The development of an effective new Alzheimer‘s medication could mark “the beginning of the end” for the neurological condition.
At a symposium in Amsterdam today, US pharmaceutical behemoth Eli Lilly will present the complete clinical trial findings for its Alzheimer’s medicine donanemab.
The medicine was proven to slow mental deterioration by 36 per cent in phase 3 trials, the company reported in May.
It operates by locating and eliminating amyloid protein clumps in the brain and is administered as a monthly blood infusion for 18 months.
The NHS would determine which patients it can be supplied to based on cost-effectiveness after the UK regulators evaluated the drug to determine whether to licence it as safe, a process that might take between 12 and 18 months.
After the donanemab trial results are made public, specialists from all over the world will analyse data to determine whether the drug’s advantages outweigh its risks of side effects, which can include bleeding and brain swelling.
But what is Alzheimer’s and are there any warning signs? Here is all the information on the disease.
What is Alzheimer’s disease?
It is a form of dementia and, according to the NHS, Alzheimer’s is the most common cause of dementia in the UK.
Dementia is the name for a group of symptoms associated with a decline in brain function. It can affect memory, thinking skills, and other mental abilities and at present there is no cure.
There are trials going on into how to slow the disease but there is no way of completely getting rid of it once a person has been diagnosed.
Scientists believe that Alzheimer’s is triggered in a patient because of an abnormal build-up of proteins in the brain. This leads to a decrease in chemical messengers — also known as neurotransmitters — which are part of the brain tasked with sending messages and signals.
Over time, different areas of the brain shrink. The first areas usually affected are those responsible for memories.
What causes Alzheimer’s disease?
The cause is not known or understood despite many years of research into the condition. However, it is believed there are a number of things that increase the risk of developing the disease, such as being older or having a family history of the condition.
The likelihood of developing Alzheimer’s disease doubles every five years after you reach 65, says the NHS. But it’s not just older people who are at risk of developing Alzheimer’s disease. Around one in 20 people with the condition are under 65.
This is called early or young-onset Alzheimer’s disease and it can affect people from around the age of 40
Untreated depression and cardiovascular disease is also thought to increase your chance of being diagnosed.
What are the symptoms of Alzheimer’s disease?
Symptoms increase over time with the condition, and the rate at which they come on varies from person to person.
According to the NHS, early symptoms include a tendency to:
- forget about recent conversations or events
- misplace items
- forget the names of places and objects
- have trouble thinking of the right word
- ask questions repetitively
- show poor judgement or find it harder to make decisions
- become less flexible and more hesitant about trying new things
There are often signs of mood changes, such as increasing anxiety or agitation, or periods of confusion and, as the condition develops, these symptoms can become worse.
Obsessive behaviour, repeated actions, getting lost, sleep disturbances and hallucinations are also symptoms.
A full list of symptoms can be found on the NHS website.
What is sundowning?
Late afternoon and early evening can be difficult for some people with Alzheimer’s disease.
They may experience sundowning, with symptoms including restlessness, agitation, irritability, or confusion that can begin or worsen as daylight begins to fade.
You might see changes in a person’s behaviour in the later afternoon or towards the end of the day, often when caregivers need a break.
Sundowning can happen at any stage of dementia but it’s especially common during the middle and later stages.
The reasons why sundowning occurs are not understood, but they could be due to a range of factors including hunger, pain or other unmet physical needs, overstimulation, tiredness, or not getting enough exposure to sunlight during the day.
Diagnosis and treatment for Alzheimer’s
If you are concerned about yourself, or another, it is best to seek help from your GP as soon as possible. Getting an early diagnosis is vital and there are treatments on trial that are believed to be able to slow down the disease’s progression.
GPs can do a number of tests and can refer you to a specialist if they believe your symptoms need looking into. Although there is no cure, there are a range of medicines that can temporarily help with symptoms.
Acetylcholinesterase inhibitors are sometimes prescribed, which increase levels of acetylcholine, a substance in the brain that helps nerve cells communicate. They can only be prescribed by specialists, such as psychiatrists or neurologists.
Memantine is another drug sometimes prescribed for moderate or severe Alzheimer’s, which works by blocking some of the chemicals in the brain associated with Alzheimer’s.
Prevention for Alzheimer’s
Although there is no cure, the NHS says there are ways to try to help prevent the diagnosis of Alzheimer’s, but even following this advice is no guarantee if the cause is genetic.
These include:
- stopping smoking
- keeping alcohol to a minimum
- eating a healthy, balanced diet, including at least five portions of fruit and vegetables every day
- exercising for at least 150 minutes every week by doing moderate-intensity aerobic activity (such as cycling or fast walking) or as much as you’re able to
- making sure your blood pressure is checked and controlled through regular health tests
- if you have diabetes, make sure you keep to the diet and take your medicine
