Did you know scientists have spent the last century researching to understand dementia and how to remove the amyloid protein since it was “consistently” demonstrated to be the culprit? So, we should be treating Alzheimer’s like a common flu, are we not?
Alzheimer’s disease: 120 years of research and progress – PMC (nih.gov)
Hi, Dr Dennis here again. I hope you have read previous blogs. If you are interested, click the link on the webpage www.primegardensrs.com.au, as it will make more sense as the stories are linked. Today, I will take you through an arduous journey through current thinking and treatment options. It is challenging because, despite relentless research, we are still far from finding the cure and prevention of this disease. We give Kudos to those who have dedicated their lives to this cause.
To this date, most evidence from research demonstrates some benefits in symptom-relieving and delaying the inevitable nursing home placement of our loved ones by a couple of years.
Please allow me to share with you my struggle when I am confronted with patients whom I have just confirmed Alzheimer’s. It is not only the shock on the faces of those I have told but the deep embarrassment within me that is sometimes unbearable. This is because I don’t have a solution! For this reason, I started searching for more answers and am so excited to come across the scientific evidence from an American physician and scientist. Stay tuned! I will slowly unravel. But, for now…
Current Therapeutic Options
Let’s revisit this slide. Replacing neurotransmitters, vital in how one neuron communicates and hence forms memory, seems logical and practical. We know this chemical is called Acetylcholine (ACh). It is made at the end of neurons and functions across neurons. Then, it will be broken down by an enzyme called Cholinesterase Inhibitors and recycled.
Currently approved medications (Donepezil, Galantamine and Rivastigmine) aim to “inhibit” the Cholinesterase Inhibitors so the Acetylcholine (ACh) can last longer to carry out its function.
The other approved medication class is NMDA antagonists (don’t worry about the class). Memantine is the medication commonly prescribed. It is used to stop the “excitatory” action of Glutamate, another molecule thought to play an active role in Alzheimer’s pathology.
How effective are Cholinesterase Inhibitors & NMDA antagonists?
Researchers found that many who take cholinesterase inhibitors (first introduced in 1997) have modest improvement in their symptoms. The most common enhancements are thinking, learning, remembering things better, and managing your daily activities more efficiently. There aren’t many differences between these medications (Cholinesterase Inhibitors).
However, the effects of cholinesterase inhibitors are usually temporary, and it depends on the stage of Alzheimer’s. The drugs can’t reverse what Alzheimer’s does to your brain. Eventually, your brain stops making enough acetylcholine for Cholinesterase Inhibitors to help.
With NMDA antagonist, Memantine blocks the over-excited Glutamate molecule, ameliorating cognitive and memory deficits.
There are also reports of combination therapies between Cholinesterase Inhibitors and NMDA antagonists.
Overall, the improvement is modest at best but the disease will progress and it seems like there is nothing to stop it on its track. For those who are interested in reading further, this is the link (trust me, it can be boring….). Cholinesterase inhibitors for Alzheimer’s disease – PMC (nih.gov)
So, what practical messages can you take away from today’s learning?
Friends, allow me to apologise for the rather disappointing message here, I wish I could have delivered otherwise. But take heart, hope is on the horizon but you have to stay tuned to hear it as I dissect and share what I have learnt last six months in the blogs to come.
- Researchers and scientists are replacing the chemical Acetylcholine (Ach) by targeting the enzyme(Cholinesterase) which breaks it down.
- There are currently three such approved medications on the market.
- All three medications demonstrated comparable results in helping the symptoms of dementia but none can reverse or slow its progress.
- Hope is on the horizon with the new perspective on the cause of Alzheimer’s disease.
If you are still confused, want to talk, or have more questions, email us at info@primegardensrs.com.au. Or, as usual, you are welcome to call Prime Garden Mont Albert North on (03) 98904488, leave a message, and our responsive staff will get back to you