Aging is a natural process of life. Our brains and bodies gradually change as we become older.
These changes have an impact on our physical and mental capabilities, as well as our risk of disease. The amount to which we experience aging differs from person to person, but for some, Alzheimer’s disease is a dreaded development in the process.
Is there a way to diagnose the condition early? How do you slow down Alzheimer’s progression?
What Causes Alzheimer’s Progression?
Alzheimer’s disease (AD) is one of the most severe healthcare issues in the United States and around the world. AD has now passed heart disease and cancer as the third leading cause of death in the United States.
There are approximately 5.2 million Americans with Alzheimer’s disease; however, this figure excludes the young Americans at risk of developing the condition at a young age. If no preventive measures are taken, around 45 million of the 318 million Americans currently living may develop AD during their lifetimes. (1)
People who develop Alzheimer’s disease are often older, but the condition is not a normal part of the aging process.
Scientists don’t know why some people get it and others don’t. What they do know is that the symptoms seem to be caused by two main proteins that damage nerves in two ways: (7)
- Nerve cells get tangles (tau), called neurofibrillary tangles, which develop inside the cell
- Beta-amyloid plaques, proteins that build up in the space between neurons
How Does Alzheimer’s Progression Affect the Brain?
In healthy aging, the brain tends to shrink to a degree, but surprisingly, it doesn’t lose a lot of neurons.
In Alzheimer’s disease, on the other hand, the damage is widespread because many neurons stop working, stop talking to each other, and die. This condition makes it hard for neurons and their networks to communicate, metabolize, and repair themselves.
This condition usually starts by killing neurons and their connections in memory-related regions of the brain, such as the entorhinal cortex and hippocampus. Later, it affects the parts of the brain that are in charge of language, thinking, and social behavior.
Over time, damage spreads to many other parts of the brain. As a result, a person with Alzheimer’s slowly loses the ability to live and work independently over time. Ultimately, the disease becomes fatal.
Current Efforts to Slow Alzheimer’s Progression
There is currently no cure for Alzheimer’s, but there are medications that can help temporarily ease the symptoms, such as:
- Acetylcholinesterase (AChE) inhibitors: These medications boost the amount of acetylcholine in the brain, a chemical that assists nerve cells in communicating with one another. At the moment, only specialists, like psychiatrists or neurologists, can prescribe them (6)
- Memantine (Namenda): This medicine is used to treat moderate to severe Alzheimer’s. It changes the amount of glutamate, a chemical in the brain that helps with learning and remembering. People with AD have too much glutamate in their brain cells. Blocking the receptors is how Namenda keeps the amount of that chemical in check. It might improve the brain and help some people do everyday tasks better.
- Aricept: This is the only treatment for AD approved by the FDA for all stages, from mild to severe. It can be taken as a pill.
- Namzaric: This drug is a mixture of Namenda and Aricept. It works best for people with moderate to severe Alzheimer’s who already take the two drugs separately.
- Razadyne: For Alzheimer’s that is mild to moderate. It comes as a tablet that works right away and is also in liquid form.
- Aducanumab: A new drug used to treat Alzheimer’s disease-related brain damage, also referred to as amyloid plaques.
Effective treatment of Alzheimer’s disease has been lacking, but recently it has been found that a particular sugar-studded protein is also altered and linked to AD, which suggests that this protein may be involved in the progression of the disease.
Discovery of Glycoprotein to Slow Alzheimer’s Progression
In a 2022 study published in the Journal of Biological Chemistry, researchers from Johns Hopkins University used brain tissue from five people who died of Alzheimer’s disease to do “reverse engineering” research.
They found that a specific sugar molecule could play a significant role in the development of AD. If more research backs up the finding, the molecule called a “glycan”1 could become a new target for early diagnostic tests, treatments, and maybe even ways to prevent Alzheimer’s disease. (3)
Even though glycobiology has a lot of unknowns, research in the last few decades has shown that these very different macromolecules play an essential role in cancer, infection and immunity, medicines, fertilization, and blood types.
Glycans are frequently found on the surface of cells, indicating a role in signaling and recognition. The same glycans can also operate differently inside the same organism, and a glycan that provides a specific function in one tissue may play a completely different role in another. Given the wide range of functional qualities of glycans, it is not surprising that glycosylation can significantly impact health and disease. (5)
Glycan dysregulation has been linked to several neurodegenerative illnesses, including Alzheimer’s disease, where the glycan profile of important disease regulators in AD such as APP, Tau, beta-secretase 1 (BACE1), and Nicastrin has been altered.
Simply put, glycans can serve as biomarkers in Alzheimer’s disease. The treatment for AD is complex because the condition is generally advanced before it is even identified. Pathologically, the progression of AD begins decades before clinical manifestation, further reducing the already limited therapy choices and underlining the need for new biomarkers and diagnostic techniques. With this discovery, AD patients can be checked for an abnormal amount of glycans before the disease symptoms show up.
So, getting the glycosylation homeostasis back to normal could lead us closer to drug development to slow the progression of this condition. Changing how these enzymes work via reverse engineering could be a possible way to alleviate Alzheimer’s disease symptoms.
Personalized Approach to Slow Alzheimer’s Progression
A 2022 study by Toups, Kat, et al. published in the Journal of Alzheimer’s disease followed 25 patients with mild cognitive impairment for nine months. At the end of the survey, subjective scores showed that 21 of 25 patients improved. (4)
Their approach to this clinical trial was personalized to each patient by looking at over 150 different variables from genetics, biochemical pathways, related diseases, lifestyle, and many more.
Research from James E. Galvin MD, MPH on the Prevention of Alzheimer’s Disease published in the Journal of the American Geriatrics Society has discovered conditions that raise the risk factors connected with AD. When the following illnesses are combined, they account for more than 50 percent of the risk for Alzheimer’s disease. This includes:
- Diabetes
- High blood pressure
- Kidney problems
- Alcohol and tobacco use
- High cholesterol
- Coronary heart disease
- Depression
- Low activity lifestyle
- Diet
And though we still cannot fully answer why some people develop the disease and others don’t, addressing the risk factors we know about could make a difference in preventing the progression of the disease. Our preemptive efforts could include lifestyle modification such as physical therapy, vitamin supplementation, stress reduction, memory exercises, or pharmacological approaches like anti-amyloid treatments to prevent AD progression. (2)
The personalized medicine approach focuses on the fact that Alzheimer’s disease affects people in different ways by identifying each person’s unique risk factors and treating them with a treatment tailored to their risk profile.
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Sources:
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4931830/
- https://www.healthinaging.org/blog/a-personalized-approach-to-alzheimers-disease-prevention/
- https://neurosciencenews.com/glycan-alzheimer-20679/
- https://www.gpb.org/news/2022/07/11/reversing-early-stage-alzheimers-disease-possible-new-study-finds-it-may-be?fbclid=IwAR0yOLI7KDpyMQKZfNlcaDC-wrmcPxzAhyldYosNYb7PlQ0Ct9gOdt3gY9g
- https://www.thermofisher.com/ph/en/home/life-science/protein-biology/protein-biology-learning-center/protein-biology-resource-library/pierce-protein-methods/protein-glycosylation.html
- https://www.verywellmind.com/what-is-acetylcholine-2794810#:~:text=Acetylcholine%20is%20a%20type%20of,learning%2C%20 memory%2C%20and%20 attention
- https://www.nia.nih.gov/health/what-happens-brain-alzheimers-disease#:~:text=Emerging%20evidence%20suggests%20that%20Alzheimer’s,clumps%20into%20plaques%20between%20neurons.
