Raise awareness of environmental health issues in order to better protect our children and future generations.

28 September 2013

Alzheimer's Disease in Switzerland : Research and Treatment

Village in canton Bern being developed to accommodate
persons with dementia, foreseen to be completed in 4 -6 years.
According to the Swiss magazine, Hebdo (30 May 2013, no. 22), 36 million persons in the world today have Alzheimer’s Disease (AD). The disease is insidious, irreversible, and incurable. One in 10 persons is affected from age 65, and 1 in 4 from age 80. Dementia is the third cause of death after cardio-vascular disease and cancer (2009 Swiss statistics). It is projected that by 2030, world-wide, there will be 65.7 million persons with AD and 115 million by 2050. The average age of diagnosis is 65. It usually takes two years between the appearance of the first symptoms and diagnosis.

In 2010, there were 110,000 persons with AD in Switzerland, with 25,000 additional cases diagnosed each year. In 2050, it is projected there will be 300,000 cases. In 2009, the cost for care of AD patients was 7 billion Swiss francs (7.68 billion dollars).

In the United States the cost of dementia was $200 billion in 2012 and could go to as high as one trillion dollars in 2050. Only 8 out of 194 Member States of the World Health Organization have a “plan Alzheimer’s” for early diagnosis, better care of the sick, assistance for family members, and support for scientific research. Switzerland will become the ninth country to implement the plan.

In 2012, four medications to treat Alzheimer’s generated $4.2 billion in sales, but these drugs only treat symptoms without preventing the disease or stopping its evolution. There is no single cause for AD, but rather, an accumulation of risk factors.

Some 455 pharmaceutical and biotech companies in the world are trying to elucidate the mechanisms of this affliction and elaborate preventive and therapeutic treatments. In Switzerland, 18 companies, not including universities and hospitals, are developing drugs or preparations eliciting hope for treatment. The companies include Novartis and Roche.

Medications are being developed for limiting the action of enzymes linked to beta amyloid deposits. Poor regulation of these enzymes may cause overproduction of these deposits. Ways to inhibit these enzymes and thus, slow down or block the process of buildup of these deposits is being explored, however these enzymes participate in other vital biological mechanisms and cannot be inhibited without perturbing other functions of the organism.

Another treatment being researched is immunotherapy through antibody injection, the concept being to destroy amyloid plaques by suppressing accumulation of toxic residues resulting from amyloid cascade. The antibody injections would enhance the immune defenses of the patient. Another way to stimulate the immune system would be through vaccination.

The drug developed by the Swiss company AC Immune, anti-Abéta (crenezumab) has been selected by the National Institutes of Health (NIH) to be the first medication ever studied in a world trial for prevention of Alzheimer’s. It is being tested on a Colombian family having a rare genetic mutation which sets off AD symptoms towards age 45. The drug is being evaluated to determine whether injections can slow appearance of the disease. The NIH has contributed $100 million towards this trial. An agreement was concluded by the Banner Alzheimer’s Institute and Genentech (a subsidiary of Roche) with AC Immune in 2006 to conduct a 5-year trial of the drug, to be launched in 2013.

AC Immune is also exploring vaccines. Results in testing on rats have been promising, but it is unlikely that a vaccine alone could treat Alzheimer’s due to the disease’s complexity. The idea is to combine a vaccine with anti-body therapy.

Current medications include donepezil (Aricept made by Pfizer-Eisai), rivastigmine (Exelon made by Novartis) and galantamine (Reminyl made by Janssen-Cilag). These prevent an enzyme known as acetylcholinesterase from breaking down acetylcholine in the brain. Increased concentrations of acetylcholine lead to increased communication between the nerve cells that use acetylcholine as a chemical messenger, which may in turn temporarily improve or stabilize the symptoms of Alzheimer's disease.

These drugs carry strong and persistent side effects including nausea, diarrhea, insomnia, vomiting, muscle cramps, fainting, fatigue, loss of appetite and weight.

Another drug, memantine (Ebixa made by Lundbeck), blocks a messenger chemical known as glutamate. Glutamate is released in excessive amounts when brain cells are damaged by Alzheimer's disease, causing the brain cells to be damaged further. Memantine can protect brain cells by blocking the effects of excess glutamate. There are a wide range of side effects similar to those of the three other drugs used to treat Alzheimer’s symptoms.

Non-medication therapies exist such as cognitive therapy but these are more difficult for persons living at home who must be moved to a hospital several times a week to receive the therapy. Other therapies include sensory stimulation, zootherapy (pet therapy), musicotherapy, art, cooking, walking, games.

For preventing Alzheimer’s, a Mediterranean diet is suggested: fruit, vegetables and fish, also green tea, red wine, vitamins C,D and E, beta-carotene, and omega 3.

In the Netherlands, there are special villages for persons with Alzheimer’s. At De Hogeweyk, south of Amsterdam, persons with AD or dementia may go out freely in the village to eat in a restaurant or go to the hair dresser’s, movies, grocery store. The persons running these establishments are also care-givers trained in how to manage those afflicted with dementia. This concept is being imported into Switzerland. Such environments encourage persons to be as autonomous and independent as possible.

Ref:  Hebdo article on Alzheimer’s (not available on-line to non-subscribers) , c-health.canoe.ca, and "Berne:  Un Village pour les malades d’Alzheimer", 24heures, 3 January 2012.

5 comments:

  1. Nice post about Alzheimer's research and treatment, really this will increase day by day. But we are responsible for providing the nursing care, health care facilities for senior or disables people. Our communities understand the unique need and provide the special environment to the seniors.

    Alzheimer specialist

    ReplyDelete
    Replies
    1. Yes, the quality of care and environment is almost more important than treatment (medications etc.). I admire those who take care of the elderly and disabled. It is such a difficult task. I play piano for persons afflicted with dementia and notice what a positive effect it has on these people: movement, singing, and even recalling past memories.

      Delete
  2. in Armenia in a small village there is one case with Alzheimer ,he came from France wellknown hospitals and he became more happy,more independent.
    Special village life for Alzheimer people should be in every country.
    Human projects and care our challanges are more important from other issues in the world.Thank you.

    ReplyDelete
    Replies
    1. Yes, village life for people with Alzheimer's should be set up in every country: a village where there is a mix of families: young, the elderly, persons with disabilities to give the latter a feeling of living in a "normal" environment and especially, of being considered as a person like any of us, that is, not labeled as a person with a disease. Unfortunately, too much money is being poured into research for a "cure" when Alzheimer's is such a complex disease. We would do better to spend this money on true prevention and care. In the book, "The Myth of Alzheimer's", reviewed on this blog, the authors conclude that we can improve the environmental health of our local and global community by "treating our loved ones better, protecting the bodies and minds of younger generations, taking responsibility for the environment..."

      Delete
  3. Thank you for sharing the testimony of your son. I personally do not believe that medication for psychological disorders helps long-term. You may have seen the post on this blog, "Bipolar Disorder without Medication". It is the testimony of a family member who has renounced medication and "cured" himself through better diet, supplements, and especially, the support and love of his family.

    We believe that one's environment and lifestyle also play a role in mental health, including overuse of wireless technology (cell phones, Wi-Fi, tablets...) which exposes the brain and body to microwave radiation causing not only physical but also psychological damage (depression, aggressive behavior, learning disorders, even pre-Alzheimer states), as you will read from the articles posted on this blog.

    PS - Just curious - where are you located?

    ReplyDelete

Note: Only a member of this blog may post a comment.