimer’s erases a persons oldest and most precious memories stored in the back of the brain. Near the end the disease compromises the persons ability to balance and control coordination. Very last, it destroys the part of the brain that regulates breathing and the heart ultimately causing death. Understanding more about the molecular and cellular levels of the disease could be essential to learning about how effective therapies can be used (Alzheimer’s Disease Fact Sheet, 2016).
Alzheimer’s was first described in 1906 and in the century since then, there have been major milestones in the understanding of how Alzheimer’s truly affects the brain and learning how to make life better for those affected. Dr. Alois Alzheimer was a German psychiatrist and neuro pathologist. He was the first person to identify the identifiers of what would later become known as Alzheimer’s disease. When his longtime patient Auguste Deter died in 1906 her brain was throughly examined and Alzheimer identified amyloid plaques and neurofibrillary tangles. Four years later Emil Kraepelin named the disease after Dr. Alois in his edition of his book Psychiatrie. In 1968 researchers develop the first measurement scale for cognitive and functional decline in older adults. In 1974 Congress establishes the National Institute on Aging as one of the National Institutes of Health. The NIA is one of the primary federal agencies supporting Alzheimer research. In 1976 Alzheimer’s is identifies as the most common cause of dementia and declared a major public health challenge. In 1987 the first launching and recruiting of participants for a clinical trial of medication that is to target symptoms of the disease is a go. In 1987 the first gene associated with genetic Alzheimer’s disease is amyloid precursor protein.In 1991 the NIA establishes a nationwide network to help clinical research and to conduct federally funded clinical trials. In 1993 Researches identify a gene on chromosome 19 as the first gene that raises risk for Alzheimer’s. In 1993 the FDA approved the first drug specifically targeting Alzheimer;s memory and thinking symptoms. Over the next ten years four more drugs are approved. In 1995 the first transgenic mouse model is announced. The mouse was developed by insetting of the human amyloid precursor protein genes. In 1999 the first in a series of reports is published showing that injecting “Alzheimer” mice with beta-amyloid prevents the animals from developing plaques and other brain changes. In 2004 researchers at the Alzheimer’s association share their first report on an imaging agent called Pittsburgh Compound B (PIB), a major potential breakthrough in disease monitoring and early detection. In 2010 a group of researchers publish a working model relating Alzheimer’s biomarkers to disease stage and symptom severity. In 2011 President Obama signs National Alzheimer’s Project Act into law which is the first ever plan to address the Alzheimer’s crisis. In 2012 the first major clinical trial for prevention of Alzheimer’s disease is initiated. In 2013 International Genomics of Alzheimer’s Project researchers identify 20 genetic risk factors for Alzheimer’s disease, 11 of which had never been linked before. In 2017 there was a $400 million increase for federal funding for Alzheimer’s disease. (Alzheimer’s Association, 2018)
Up to this point there has been a high clinical failure rate (99.6%) for drugs to slow progression of dementias. However, a bright spot of hope seems to be that the occurrence of dementia has been reported to be stabilizing in Western Europe