Alzheimer’s disease is the most common of the neurodegenerative diseases that cause dementia. September 21 has been designated as World Alzheimer’s Day in order to raise public awareness of the disease, but also to awaken and activate the State. Dementias in general are diseases that cause a progressive impairment of higher mental functions to an extent that makes it problematic for patients to live independently.

In addition to mental impairment, behavioral and mental disorders often coexist. Its frequency is high as it is estimated that among people over 80 years of age, about one in three suffer from it. In our country, dementia patients are estimated at 150,000.

Where is it due to?

“Alzheimer’s disease progresses progressively over many years. It is due to the deposition of β-amyloid and neurofibrillary tangles (Tau protein) in various areas of the brain leading to atrophy. The lesions begin in the temporal lobes of the brain and slowly spread to other neighboring areas,” explains Mr. Stylianos Doris Neurologist Director of the 1st Neurological Clinic of the Metropolitan General And it continues:
“The etiology of the disease is multifactorial. This means that DNA and environmental factors interact to eventually manifest the condition. Environmental factors include head injuries, arterial hypertension, dyslipidemia, diabetes, sedentary lifestyle, smoking, alcohol abuse, etc.”

Symptoms

During the initial phase of the disease, we have changes in the brain without clear clinical manifestations. This can take several years. Later, clinical symptoms appear progressively and steadily worsen.

“The most common symptom is recent memory impairment. There are also disorders of speech, orientation in space and time, difficulty in planning and performing complex activities as well as mental disorders (depression, anxiety, aggression, inappropriate behavior, delusional ideas of persecution, hallucinations).

The order in which clinical manifestations appear varies from patient to patient. This means that in the initial stages there is a great clinical heterogeneity. However, in the final stages, sufferers are confined to bed with severe motor and mental disorders and completely dependent even for their basic functions,” the expert points out.

Diagnosis

“The diagnosis of the disease is mainly based on the detailed history, the clinical examination of the patient, various neuropsychological tests as well as the exclusion of diseases that can “imitate” Alzheimer’s disease. There is no specific test that is sufficient to document the diagnosis. However, blood tests, brain CT or MRI, blood flow scintigraphy and positron emission tomography (SPECT), lumbar puncture and possibly genetic testing are useful,” he adds.

Treatment

Alzheimer’s disease affects not only the sufferer but also his whole family and especially the people who take care of him. These people take too much of an emotional toll from patients.

“Treatment involves the administration of drugs that delay the progression of the disease. These drugs have very little effect on the progression of the disease. Also, other drugs are administered to treat the patients’ behavioral and mental disorders, which are often the most serious problem”, he emphasizes and adds:

“In terms of new drug treatments, a monoclonal antibody called Lecanemab has recently been approved by the US Food and Drug Administration (FDA), while another drug, Donanemab, is expected to receive approval soon. For the time being, neither of them has received marketing approval in Europe. Both of these substances seem to reduce the concentration and deposition of β-amyloid in the brain and delay the progression of the disease. The indication for their administration is the mild form of Alzheimer’s.

However, there is a great deal of debate and disagreement regarding both the effectiveness and the safety of these drugs. Side effects include brain swelling and brain bleeds. However, these are two revolutionary treatments that pave the way for other better and safer ones in the future”, concludes Mr. Doris.