For a long time, Alzheimer’s disease was considered the price to pay for the weight of years and a consequence of an unfortunate genetic predisposition. And, it is a fact, this pathology undermining the memory most often rhymes with advanced age and the genetic influence is not excluded. But more and more studies also show its link with the way of life and with a multitude of factors a priori “avoidable”. That’s not all: thanks to technical advances in recent years, it is now possible to detect the disease in its very early stages. However, the experts are unanimous: therapeutic interventions benefit from being undertaken as soon as possible.
As a reminder, Alzheimer’s disease is characterized by a progressive loss of memory. It can also present as psychiatric symptoms such as anxiety, apathy and depression. A set of disorders that can complicate diagnosis in the early stages of the disease. But over the past twenty years, diagnostic techniques have made spectacular progress (read framed). In particular, they have made it possible to map the pathological aging processes of the brain in patients during their lifetime and to identify characteristic abnormalities, sometimes very early, of Alzheimer’s disease. Additional fact: these lesions might be correlated with certain life circumstances.
Thus, we now know, for example, that untreated high blood pressure for many years can damage certain blood vessels in the brain, leading to progressive loss of cognitive performance, but also that, conversely, a treatment suitable for hypertension can significantly reduce the risk of developing dementia in old age.
Interventions during the early phases
The new technologies at work have also shown that degenerative brain diseases such as Alzheimer’s are characterized by early phases that can last for years.
The brain changes during this time, as evidenced by amyloid beta and tau protein levels or altered blood vessels, but no cognitive symptoms yet appear during these early phases. In contrast, psychiatric symptoms such as anxiety and apathy may already occur.
This early phase represents a real opportunity for therapeutic interventions aimed at halting the progression of the disease. Preliminary results from several clinical trials are promising. Quite recently, the Food and Drug Administration (FDA) has approved the first drug that might slow the progression of Alzheimer’s disease by reducing beta-amyloid protein.
Another key axis: non-drug preventive approaches. The results of various studies suggest that there is a link between a healthy lifestyle and a significant reduction in the risk of developing dementia. Beneficial reflexes? Sufficient physical activity, adequate sleep, a healthy diet, the absence of smoking and a rich social and intellectual life. Possible proof of their effectiveness: over the last twenty years, the probability of occurrence of age-related dementia has decreased by regarding 20% in Western Europe and North America. The hypothesis put forward by the experts is indeed that of an improvement in the hygiene of life.
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* Adapted from: Unschuld P. Prevention of Alzheimer’s Disease: Importance of Lifestyle and Early Therapeutic Interventions. Rev Med Switzerland 2021;751:1614-16.
Appeared in Planète Santé magazine N° 44 – March 2022
