Research into dementia critical

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There’s no cure for Alzheimer’s disease on the immediate horizon, but professionals say in many cases the effects can be slowed by eliminating certain risk factors.

That’s the message Jay Ingram delivered to Okotokians on Jan. 25, when he visited town to give a talk during Alzheimer’s disease awareness month.

“I think there are really three fundamental questions most people have: am I going to get it, what can I do to reduce that risk of getting it, and if I do get it what will the course of events be from there?” Ingram said during his presentation. “I think some misconceptions about Alzheimer’s arise from not knowing how we’ve come to the point we are.”

Dr. Alois Alzheimer was first to uncover the disease named after him. The German psychiatrist and neuropathologist also worked as a lab scientist. One of his psychiatric patients, Auguste Deter, was 51 years old when she came to him in 1901 with dementia. In his interviews with her – available online – she was confused, anxious and mentally disorganized, said Ingram.

Deter died five years later, while still a patient of Alzheimer, and he had her brain sliced so he could examine it under a microscope. He noticed abnormalities, darker blobs on the slide that he called plaques – the same term still used today in describing deposits outside nerve cells in the brain’s grey matter.

Alzheimer also saw teardrop-shaped deposits inside the neurons, which he called tangles. Deter’s brain was full of plaques and tangles, which are still characteristic of Alzheimer’s disease 112 years later, said Ingram.

In addition, her brain appeared to be shrunken and he had already documented her dementia. Alzheimer put it all together and brought it forward to his colleagues in Germany to almost complete scientific indifference, said Ingram. Not one question was asked.

“However, when you consider today that plaques and tangles are still the most characteristic feature of the brain of someone who has Alzheimer’s, that’s why this was quite a remarkable discovery,” said Ingram. “And further, if that really was 112 years ago, why do we still have a struggle on our hands to treat this disease?”

He said part of the reason is that for years people assumed, because Deter was only 51 years old when she had dementia, that the disease only affected a small minority of people. Loss of memory later in life, particularly until the 1950s, wasn’t seen as a medical issue, it was attributed to aging.

Since the mid-20th century, the image of Alzheimer’s as a disease and the need to consider treatments for dementia became more prevalent, he said.

There are still some who believe the disease is an epidemic that sprung up suddenly in the past 50 to 75 years, but that’s not the case, he said.

“If you look 100 years ago it didn’t exist, and there have been lots of off-the-wall theories about why suddenly this disease could appear,” said Ingram. “It’s not new, it’s not a mysterious epidemic. The biggest risk factor is age and the truth is, people are living longer.”

According to the Alzheimer Society of Canada, an estimated 564,000 Canadians were inflicted by dementia in 2016 with about 25,000 cases being diagnosed each year. By 2031, the society expected that number to rise to 937,000 – an increase of 6 per cent.

Though age is a significant risk factor, there is also a strong genetic component, he said. It applies mostly to early-onset Alzheimer’s disease, which is usually not people age 65 or older, he said – it accounts for only one per cent of cases.

Other major factors that contribute include poor diet, low education levels and physical activity, he said. Those who continue their education beyond high school and are active in their daily lives reduce their risk level, he said.

Though there is no cure for Alzheimer’s disease, research is being conducted to develop treatments that may fight plaques and tangles from forming in the brain, he said. Even if a drug is approved, treatment is not guaranteed because damage can’t be reversed, he said.

“What we’d really like to do is start treatment early, but people at that age are mentally normal,” said Ingram. “They’re not demented, how do you decide this person is running this risk of dementia and therefore we can give them whatever drug?”

More research is necessary, not only to develop treatment but to work toward early diagnosis, he said. It’s been difficult in the past without financial backing to push research, he said.

“Until quite recently, Alzheimer’s research was funded very poorly in comparison to HIV, AIDS, cancer and heart disease,” said Ingram. “And I think all of us would agree, not to take away funding from those other conditions, but obviously Alzheimer’s as a growing problem deserves to be funded.”

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