One in ten over-65s suffer from Alzheimer's disease
Ainhoa Sorrosal
Hospitals such as Sant Pau and Quirn Dexeus are working on preventive treatments to fight the appearance of clinical symptoms

Alzheimer's disease is the most common form of dementia, with more than 120,000 cases diagnosed in Catalonia and 800,000 across all of Spain. With one in every ten people over the age of 65 suffering from the disease, specialists are now referring to it as an epidemic. Worldwide, the WHO say there are almost 10 million new diagnoses of dementia a year (almost one every 4 seconds), of which between 60% and 70% are Alzheimer's. It is estimated that by the year 2050 there will be over 115 million cases.

At the moment there are no treatments that stop or alter the development of Alzheimer's. Jaume Kulisevsky, medical doctor and professor at the UOC who specializes in neurodegenerative diseases explained that "faced with this problem, research teams have moved their focus to attempts to find some form of vaccine or effective drugs to work against the abnormal proteins that lead to the death of neurons". This approach to treatment would not only improve symptoms, as current treatments do, but would also halt the continued deterioration that is the full onset of the disease.

Early diagnosis, key to tackling the disease

Although some of the medicines and preventive treatments that reduce the accumulation of abnormal proteins associated with the death of neurones have not been effective in cases where all the clinical symptoms of Alzheimer's are present, it is thought that the medicines currently being developed may be effective in very early stages of the disease.

Currently there are diagnostic tests, for example positron-emission tomography (PET), which can be used to analyse cerebrospinal fluid, and this is an effective way of identifying people at risk of developing Alzheimer's. "These tests allow us to detect it before characteristic symptoms such as memory loss kick in," said Kulisevsky.

Early detection methods have enabled the start of clinical trials with new preventive treatment medicines. The researchers believe that people in the initial stages of the disease are potential beneficiaries as the neuronal population threatened by the onset of the disease is not yet fully lost.

In some of Barcelona's health centres, such as Hospital de Sant Pau i la Santa Creu, Hospital Universitari Quirn Dexeus and the Fundaci ACE's centre, various teams are working with volunteer patients who are participating in the trial despite not showing any of the symptoms. Indeed, it is in this group that clear improvements may be seen, insisted Kulisevsky – who also leads the CIBERNED research group – because the disease begins years before the clinical symptoms appear.

One indicator that, while not definitive, does provide a guideline is family history. "Although a minority of patients inherit a causal gene for the disease and see it start at an earlier age, most patients have a range of different genetic risk factors which, acting together, increase the risk of suffering Alzheimer's from 65 years old and above," he said.

Still terminal

A brain disease, Alzheimer's is non-contagious, degenerative and terminal. It affects sufferers' personalities and gradually destroys their memory. It also affects their abilities to learn, reason, make judgements, communicate and carry out daily tasks. The cause of this loss of abilities is the death of neurones.

There are some medicines that help to temporarily alleviate the disease's symptoms. Some of the most commonly used are Rivastigmine (Prometax, Exelon), Memantine (Ebixa, Axura), Donepezil (Aricept) and Galantamine (Reminyl). In recent years, pharmaceuticals have been used in combination with activities aimed at stimulating patients' brain activity and improving their quality of life.

Indeed, innovative methods are being explored such as therapy that involves virtual reality. These are techniques that boost neuronal activity and delay the degenerative process. Recent studies in this field show a positive effect from virtual reality during the initial stages of the disease.



Photograph of Jaume Kulisevsky Bojarski

Jaume Kulisevsky Bojarski

Lecturer in the Health Sciences Department

Expert in: Movement disorders and neurodegenerative diseases (Alzheimer's, Parkinson's, Huntington's, restless legs syndrome, etc.).

Knowledge area: Neurology.

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