5 Things to “Remember” About Alzheimer’s Disease

Neurological diseases are a bit intimidating to talk about – the last time most of us thought about axons and neurotransmitters, we were in high school biology – so in an effort to make the science a little easier to digest, we're going to make an effort to start trying to deconstruct some of the key studies and overarching findings.

So let's start by deconstructing Alzheimer's disease. There has been a rapid rise in research pertaining to Alzheimer's, which means there's more to understand. Before we dive into any specific studies or what you can do, it's important to clarify a few things.

5 Key Facts About Alzheimer's Disease

1. Dementia does not equal Alzheimer's disease. Dementia, or in it's earlier stages, which doctors call "mild cognitive impairment," is a term referring to clinical issues with memory, planning, navigating. Dementia is a characteristic found in a handful of different diseases. Alzheimer's is one of the diseases, but dementia can be found in patients with Parkinson's, frontotemporal dementia, and more. It's important to figure out what the specific cause is, as some causes are treatable.
2. Alzheimer's is a disease with many contributing factors - age, genes, proteins and more. In terms of risk factors, almost all cases of Alzheimer's are sporadic (with no family history), and as you get older, the risk goes up. That said, just as you can be at risk for breast cancer if you have a genetic marker, you can be at greater risk for Alzheimer's if you carry a genetic marker, called APOe4. Other genes also play a role.
3. Proteins are important to understand. In cancer, we know that cells replicate out of control and can mutate into a tumor. In neurodegenerative disease, just remember that there are normal proteins that somehow become toxic, spreading the damage from cell-to-cell, misfolding and building up throughout the brain, causing disruption of normal brain activity. Depending on the disease, there may be one (or more) key proteins involved, and one person can have a mix of these proteins, given them characteristics of more than one disease.  Here are the main proteins:
   
   Amyloid - found in Alzheimer's cases, as well as some people without Alzheimer's.
   
   Tau - also present in Alzheimer's and about 50 percent of frontotemporal degeneration cases (FTD-tau).
   
   TDP-43 - The major disease protein in 40 percent of FTD cases (FTD-TDP43) as well as the driving force behind Amyotrophic lateral sclerosis (ALS).
   
   Alpha-synuclein - the culprit in most Parkinson's cases. The clumps of alpha-synuclein deposits are called Lewy bodies.
4. While it used to be that the only way to get a diagnosis was in an autopsy after death, it is possible to get a clear diagnosis during life, especially at a dedicated Alzheimer's center where they are conducting research and clinical trials. In the last 5 years, there's been a rapid uptick in the number of ways that doctors can measure and track disease proteins via a variety of imaging and spinal fluid tests.
5. There are no drugs that stop the disease progression of Alzheimer's. There are drugs prescribed that can help with some of the symptoms, but behind the scenes, the disease is still actively progressing further and further. This is the case for many of the neurodegenerative diseases, so the need for drugs that intercept and neutralize the different proteins is great.

Jason Karlawish, MD, professor of Medicine, Medical Ethics and Health Policy, recently spoke with NPR's Weekend Edition, about the latest on Alzheimer's disease. To hear his interview, listen here.

We'll try to deconstruct things for future posts, so if there's a particular study or area of research that you are interested in, please let us know in the comments below!

For more information, please visit the National Institute on Aging and the Alzheimer's Association.