Alzheimer’s Disease: The Century-Old Challenge

by dr. Dina Atrasina Satriawan, Mnsci(Adv) (Faculty of Biomedicine)

Remember that time you met your old friend from high school and couldn’t recall their name? Or maybe you lost your phone for the umpteenth time because you forgot where you put it? What about the classical case of the missing eyeglasses found sitting nicely on the top of your head? You are definitely not alone – we all forget things once in a while. But what if… not only do you forget the schedule of your regular bus back home, you actually forget where you live? This might be a sign of a serious memory problem.

Profound memory loss was one of the main symptoms a particular psychiatrist noticed in the haunting case of a 51-year-old woman, Auguste Deter, at the Frankfurt Asylum about a century ago (Figure 1). Deter would forget her own name, scream for hours in the middle of the night, drag sheets across the house, and mutter to herself repeatedly: “I have lost myself… I have lost myself…” [1]


After her death, the German psychiatrist obtained the permission to examine Deter’s brain and medical records. In her brain he found many peculiar clumps and twisted bundled fibers, anomalies more known now as amyloid plaques and neurofibrillary tangles [2]. The name of the psychiatrist was Dr. Alois Alzheimer. He did not know at that time that he would later be renowned as the first person to identify Alzheimer’s disease.


Figure 1. Auguste Deter: the German housewife who became the first Alzheimer patient in the world. Photograph dated November, 1902 [1]

Today, Alzheimer’s disease is the most common form of dementia where it accounts for up to 70% of cases [3]. Dementia is a general term to describe a group of symptoms associated with memory loss and other mental abilities, severe enough to reduce a person’s ability to perform daily activities [4]. People with dementia suffer progressive impairment in memory, communication and language, ability to focus or pay attention, reasoning and judgement, and visual perception [4]. In severe cases, these symptoms render the patients capability to do simple everyday tasks such as buttoning a shirt, bathing, using the toilet, paying bills, walking, and even eating [5].

Now, what does this mean for us and our loved ones? We would like to think that there is a cure for this disease. However, there is currently none. There are only four available drugs approved for treating Alzheimer’s disease and all of these drugs are symptomatic, meaning they reduce the symptoms of the disease but none of them can eliminate the rapid, fatal progression of the disease [6]. If we do not do something about this quickly, according to the World Health Organization (WHO), the number of cases will triple by 2050. This means that there will be over 135 million people suffering from dementia worldwide [7].

The alarming facts have led nations to come up with global efforts to fight and reduce the burden of Alzheimer’s: in 2009, Alzheimer’s Indonesia joined Alzheimer’s Disease International, the umbrella organization of Alzheimer’s associations, and committed to help and support the quality of life of people with dementia, along with their family and caregivers [8]; in 2010, former US president Barrack Obama, signed the groundbreaking National Alzheimer’s Project Act which aimed to provide national support and funding for Alzheimer’s research [9]; and in 2013, the G8 Dementia Summit in the United Kingdom launched an action plan to find a cure for Alzheimer’s by 2025 [10].

Now, here we are in 2021. There is no doubt that there have been many advances in Alzheimer research within the past decade with novel drugs undergoing clinical trials [11,12], and promising diagnostic methods introduced. However, the odds seem quite unlikely for a cure for Alzheimer’s to be found by 2025. Despite so, quoting the famous words of Nelson Mandela, “it always seems impossible until it is done”.

References
1. Maurer, K., Volk, S., & Gerbaldo, H. (1997). Auguste D and Alzheimer’s disease. The Lancet, 349(9064), 1546–1549. doi:10.1016/s0140-6736(96)10203-8
2. Graeber, MB (2003) History of Neuroscience: Alois Alzheimer (1864-1915), IBRO History of Neuroscience [http://www.ibro.info/Pub/Pub_Main_Display.asp?LC_Docs_ID=3445] Accessed: 22 March 2019
3. Alzheimer’s Association. 2013 Alzheimer’s disease facts and figures. Alzheimers Dement, 9 (2013), pp. 208-245
4. https://www.alz.org/alzheimers-dementia/what-is-dementia
5. https://www.alz.org/alzheimers-dementia/stages
6. Folch, J., Ettcheto, M., Petrov, D., Abad, S., Pedrós, I., Marin, M., Camins, A. (2018). Review of the advances in treatment for Alzheimer disease: strategies for combating β-amyloid protein. Neurología (English Edition), 33(1), 47–58.
7. https://www.who.int/mental_health/publications/dementia_report_2012/en/
8. https://www.alzi.or.id/tentang
9. https://www.alz.org/alzheimers-dementia/research_progress/milestones
10. https://www.gov.uk/government/publications/g8-dementia-summit-global-action-against-dementia/g8-dementia-summit-global-action-against-dementia-11-december-2013
11. Yiannopoulou, K. G., & Papageorgiou, S. G. (2013). Current and future treatments for Alzheimer’s disease. Therapeutic advances in neurological disorders, 6(1), 19-33.
12. https://www.clinicaltrials.gov/ct2/show/NCT01760005

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