World Alzheimer's Day is observed annually on the 21st of September. It serves as a worldwide initiative aimed at increasing awareness, challenging stigma, and dispelling misconceptions surrounding Alzheimer's and related diseases. This significant event provides a platform for governments, organizations, and individuals to come together, collaborate on research, and work on initiatives related to prevention and care.

What is Alzheimer's

Alzheimer's Disease (AD) is a neurological condition characterized by the progressive loss of brain cells, leading to a decline in memory and cognitive abilities. It stands as the most prevalent form of dementia and predominantly affects older individuals. Around 55 million people worldwide, are affected by dementia, with the majority being Alzheimer's. This disease primarily affects the region of the brain responsible for thought, memory, and language, resulting in common symptoms such as cognitive impairment and unpredictable behaviour.

AD is characterised by the presence of plaques and tangles in the brain, as detailed by the Alzheimer's Association. 

Plaques are formed as the amyloid protein begins to aggregate and accumulate between neurons. These plaques hinder communication between cells and may trigger inflammation. This prompts the immune system to target and eliminate the compromised cells. Tangles, on the other hand, develop inside neurons and disrupt cellular processes, ultimately resulting in cell death. 

Types of Alzheimer’s:

There are mainly two types of Alzheimer’s: Early- onset and late onset. Both types have a genetic component. Less than 10% of the people have an early onset AD, occurring between the ages of mid-30s to mid-60s. Most of the Alzheimer’s patients suffer from late-onset AD, where the symptoms are apparent in their mid to late 60s. (What Causes Alzheimer’s Disease?, n.d.)

Understanding the Symptoms:

Memory loss is the primary symptom of Alzheimer's, often appearing as an initial sign. While it might not be immediately noticeable, as the condition progresses, changes become more apparent. Alzheimer's-related brain changes impact several areas:

Memory:

Memory lapses are common, but in Alzheimer's, these symptoms worsen and deteriorate progressively. Individuals may:

•  Repeatedly repeat statements and questions.
•  Forget important appointments.
•  Struggle to recall the names of close family members.
•  Face difficulty engaging in conversations.

Thinking and Reasoning:

People with Alzheimer's experience challenges with concentration and thinking. Multitasking becomes difficult, and they may eventually have trouble working with numbers.

Performing Day-to-Day Activities:

Routine activities that involve step-by-step processes, such as cooking or playing games, can become increasingly difficult.

Personality or Behavioral Changes:

Alzheimer's can affect mood and behaviour, leading to:

• Depression
•  Mood swings
•  Withdrawal
•  Aggression
•  Wandering
•  Delusions
•  Loss of inhibitions

Getting to know the risks:

The cause of Alzheimer's is multifaceted and can develop from multiple factors such as genetics, lifestyle, and environment. Some risk factors can be mitigated while others like age, heredity, and genetics cannot be changed.

 Age:

Increasing age is a greater risk factor for dementia and Alzheimer's but these disorders are not ageing related disorder. It usually affects the older population but it is not a normal part of ageing.

Genetics:

Genes involved in Alzheimer’s are known and can be tested for. There are two categories of genes that influence diseases: Risk genes: genes when present, that increase the risk of developing a disease and Deterministic genes: genes that cause a disease. Alzheimer's genes have been found in both categories.

While Genetics cannot be controlled there is ongoing research regarding other risk factors that we may be able to control through lifestyle choices and management of other health conditions. Smoking, excessive alcohol, physical and cognitive inactivity, social isolation and depression increase the risk of developing Alzheimer’s. 

Gender:

Gender disparity is apparent with AD. Women are at a higher risk of Alzheimer’s as compared to men. This is due to the neurobiological vulnerability in post-menopausal women. The estrogen protects the brain and nerves, due to a sudden decrease in the hormone during menopause, the brain cells are susceptible to damage. Another reason is the higher deregulated inflammatory response in females, increasing the risk of AD and other types of dementia. (Podcasy & Epperson, 2016)

World Alzheimer's Day meaning, history and motive

Alzheimer's disease, initially named by German doctor Emil Kraepelin after psychiatrist Alois Alzheimer who identified it, is a severe brain disorder that profoundly impacts memory and daily functioning. When not diagnosed promptly, it can significantly erode mental capabilities and compromise physical and emotional well-being, affecting not only the patient but also their family and friends.

In 1984, Alzheimer's Disease International (ADI) was established to offer support and guidance to Alzheimer's patients and their families. On September 21, 1994, ADI launched World Alzheimer's Day, which has since grown into a global initiative to raise awareness and challenge misconceptions and stigma surrounding dementia. Since 2012, the entire month of September has been designated as Alzheimer's month, bringing together people, Alzheimer societies, and organizations worldwide to provide support for individuals and families affected by dementia or Alzheimer's.

During this month, various activities are organized to debunk myths, educate the public about warning signs and symptoms, promote early diagnosis and treatment, and offer social and financial support to those affected by the disease.

What is the theme for this Year

The campaign theme for 2023 is ‘Never too early, Never too late’ aims to identify the risk factors and adopt preventive measures to delay and if possible, prevent the onset of Dementia. 

Risk recognition and management can significantly slow the progression or prevent the development of the disease. World Health Organization (WHO) has issued a list of recommendations that reduce the risk of dementia. 

Reducing the risk of cognitive decline, dementia and brain protection involves:

• engaging in physical activity 
• refraining from smoking 
• limiting alcohol consumption
• managing weight
• adopting a nutritious diet
• regulating healthy blood pressure, cholesterol, and blood sugar levels.
• Social interaction
• Learning and Cognitive stimulation

What Are Alzheimer's treatment options that are Available:

Medications:

There are no known medications that help cure Alzheimer's, however, there are several FDA-approved drugs that help manage the symptoms.  The two types of drugs that are currently used to alleviate the symptoms are:

Cholinesterase inhibitors:

These medicines boost cell-to-cell communication by preserving the chemical messenger depleted because of Alzheimer’s. They might improve behavioural symptoms, such as agitation or depression. Side effects of these drugs can include diarrhoea, nausea, loss of appetite and irregular sleep. 

Memantine:

This medicine improves the nervous communication system in the brain, slowing the progression of Alzheimer's. They are used along with cholinesterase inhibitors. The side effects are confusion and dizziness

Antibody treatments:

 Aducanumab, donanemab and Lecanemab are currently being administered to patients with early Alzheimer's. These have adverse side effects and aren't widely used. Antibody treatments are still being explored and more research is required in the field. 

Supplements

Long-term use of supplements can help keep the brain health safe and sound, delaying and potentially preventing the onset of neurodegenerative diseases. Supplements such as:

Vitamins D and E:

Researchers believe that the antioxidative properties of Vitamin E help reduce oxidative stress while deficiency of vitamin D increases the risk for AD. (Mielech et al., 2020)

Spermidine:

Spermidine has been shown to dissolve amyloid beta plaques by autophagy, improving cognitive function and preventing cognitive function. (Pekar et al., 2019)

Ca-AKG:

calcium levels regulate the condition of your nerves and are involved in electrical impulses. Evidence suggests that age-related dysregulation of neuronal Calcium might be an important factor in the pathogenesis, progression of any disease,  of Alzheimer’s. (Tong et al., 2018)

Can I be a part of World Alzheimer's Day?

The answer is Yes, of course, you can participate. You can contribute in your own way by:

1. Being Aware: Being well-informed about the disease is the first step towards contributing to the greater good. Know the facts and understand the implications of the disease. You can get updated by the ADI toolkit
2. Spreading Awareness: Sharing useful information about the disease with your friends, and family by posting on social media. 
3. Volunteer at your local Alzheimer's association: Volunteer and participate in the activities conducted by your local NGO to promote awareness.
4. Donate: ADI encourages individuals and organizations to contribute financially. Your financial support plays a crucial role in raising awareness and facilitating event organization.
5. Create a safe and supportive environment:
   Here are some practical tips for caring for someone with Alzheimer's at home:

• Organize Valuables: Store keys, wallets, mobile phones, and other valuables in a consistent location to prevent them from getting lost.
• Medication Management: Keep medications in a secure place and use a daily checklist to ensure doses are taken as prescribed.
• Financial Arrangements: Set up automatic payments and deposits for financial matters to simplify management.
• Mobile Phone with Tracking: Provide the person with Alzheimer's with a mobile phone with location tracking and program important numbers.
• Security Measures: Install alarm sensors on doors and windows for added safety.
• Visual Schedules: Use a calendar or whiteboard to track daily routines and encourage checking off completed tasks.
• Safety Modifications: Remove excess furniture, and clutter, and throw rugs to prevent falls. Install sturdy handrails in bathrooms and on stairs.
• ID and Medical Alert: Ensure the person with Alzheimer's carries identification or wears a medical alert bracelet.
• Personal Touch: Decorate the home with meaningful photos and objects to provide comfort and familiarity.

Conclusion

World Alzheimer's Day offers associations, research organisations and hospitals a valuable chance to gain recognition for their efforts, enhancing their ability to achieve their organization's objectives. Each year, a dedicated theme is chosen for the observance, serving to abolish the common misconceptions about the disease. The fight against Alzheimer's unites individuals worldwide, spanning victims, caregivers, medical professionals, and researchers, who all share a common struggle.

 

 

References:

Mielech, A., Puścion-Jakubik, A., Markiewicz-Żukowska, R., & Socha, K. (2020, November 11). Vitamins in Alzheimer’s Disease—Review of the Latest Reports. Nutrients; Multidisciplinary Digital Publishing Institute. https://doi.org/10.3390/nu12113458

Pekar, T., Wendzel, A., Flak, W., Kremer, A., Pauschenwein-Frantsich, S., Gschaider, A., Wantke, F., & Jarisch, R. (2019, December 12). Spermidine in dementia. Wiener Klinische Wochenschrift; Springer Science+Business Media. https://doi.org/10.1007/s00508-019-01588-7

Tong, B. C. K., Wu, A. J., Li, M., & Cheung, K. H. (2018, November 1). Calcium signaling in Alzheimer’s disease & therapies. Biochimica Et Biophysica Acta. Molecular Cell Research; Elsevier BV. https://doi.org/10.1016/j.bbamcr.2018.07.018

What Causes Alzheimer’s Disease? (n.d.). National Institute on Aging. https://www.nia.nih.gov/health/what-causes-alzheimers-disease#:~:text=There%20are%20two%20types%20of,types%20have%20a%20genetic%20component.

Podcasy, J. L., & Epperson, C. N. (2016, December 31). Considering sex and gender in Alzheimer disease and other dementias. Dialogues in Clinical Neuroscience; Laboratoires Servier. https://doi.org/10.31887/dcns.2016.18.4/cepperson