Alzheimer's is a complex disease and it is impossible to
cure it at this time. However, many medications and therapeutic explorations
are optimistic, and they are still time-limited and their purpose is to cure
the pathological process of the disease while awaiting its elimination, in
addition there are medications that alleviate the suffering to some extent and
improve cognitive performance..
The efficacy of the treatments is evaluated by the doctor after 3 to 6 months. If necessary, the treatments are then changed. At the moment, the benefits of treatment are modest and medications do not prevent the disease from evolving.
The Foundation for Medical Research estimates
that there are in 2016, nearly 900 000 people affected by Alzheimer's disease
in France.
Medicines
The following medications are issued by prescription. One cannot
know a priori which one will best suit the patient. Sometimes it takes a few
months to find the proper treatment. According to studies, after 1 year of
medication, 40% of people see their condition improve, 40% have a steady state
and 20% do not feel any effect.
Cholinesterase inhibitors
They are used primarily to treat mild or moderate symptoms.
This family of medications helps to increase the concentration of acetylcholine
in certain regions of the brain (by decreasing its destruction). Acetylcholine
makes neurodegenerative moves between neurons. It has been noted that people
with Alzheimer's disease have lower amounts of acetylcholine in the brain
because the destruction of their nerve cells reduces the production of this
neurotransmitter.
In Canadian markets and at the moment there are three inhibitors
of the cashew (the enzyme that destroys
acetylcholine)
• Donepezil or E2020 (Aricept ®). It is taken in the form of tablets. It attenuates the mild, moderate and advanced symptoms of the disease;
• Rivastigmine (Exelon ®). Since February 2008, it has also been proposed as a skin patch: the medicine is absorbed slowly by the body for 24 hours.
• The Galantamine hydrobromide (Reminyl ®). It is sold in tablet form taken once a day in the case of mild or moderate symptoms.
These medications lose their efficacy over time, since
neurons still produce less and less acetylcholine. They can also cause side
effects, such as nausea and vomiting, loss of appetite and stomach aches. In
such a situation you must see your doctor who will regulate the dosage as you
need it.
.
In the United States and France, Tacrine (Cognes ®) is used
as a cholinesterase inhibitor. And on this can cause serious side effects and
in Canada not approved
NMDA receptor antagonist
Since 2004, Memantine hydrochloride (Ebixa ®) has been given
to relieve moderate or severe symptoms of the disease. This molecule acts by
attaching to the NMDA (N-methyl-D-aspartate) receptors located on brain
neurons. It thus takes the place of glutamate which, when present in large
quantities in the environment of neurons, contributes to the disease. There is
no indication, however, that this drug slows down the degeneration of neurons
Current research
Major efforts are being made in the search for new drugs.
The main objectives are as follows:
• Destroying beta-amyloid protein plaques through the
injection of antibodies that can remove them. These plaques are, in fact, one
of the most important brain lesions of the disease. Such an antibody has been
developed (the name of the molecule is bapineuzumab) and is being clinically
evaluated by people with the disease. This approach is called "therapeutic
vaccine". Another solution tested would be to activate certain brain cells
(microglia) to remove the plaques in question
• Replace neurons. The scientific community has a great deal
of hope for the replacement, using a transplant, of neurons destroyed by the
disease. Nowadays, researchers are able to create cells that resemble neurons
from stem cells obtained from human skin. However, the method is not quite in
focus. It still does not allow to create neurons that possess all the
properties of "natural" neurons.
People with Alzheimer's disease who wish to participate in
clinical studies can contact the Alzheimer Society of Canada
Physical exercise
Doctors advise Alzheimer's patients to exercise. It improves
strength, stamina, cardiovascular health, sleep, blood circulation and mood,
and increases dynamism and energy levels. In addition, physical exercise has a
particularly beneficial effect for people with this disease:
• helps maintain motor capacity;
• It gives an impression of meaning and purpose;
• It has a soothing effect;
• Maintains the level of energy, flexibility and balance;
• Reduces the risk of serious injury in the event of a fall.
People who take care of the sick can make two strokes with one stone while exercising at the same time as their patients
Social support
Considered a component of treatment, social support for the
sick is crucial. The doctors advise various strategies to the family and
caregivers of the patients.
• Make regular visits to patients to provide support,
depending on their needs;
• Provide them with aide-memoires;
• Create a stable and calm living structure in the house;
• Establish a bedtime ritual;
• Ensure that they always have a card (or bracelet) in their
pocket with an indication of their health status, as well as telephone numbers
in case they égareraient.
The associations also offer support in various forms. See
the Sites of Interest section.
It is
difficult to get in touch with someone who has Alzheimer's disease. Here are
some conseils.
To do
*. Show a thoughtful listening attitude.
*. Approach the person from the front, looking into the eyes.
Introduce yourself if this proves necessary.
*. Speak slowly and quietly, with a sympathetic attitude.
*. Use simple and short terms
*. Demonstrate empathy, patience and understanding. Touch the
person, or squeeze it in your arms, if you think it can help.
*. Ask only one question at a time and give enough time for the
answer.
*. Formulate your suggestions in a positive way. Instead of
saying ' Let's not go there ', for example, say ' Let's go to the garden '.
*. When talking about a third person, repeat the name.
*. If the person has
difficulty making a choice, give him or her a suggestion.
Not to be done
*. Do not treat it as a child.
*. Do not talk about the person as if they were not there.
*. If this can be avoided, do not correct it and do not seek to confront it.
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