The underlying reasons behind Alzheimer's development are yet to be fully understood.
Each year, tens of thousands of individuals in Germany get diagnosed with dementia or Alzheimer's. On World Alzheimer's Day, which occurs yearly, this brain disorder, initially outlined by neurologist Alois Alzheimer in 1906, gains prominence. However, combating this ailment is a challenge, with various aspects remaining a mystery for researchers. Here's a summary of the primary questions and answers:
What is Alzheimer's?
Alzheimer's is the most prevalent type of dementia. This brain condition triggers a loss of cognitive functions such as thinking, speech, decision-making, and spatial awareness, as well as the death or severe damage of brain cells, mainly in the cerebral cortex. Social interaction skills also deteriorate. Besides Alzheimer's, vascular dementia and frontotemporal dementia are the most common dementia disorders.
Forgetfulness is not always a sign of dementia. Other physical ailments, like untreated thyroid issues, vascular issues, or drug misuse, can also induce memory disorders.
How many people are afflicted?
Currently, more than 1.8 million individuals in Germany handle dementia. Approximately two-thirds of them, around 1.2 million, have Alzheimer's. In 2023, roughly 445,000 individuals aged 65 and above developed dementia for the first time. Due to an aging population, the number of affected individuals is on the rise.
The number of Alzheimer's-related deaths in Germany nearly doubled within 20 years. According to recent statistics from the Federal Statistical Office, around 10,100 people passed away from Alzheimer's in 2023. Around 19,000 individuals were treated in hospitals with this diagnosis in 2022 - a 61% increase from 20 years ago.
If there's no breakthrough in prevention or treatment, up to 2.7 million individuals aged 65 and above might be affected in Germany by 2050, as per current estimates.
What are the symptoms?
Alzheimer's starts with forgetfulness and loss of motivation. As it progresses, ordinary actions become challenging. Patients often forget words, become disoriented, and struggle with remembering. Basic tasks like fastening and unfastening buttons become impossible.
Eventually, patients lose their independence and may not recognize their loved ones. Cognitive and judgmental impairments make daily life increasingly hard. Many affected individuals become suspicious, aggressive, or depressed, and their personality may change.
What causes the condition?
This is still not fully understood, despite decades of research. Research shows that two toxic protein buildups in the brain could be related to the disease's advancement - clusters of amyloid-beta, a protein naturally found in the brain, and tau fibrils, which typically preserve stability and nutritional supply inside brain cells.
The brains of Alzheimer's patients typically display these protein buildups. Misguided metabolic processes harm nerve cells, and inflammatory compounds are activated. The brain's memory and attention-related neurotransmitters can no longer be produced.
In almost all cases, genetic factors, aging processes, existing brain diseases, and environmental influences work together. Only about 1% of cases are purely hereditary. People with affected first-degree relatives, such as parents, siblings, or children, have a four times higher risk of developing the disease than the general population.
Who is affected?
Although this disorder can also strike before the age of 50, age is undoubtedly the greatest risk factor for Alzheimer's. Approximately 1.7 million of the total 1.8 million afflicted are over 65 years old, with around two-thirds being women. However, around 47,000 people between 40 and 59 also deal with dementia.
What are the risk factors?
To date, 14 risk factors for dementia have been identified, including hearing impairment, tobacco and alcohol consumption, visual impairments, high cholesterol levels, obesity, depression, head injuries, and social isolation. It is estimated that up to 45% of dementia cases could be delayed or prevented through a healthy lifestyle and medical care.
Is there a cure?
No. Although biomarkers can now identify Alzheimer's in the early stages of mild cognitive impairment, before dementia sets in, the disorder is typically only detected when the damaged brain cells are irretrievably lost.
Medication therapy can momentarily delay the decline in cognitive ability, and behavioral, speech, and music therapies, or memory training can improve quality of life.
What is the current research status?
Finding an effective drug is tricky because the underlying mechanisms of Alzheimer's disease are not yet fully understood. In recent years, there have been numerous setbacks, with initially promising drugs failing in patient trials.
The recently approved drug Leqembi in the USA and UK aims to aid patients with early-stage Alzheimer's. The drug targets the beta-amyloid protein causing deposits in the brain, potentially slowing the progression of dementia.
However, the European Medicines Agency rejected the approval of Leqembi because the observed effect on delaying cognitive decline did not outweigh the risk of severe side effects, particularly the risk of brain bleeds.
What can be done preventatively?
Experts recommend mental, physical, and social activities to reduce the risk of developing the condition. They also advise a balanced, low-fat and cholesterol diet rich in fruits and vegetables, as well as controlling high blood pressure, heart rhythm disorders, and diabetes.
The disease, in this case, Alzheimer's, affects approximately 1.2 million individuals in Germany, making it the most common type of dementia among those diagnosed annually. Despite decades of research, the causes of Alzheimer's are still not fully understood, and there is currently no cure for the disease.
