alzheimer's disease

Introduction :-

• Alzheimer's disease (AD), also known as Alzheimer disease, is the most common form of dementia.

• There is no cure for the disease, which worsens as it progresses, and eventually leads to death.

• It was first described by (and later named after) German psychiatrist and neuropathologist Alois Alzheimer in 1906. Most often, AD is diagnosed in people over 65 years of age, although the less-prevalent early-onset Alzheimer's can occur in much younger people. In 2006, there were 26.6 million people worldwide with AD. Alzheimer's is predicted to affect 1 in 85 individuals globally by 2050.

• Initial symptoms are often mistaken for 'age-related' concerns, or manifestations of stress. 

• The most common early symptom is short term memory loss—difficulty in remembering recent events. The diagnosis is usually confirmed with tests that evaluate behaviour and thinking abilities, often followed by a brain scan if available, however, examination of brain tissue is required for a conclusive diagnosis. As the disease advances, symptoms can include confusion, irritability, aggression, mood swings, trouble with language, and long-term memory loss. 

• As the person's condition declines they often withdraw from family and society. Gradually, bodily functions are lost, ultimately leading to death.

• Although the speed of progression can vary, the average life expectancy following diagnosis is approximately seven years. Fewer than 3% of individuals live more than 14 years after diagnosis.

Comparison of a normal aged brain (left) and the brain of a person with Alzheimer's (right). 

Differential characteristics are pointed out.

Characteristics :-

Stages of Alzheimer's Disease

Effects of aging on memory but not AD

• Forgetting things occasionally

• Misplacing items sometimes

• Minor short-term memory loss

• Forgetting that memory lapses happened

Early stage Alzheimer's

• Absent-mindedness

• Forgetting appointments

• Slight changes seen by close loved ones

• Some confusion in situations outside the familiar

Middle stage Alzheimer's

• Deeper difficulty remembering recently learned information

• Deepening confusion in many circumstances

• Speech impairment

• Repeatedly initiating the same conversation

Late stage Alzheimer's

• More aggressive or passive

• Some loss of self-awareness

• Debilitating cognitive deficit

• More abusive, anxious, or paranoid

Causes :-

Genetics

• Around 0.1% of the cases are familial forms of autosomal (not sex-linked) dominant inheritance, which usually have an onset before age 65.  

• This form of the disease is known as early onset familial Alzheimer's disease.

Cholinergic hypothesis

• The oldest, on which most currently available drug therapies are based, is the cholinergic hypothesis, which proposes that AD is caused by reduced synthesis of the neurotransmitteracetylcholine.

Amyloid hypothesis

• In 1991, the amyloid hypothesis postulated that extracellular beta-amyloid (A_β) deposits are the fundamental cause of the disease.

Tau hypothesis

• The tau hypothesis proposes that tau protein abnormalities initiate the disease cascade. In this model, hyperphosphorylated tau begins to pair with other threads of tau. Eventually, they form neurofibrillary tangles inside nerve cell bodies. When this occurs, themicrotubules disintegrate, collapsing the neuron's transport system. This may result first in malfunctions in biochemical communication between neurons and later in the death of the cells.

Other hypotheses

• Herpes simplex virus type 1 has been proposed to play a causative role in people carrying the susceptible versions of the apoE gene.

• Some studies have shown an increased risk of developing AD with environmental factors such as the intake of metals, particularly aluminium.

• While some studies suggest that extremely low frequency electromagnetic fields may increase the risk for Alzheimer's disease.

• Smoking is a significant AD risk factor.

•  Systemic markers of the innate immune system are risk factors for late-onset AD.

• Another hypothesis asserts that the disease may be caused by age-related myelin breakdown in the brain. Iron released during myelin breakdown is hypothesised to cause further damage. Homeostatic myelin repair processes contribute to the development of proteinaceous deposits such as beta-amyloid and tau.

Pathophysiology :-

Neuropathology

• Alzheimer's disease is characterised by loss of neurons and synapses in the cerebral cortex and certain subcortical regions. This loss results in grossatrophy of the affected regions, including degeneration in the temporal lobe and parietal lobe, and parts of the frontal cortex and cingulate gyrus.
• Degeneration is also present in brainstem nuclei like the locus coeruleus.

• Both amyloid plaques and neurofibrillary tangles are clearly visible by microscopy in brains of those afflicted by AD. Plaques are dense, mostlyinsoluble deposits of beta-amyloid peptide and cellular material outside and around neurons. Tangles (neurofibrillary tangles) are aggregates of the microtubule-associated protein tau which has become hyperphosphorylated and accumulate inside the cells themselves. Although many older individuals develop some plaques and tangles as a consequence of ageing, the brains of people with AD have a greater number of them in specific brain regions such as the temporal lobe. Lewy bodies are not rare in the brains of people with AD.

Histopathologic image of senile plaques seen in the cerebral cortex of a person with Alzheimer's disease of presenile onset. Silver impregnation.

Biochemistry

• Alzheimer's disease has been identified as a protein misfolding disease (proteopathy), caused by plaque accumulation of abnormally folded beta amyloid and tau amyloidproteins in the brain. 

• Plaques are made up of small peptides, 39–43 amino acids in length, called beta-amyloid (A_β). Beta-amyloid is a fragment from a larger protein calledamyloid precursor protein (APP), a transmembrane protein that penetrates through the neuron's membrane. APP is critical to neuron growth, survival and post-injury repair. 

• In Alzheimer's disease, an unknown process causes APP to be divided into smaller fragments by enzymes through proteolysis. 

• One of these fragments gives rise to fibrils of beta-amyloid, which form clumps that deposit outside neurons in dense formations known as senile plaques.

• AD is also considered a tauopathy due to abnormal aggregation of the tau protein. 

• Every neuron has a cytoskeleton, an internal support structure partly made up of structures called microtubules. 

• These microtubules act like tracks, guiding nutrients and molecules from the body of the cell to the ends of the axon and back. 

• A protein called tau stabilises the microtubules when phosphorylated, and is therefore called a microtubule-associated protein. 

• In AD, tau undergoes chemical changes, becoming hyperphosphorylated; it then begins to pair with other threads, creating neurofibrillary tangles and disintegrating the neuron's transport system.

Enzymes act on the APP (amyloid precursor protein) and cut it into fragments. The beta-amyloid fragment is crucial in the formation of senile plaques in AD.

Disease mechanism

• Exactly how disturbances of production and aggregation of the beta-amyloid peptide gives rise to the pathology of AD is not known. 

• The amyloid hypothesis traditionally points to the accumulation of beta-amyloid peptides as the central event triggering neuron degeneration. 

• Accumulation of aggregated amyloid fibrils, which are believed to be the toxic form of the protein responsible for disrupting the cell's calcium ion homeostasis, induces programmed cell death (apoptosis). 

• It is also known that A_β selectively builds up in the mitochondria in the cells of Alzheimer's-affected brains, and it also inhibits certain enzyme functions and the utilisation of glucose by neurons.

• Various inflammatory processes and cytokines may also have a role in the pathology of Alzheimer's disease. 

• Inflammation is a general marker of tissue damage in any disease, and may be either secondary to tissue damage in AD or a marker of an immunological response.

For More Details :-

• http://en.wikipedia.org/wiki/Alzheimer's_disease

Treatment in Homoeopathy :-

" One Single Simple Drug Substance In Its Most Suitable Potency, According To Symptom Similarity Based On Totality! "

Baryta Carb helps those who have regressed back to childish behavior. They may be fearful, timid and shy and lack confidence. There is loss of memory and some patients may suffer from chronic glandular disorders.

Natrum Sulf can often bring relief to those who are fixated with and dwell on past hurts and unpleasant events. They may feel sad and lonely, be filled with self-pity, or be unable to express the love they feel for others. These people often have headaches and painful joints.

Nux Vomica patients are often angry, quarrelsome and irritable, fault finding and insensitive to other's feelings; however, they themselves are extremely sensitive to everything, becoming easily hurt and insulted.

Alumina is an excellent remedy for those who are depressed and afraid of losing their minds. They become confused with their identities and experience rapidly changing moods. Patients are often chilly, constipated, and very hurried in their actions and movements.

Some other important Homoeopathic Remedies for alzheimer's disease are :-

• Mercurius – complete loss of all sense of decency; filthy in body with groveling mentality; great weakness of memory; impaired vision; foul breath; heavy coated tongue.

• Ignatia – extreme mental sensitiveness due to grief, disappointment in love affairs.

• Calcaria Carb – complete lack of development of brain and other organs with forgetfulness. Slowness and inability to acquire knowledge.

• Lycopodium – great depression of spirits; despondent; worried about his salvation; about being able to perform his duties; about passing in examination, fretful, irritable, morose, very vehement and angry. Constipation, eructations of sour food.

• Staphisagria – sleeplessness. Coward with shamefulness, disgust, humiliation, despair, shyness with desire for solitude.

• Chamomilla – sensitiveness; irritability, peevishness; very easily angered and suffers profoundly as a result thereof.

• Terentula His – rages over something and throws whatever in hand and whatever he could reach. On slightest contradiction or objection he will hit the person with whatever he can get hold of.

& The List Goes On.....

Ultimately similimum can only be found by taking totality of the symptoms as per the individual case.

For More Details :-

• http://hpathy.com/cause-symptoms-treatment/alzheimers-disease/
• http://www.naturalnews.com/034416_alzheimers_disease_homeopathic_remedies_treatment.html#

Take Care Of Your Body,

It's The Only Place You Have To Live In.

With Best Regards, Karnav Thakkar :) :)