[이데일리 이순용 기자] This coming 21st is World Alzheimer’s Day (September 21) designated by the International Alzheimer’s Association. Alzheimer’s is a ‘degenerative brain disease’ that causes ‘dementia’ that 1 in 10 elderly people in Korea suffer from.
One of the most important causes of Alzheimer’s disease is that abnormal proteins accumulate excessively in the brain and affect brain cells. Abnormal protein called beta-amyloid is produced too much or is not removed properly, so it gradually accumulates in the brain, breaking the link between brain cells and destroying brain cells, causing symptoms of dementia. Dementia as we know it is the result of extensive brain damage that starts 15 to 20 years before the onset of symptoms and continues over a long period of time. As the elderly population increases, the number of patients with dementia due to Alzheimer’s continues to increase. According to the statistics of the Health Insurance Review and Assessment Service, in 2018, the number of patients over 60 who received treatment for “dementia in Alzheimer’s disease”, a result of Alzheimer’s disease, was 45. reached ten thousand people.
Memory impairment in Alzheimer’s disease is a symptom that occurs because the part of the brain affected in the early stages of the disease acts as an entrance to the stored memory. When the brain is healthy, past memories that have already entered the brain are not affected, and newly created memories cannot enter because the entrance is broken. They may complain of a pattern of memory impairment in which they remember things from the past very well, but not remember recent events at all. However, as the disease progresses, the memory of the past is eventually damaged, and other brain functions other than memory cannot function properly.
Professor Lee Hak-young of Neurology Center at Kyunghee University Hospital in Gangdong said, “Alzheimer is sometimes confused with Parkinson’s disease, which is one of the degenerative brain diseases. The course of the disease may be similar, but the initial symptoms are very different because the brain regions that are damaged are different.”
In Parkinson’s disease, movement-related symptoms such as slow motion and shaking hands appear, and in Alzheimer’s disease, symptoms related to ‘higher brain functions’ that the brain senses, remembers, and judges appear. Also, in Alzheimer’s disease, the onset of symptoms is usually a ‘gradual decline in episodic memory’ for past events, so it may seem that you are not good at remembering important events that occurred a few days ago, although this was not the case in the past. However, in Alzheimer’s disease, “movement” abnormalities may also appear in the late stages, making it difficult to distinguish from Parkinson’s disease.
Normally, as you get older, the symptoms of flickering tend to increase. However, the decline in brain function due to normal aging is clearly different from the decline in brain function caused by Alzheimer’s disease. Professor Lee Hak-young said, “It is necessary to distinguish whether the memory disorder we call forgetfulness is caused by normal aging or a disease, but not everyone needs to undergo a thorough examination. However, it is necessary to consult a neurologist for memory impairment that worsens for more than 6 months.”
◇ Treatment to slow the progress and relieve symptoms
A fundamental solution, such as removal of amyloid protein that affects brain cells, is still being searched for, and research is being conducted in countries around the world, including Korea. It’s not that there aren’t many treatment options. Various means, including drug treatment, are used to prevent cognitive deterioration as much as possible and manage dementia symptoms to be alleviated. As the course progresses slowly over a long period of time, it is a therapeutic approach to maintain the current function for as long as possible while regularly checking the patient’s cognitive function.
Professor Lee Hak-young said, “There are very few therapeutic drugs that have been recognized for their medical effects, and only five ingredients have been recognized, and four of them are currently being prescribed. A representative example is ‘acetylcholinease inhibitors’, which improve the cognitive function of patients by increasing the concentration of acetylcholine in the synaptic gap, which has been reduced due to disease. In addition, ‘NMDA receptor antagonists’, which enhance learning and memory ability in Alzheimer’s disease patients by inhibiting NMDA receptors, are being used for treatment.”
In addition to drug treatment strategies to improve cognitive function, various drugs are also used to alleviate behavioral and psychological symptoms of dementia patients. In addition, cognitive interventional therapy and exercise therapy are being used as non-pharmacological treatments, and it is very important to use various administrative services and to prepare for the future of individuals and families that may change as cognitive function deteriorates. can
Although not everything is known regarding the pathogenesis of Alzheimer’s disease, it is relatively well known which people are less likely to develop dementia. Professor Lee said, “Unfortunately, as we age, amyloid protein in the brain is observed in many cases. However, not all amyloid proteins present symptoms of dementia. A person with a healthy brain sufficient to compensate for the damage to the brain may be able to absorb this shock sufficiently. Therefore, building a healthy brain is like insurance once morest dementia. The key to a healthy lifestyle to prevent dementia is to wear your head, body, and eat good things.”
