Alzheimer’s:  Our focus is on helping those with Hearing Loss but there are other things you can do to help treat.

There is no cure for Alzheimer’s but there are treatments available to help the patient and family live with the disease by lessening its effects.  The challenge lies in the path this disease can take.  The saying goes:  “Once you have seen one person with Alzheimer’s, you have [only] seen one person with Alzheimer’s.”  This is a multifactorial disease process.  According to Dr. Richard Isaacson, of Florida Atlantic University’s Schmidt College of Medicine, “The disease presents differently and progresses differently in different people.”  That is why we are interested in learning more and sharing it with you, our consumer.   It is important to know and talk about.

This is our 3rd blog in a series.  Our first blog was on our clinic website here https://hearstou.com/is-dementia-alzheimers/.  The second one was published on our store website here

Alzheimer’s Disease:  What are other Risk Factors besides Hearing Loss? 

As with many diseases that have no cure, what can be treated are the symptoms.

As of today, the Summer of 2022, there are several medications that can be given to address memory loss (classes of medications called cholinesterase inhibitors, glutamate regulators, or a combination), and to address behavioral and psychological symptoms there is an orexin receptor antagonist to treat insomnia.  Antidepressants have proven helpful.  Also there are anxiolytics to address anxiety, restlessness, and verbally disruptive behavior.  Some will prescribe antipsychotic medications, but these should be given with great care.  They have not been approved to treat dementia symptoms and come with an increased risk of stroke.

We have also learned that a medication called Aducanumab has received approval as a treatment for Alzheimer’s disease from the FDA.  It has been shown to remove beta-amyloid plaques from the brain.  However, the clinical trial that showed the removal of amyloid showed only a small improvement in cognition.  In April 2022, CMS issued a ruling that states it will cover the cost of the drug only if the patient is participating in a CMS-approved clinical trial.  More study is needed.

Accoring to Maria Carrillo, chief science officer of the Alzheimer’s Association, “Certainly, plaques and tangles are a hallmark.  It doesn’t mean plaques are the case of cell death.”

Plaques are clumps of a protein called beta-amyloid that appear in the spaces between neurons.  Tangles are made up of a protein called tau that appears inside a neuron.  Both proteins tend to accumulate in the brains of people with Alzheimer’s, but their role in killing brain cells is still unclear.

Carrillo says that the Alzheimer’s field need to look to cancer research where a deeper understanding of the disease has led to better treatments.

A group of researchers from the University of Washington have unveiled a highly detailed atlas showing how different types of brain cells change in Alzheimer’s.

According to Dr. C Dirk Keene a neuropathologist at the University of Washington, “what we are trying to do with this study is to look at cell vulnerability early on in disease, before plaques and tangles, before they have cognitive impairment.”  They analyzed more than a million cells from 84 brains donated by people who had signed up for Alzheimer’s research projects run by the University of Washington and Kaiser Permanente Washington Research Institute.  They have defined what a normal brain looks like, and that knowledge can be used to look for changes in specific types of cells.

Other areas of research include finding therapeutics to target the immune system as well as inflammation in the brain.

Others are looking at cell metabolism to help improve Alzheimer’s as a treatment and how cells use energy, even how brain cells are connected and communicate through synapses.

A study in Korea is looking at the use of ultrasound-based gamma entrainment for Alzheimer’s treatment.  It is a technique that involves syncing up a person’s brain waves above 30Hz with an external oscillation.  Thus far, it has been used on mice but showed reduced beta-amyloid and tau protein levels in the brain.  EEG analysis showed functional improvements with no sign of harm to the brain tissue.

A study out of the University of Texas Health Science Center in Houston involved whole blood exchange, which effectively decreased the formation of amyloid proteins in the brains of mice.  “This article provides a proof-of-concept for the utilization of technologies commonly used in medical practice, such as plasmapheresis or blood dialysis, to ‘clean’ blood from Alzheimer’s patients, reducing the buildup of toxic substances in the brain,” says Claudio Soto, PhD, professor in the department of Neurology, director of the George and Cynthia Mitchell Center for Alzheimer’s Disease and Related Brain Disorders and the Huffington Foundation Distinguished Chair in Neurology at McGovern Medical School.  “This approach has the advantage that the disease can be treated in the circulation instead of the brain.”

While these are exciting avenues of research, preventive methods are also a key focus.  This is where hearing health comes into play.

Screening tools would speed up research and help clinicians find cases at earlier stages.  Most current tests are invasive and expensive (spinal taps or PET scans).  Managing risk factors through lifestyle changes are showing impressive results for people early in the disease process.  Changes such as; improving exercise, eating a plant-based diet, addressing sleep deficits, reducing stress, improving social connections/engagement, ensuring good vision and hearing abilities, keep cholesterol and blood sugars in check are all good examples of the key to good brain health.

Dementia has been declared a public health priority by the World Health Organization, which has prioritized research into prevention.

Risk reduction and prevention are pivotal in managing the dementia epidemic globally, and sharing information is vital to informing this process.  World Wide FINGERS (WW-FINGERS) will facilitate the use of date from several countries.  FINGER stands for Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability.  According to the study, people who participated improved their cognition be 25% over two years!

The FINGER trial is the first randomized controlled trial showing that it is possible to prevent cognitive decline using a multidomain lifestyle intervention among older at-risk adults.  In 2018, several WW-FINGERS trials had been planned in several European countries, the US, China, Singapore, and Australia.  Currently, there are discussion about further studies in Central and South America, Japan, South Korea, Canada, India and Malaysia.

While time is not on the side of those currently suffering with the disease, all these areas of research provide a glimmer of hope.  More is being learned every day and soon the first person will be cured of this terrible disease.

I relied upon several articles and websites for this series of articles:

www.alz.org

www.cms.gov

-The fight against Alzheimer’s:  Where are we now?  By Sandee LaMotte, CNN updated July 31, 2022

-Scientists map changes in the brain to better treat Alzheimer’s disease NPR Morning Edition with Jon Hamilton on August 1, 2022

-Researchers propose ultrasound stimulation as an effective therapy for Alzheimer’s disease in new study.  Science Daily. Gwangju Institute of Science and Technology. January 24, 2022

-Whole blood exchange could offer disease-modifying therapy for Alzheimer’s disease.  Science Daily.  University of Texas Health Science Center at Houston.  July 15, 2022

-Scientists reveal new evidence of key mechanism in Alzheimer’s.  Science Daily.  Rutgers University.  July 18, 2022