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Welcome to Alzheimer's by Arnav Kolluru

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Though those with Alzheimer's might forgot us, we as a society must remember them
           -Scott Kirschenbaum

F.D.A. Approves New Treatment for Early Alzheimer’s in January 2023

The drug, Leqembi, may modestly slow cognitive decline in the early stages of the disease but carries some safety risks. Still, data suggests it is more promising than the small number of other available treatments. A new study by scientists at The Neuro (Montreal Neurological Institute-Hospital) of McGill University finds a correlation between neurodegeneration in obese people and Alzheimer's disease (AD) patients, suggesting that losing excess weight could slow cognitive decline in aging and lower risk for AD.

19-year-old with Alzheimer's

According to the news report from sciencealert.com “Neurologists at a memory clinic in China have diagnosed a 19-year-old with what they believe to be Alzheimer's disease, making him the youngest person to be diagnosed with the condition in 

the world.” They also stated that “Before this recent diagnosis in China, the youngest patient with Alzheimer's was 21 years old. They carried the PSEN1 gene mutation which causes abnormal protein to build up in the brain, forming clumps of toxic plaques, a common feature of Alzheimer's.”

New research from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King's College London has established a blood-based test that could be used to predict the risk of Alzheimer's disease up to 3.5 years before clinical diagnosis.

About Me

Arnav Kolluru

As a freshman at Liberty Senior High School in Renton, Washington, I recently became fascinated with Alzheimer's disease after watching the documentary "Monster in the Mind." Despite numerous medical advancements and ongoing investigations by dementia specialists worldwide, the underlying cause of Alzheimer's remains a mystery. This sparked my curiosity, and I decided to delve deeper into this topic. With the guidance of my mentor Jessica Apulei, who has experience studying Alzheimer's, I have compiled information from various sources such as documentaries, articles, interviews, and journal publications to create a website to educate others about this disease. I hope you find my website informative and invite you to explore it.

         Alzheimer's is a type of dementia that impacts an individual's cognitive abilities. Dubbed the "Monster in the Mind," the disease leads to the death of brain cells once a person is diagnosed. There are three stages of Alzheimer's development, which offer a glimpse into what to expect from individuals at different stages of the disease. The first stage is known as "Mild Alzheimer's" and is characterized by symptoms such as forgetfulness, mood swings, difficulty concentrating and learning, and mild coordination issues. The second stage marks an acceleration in the decline of thinking and memory and the need for caregivers to provide support. Despite this, the individual may still be able to perform most daily tasks independently. Finally, in the third and most severe stage, the individual cannot live alone and requires full-time care, eventually leading to their passing. Throughout all three stages, the individual continues to lose brain cells, leading to an increasing dependence on others.

Introduction to Alzheimer's 

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History of Alzheimer's

The discovery of Alzheimer's disease can be traced back to Dr. Alois Alzheimer in 1906. After conducting an autopsy on a woman who had passed away unexpectedly, Dr. Alzheimer observed changes in her brain tissue, including the presence of plaques and tangles and a loss of connections between neurons. In 1909, he published his findings, which were later included in the chapter on "Presenile and Senile Dementia" by renowned psychiatrist Dr. Kraepelin in the 8th edition of his Handbook of Psychiatry in 1910. This marked the official recognition of the disease and its naming as Alzheimer's. 

Statistics on Alzheimer's :
  • Alzheimer's disease impacts approximately six million Americans.

  • Neurologists predict that by 2050, this number will double due to the increasing number of diagnosed cases.

  • One in three elderly individuals passes away from Alzheimer's or another form of dementia.

  • The COVID-19 pandemic has led to a 17% increase in Alzheimer's diagnoses, according to health officials.

  • Two-thirds of Alzheimer's patients are women.

  • In 2022, Alzheimer's caused a financial burden of 321 billion dollars in the US, and experts estimate that this cost will reach a trillion dollars by 2050.

  • Each year, 10-15% of those with Mild Cognitive Impairment (MCI) eventually progress to develop dementia.

 

 

Diagnostic Tests
Brain Scans

There is currently no single definitive test for Alzheimer's disease, and the diagnosis of Alzheimer's typically involves a combination of several different tests and assessments. However, here are some standard tests used:​.

Cognitive and neuropsychological assessments

These tests are MMSE, MoCA, NAB, CAB, and CDR. These tests evaluate a person's thinking, memory, and language skills and ability to perform daily activities. Most of these tests are done in the office setting.​

Brain imaging tests

MRI and PET scans can provide brain images and help detect the characteristic brain changes associated with Alzheimer's. For example, MRI scans can show shrinkage in brain regions affected by AD, while PET scans detect the buildup of amyloid plaques, a hallmark of AD. In addition, functional MRI (fMRI) and magnetoencephalography (MEG) can provide more detailed information about brain activity and detect Alzheimer's in its early stages.

Blood tests

One area of focus for researchers is developing blood tests for Alzheimer's. These tests would measure the levels of specific biomarkers in the blood, such as tau protein or beta-amyloid. The idea behind these tests is that they would be non-invasive and could be performed quickly and easily.

Genetic testing

Genetic tests can identify mutations in specific genes associated with a higher risk of developing AD and help determine the likelihood of passing the disease on to future generations. For example, the presence of the apolipoprotein E (APOE) gene is a known risk factor for developing AD.

Spinal fluid analysis

Researchers are also exploring using cerebrospinal fluid (CSF) markers for diagnosing Alzheimer's. For example, researchers have found that a decrease in the levels of Aβ42 and an increase in the levels of tau protein and phosphorylated tau protein in the CSF are associated with Alzheimer's. Biomarker tests can provide additional information to support a diagnosis of AD and help differentiate AD from other forms of dementia.

Eye Tests

Researchers are investigating the use of eye tests to diagnose AD. These tests use unique imaging technology to measure changes in the blood vessels in the retina, which can reflect changes in brain function. For example, researchers have found that changes in the retinal blood vessels are associated with AD, which can be measured using optical coherence tomography (OCT). Eye tests may offer a non-invasive and convenient alternative to current diagnostic methods.

Breath Tests

Breath tests are being developed to detect the presence of specific volatile organic compounds (VOCs) in the breath, which are associated with AD. Breath tests may offer a non-invasive alternative like eye tests.

While these tests are still in the developmental stage, they offer hope for the future of Alzheimer's diagnosis. If these tests can be validated in more extensive studies, they could become an essential tool for the early diagnosis and management of Alzheimer's. It's important to note that these tests are used to support a diagnosis of Alzheimer's, but they cannot definitively diagnose the disease. Therefore, a complete evaluation should include a comprehensive medical history, a physical and neurological examination, and a detailed assessment of symptoms and functional abilities. The final diagnosis of Alzheimer's is typically made by a neurologist or a specialist in geriatric medicine after a thorough evaluation.

'Brain scans (FDG PET) are used to diagnose Alzheimer's disease. The scans show a healthy brain, a brain with mild cognitive impairment, and a brain with Alzheimer's disease. Areas that are black and blue represent healthy brain metabolism. Areas that are green, yellow, and red represent worsening brain metabolism as the disease progresses."- copied from Mayo clinic website.

Causes and Risk Factors 

Despite significant advances in medical research, the exact cause of Alzheimer's disease is still unknown. However, scientists identify various factors that may contribute to the development of this condition, including genetics, lifestyle choices, environmental factors, infections, cancer, and cardiovascular diseases. 

Genetics

One of the most significant causes of Alzheimer's disease is genetics. Studies have shown that people with a family history of the condition are at an increased risk of developing Alzheimer's. In particular, mutations in specific genes, such as APOE-e4, have been linked to an increased risk of Alzheimer's. In addition, these genetic mutations may cause changes in the brain that result in the accumulation of the protein amyloid, a hallmark of Alzheimer's disease.

Fruits and Nuts

Lifestyle choices

Physically inactive People with poor diets and chronic stress are more likely to develop cardiovascular diseases and type 2 diabetes, known risk factors for Alzheimer's disease.

Additionally, studies have shown that people who smoke and consume excessive amounts of alcohol are at an increased risk of developing Alzheimer's.

Environmental factors

Environmental factors, such as exposure to toxins, have also been linked to an increased risk of Alzheimer's disease. For example, studies have shown that exposure to lead and mercury can damage the brain, increasing the risk of developing Alzheimer's.

Repeated head injury has been linked to an increased risk of developing Alzheimer's disease and other forms of dementia.

Treatments

Currently, there is no cure for Alzheimer's, but treatments and prevention strategies can help slow down its progression and improve the quality of life of those affected.

Medication

  • Cholinesterase inhibitors, such as donepezil, rivastigmine, and galantamine, increase the levels of acetylcholine, a neurotransmitter essential for memory, and cognitive function, in the brain.

  • NMDA receptor antagonists, such as memantine, work by blocking the overactivity of the NMDA receptor, which causes neuronal death in Alzheimer's disease.

  • Aducanumab( Aduhelm): This is the first disease-modifying medication approved to treat Alzheimer's. It is a human monoclonal antibody drug developed by Biogen to treat Alzheimer's disease. It is designed to target and remove aggregates of beta-amyloid protein. Despite the controversies, aducanumab received conditional approval from the US Food and Drug Administration (FDA) in June 2021. Aducanumab was a significant milestone in Alzheimer's research, as it was the first drug to receive approval specifically for treating Alzheimer's disease in over 15 years.

  • Lecanemab (Leqembi): This drug, from the drugmakers Eisai and Biogen, was approved by the Food and Drug Administration on January 6th, 2023, for use in people with mild cognitive impairment or early Alzheimer’s disease. It’s only the second drug approved in the United States. It is an antibody ( BAN2401) treatment for Alzheimer's disease developed by Biogen in partnership with Eisai Co., Ltd. The goal of BAN2401 is to slow down or stop the progression of Alzheimer's disease by removing beta-amyloid deposits from the brain.

Antibody treatment

  • Tau protein-targeting antibodies: These antibodies address the abnormal accumulation of tau protein in the brain, which is thought to contribute to the death of brain cells in Alzheimer's disease.

  • JNJ-54861911: This is developed by Janssen Pharmaceuticals, a subsidiary of Johnson & Johnson, for treating Alzheimer's disease. It is a beta-secretase cleaving enzyme (BACE) inhibitor that reduces the production of amyloid beta. JNJ-54861911 was in the early stages of clinical development, and its safety and efficacy have not yet been established.

Prevention

  • Regular physical exercise improves cardiovascular health and reduces the risk of Alzheimer's disease.

  • A healthy diet rich in fruits, vegetables, and omega-3 fatty acids is also important. Social interaction and leisure activities can help reduce stress levels and improve overall mental and emotional health, which can help reduce the risk of developing Alzheimer's disease.

  • Early detection and intervention can help to slow the progression of Alzheimer's and improve the quality of life for those affected by the disease.

  • Make homes where elderly people are living fall-proof.

  • Cognitive stimulation therapies, such as brain training games and memory exercises, can help to improve memory, problem-solving skills, and overall cognitive function.

Make a change

While a cure for Alzheimer's has yet to be found, there are ways to reduce the risk of developing the disease. While much work remains to be done, the continued advancement of treatments for Alzheimer's disease offers hope for those affected by the condition and their families. Experts continue to make progress in unraveling the mystery of Alzheimer's. The ongoing research in this field holds great promise for the future of Alzheimer's diagnosis and management.

Get in Touch With Me! 

Let me know if you have any doubts or concerns about the information being presented on this website. I will be more than glad to help you out! 
 

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