2023-07-02 05:53:50
Although doctors first identified Alzheimer’s disease in 1906, in barely a century It has become one of the central pathologies of public health. The reason is simple: today there are 50 million people diagnosed in the world –at least 500 thousand in Argentina– and is the most common cause of age-related dementia.
According to experts, 10% of those over the age of 65 suffer from some degree of dementia and around 75% of those cases are Alzheimer’s. The number increases with age and about 40% of those over 85 years of age have some form of dementia. And –again– the central incidence is for this evil. And the worst thing is that doctors only have a handful of symptomatic treatments and nothing capable of changing the course of the disease. Until now.
“For this pathology, medicine only had some medications to alleviate symptoms such as depression, delirium or a language disorder. But practically nothing that slowed down or changed the course of the disease”, he summed up PROFILE Fernando Taraganopsychiatrist, Conicet researcher and member of the scientific committee of the NGO ALMA (Association Fights against Alzheimer’s Disease).
However, a few years ago some sophisticated and expensive drugs – monoclonal antibodies – began to be used, which showed that, in certain cases, they could slow her down. “But these therapies are not, for now, a solution, since they have shown an efficacy of 30% in slowing down the progress of the disease,” explained Taragano. “It helps to gain autonomous life for the patient through a chemical elimination of the “sick” proteins responsible for the disease and that circulate in their blood.”
But this pharmacological option showed its risks: almost 40% of the patients who received it had to suspend it because of the dangerous side effects it caused them.
While other scientists tried other paths. “In 2020, the results of plasmapheresis studies for the treatment of Alzheimer’s were published. This technique, which has been used for many years in other pathologies, involves filtering the blood to extract harmful molecules. The truth is that it showed very good preliminary results for Alzheimer’s ”, he commented to PROFILE the neurologist Guido Dormanmember of the Neurogerontopsychiatry and Ineco Memory Clinic staff.
In fact, according to Taragano, the studies published to date have shown a slowdown of the disease of between 50% and 70% and could benefit one in four Argentines with the diagnosis. Something that, still under the umbrella of “research protocols“, is already being tested in Argentina.
But that is not all. The plasmapheresis treatment’pulls out‘ harmful proteins from the body of the patient with a different mechanism than monoclonal antibodies. And, for that reason, it unleashes fewer side effects. “In fact,” Taragano emphasized, “the rate of people who entered these research protocols and then had to drop out because of side effects was low: just 1%.”
Other advantages of this approach The possible treatment of the disease is that medicine has used plasmapheresis for decades in various diseases of the immune system, rheumatological pathologies and hematological conditions, among others. Therefore, “at this point they are safe techniques, which can be implemented on an outpatient basis and do not require an operating room. A conditioned office and trained doctors are enough”the experts explain.
Thus, the global acceptance of plasmapheresis as a standard treatment for Alzheimer’s should be a more simple than the long path of approval that each new drug must go through. In fact, two weeks ago a article in a high-level scientific journal, in which, for the first time, evidence-based guidance on how and when to use this practice in ‘mild’ or ‘moderate’ Alzheimer’s is mentioned. This post is a boost.
All that does not mean that plasmapheresis is free of complications that must be resolved. “For now, it is a safe treatment, but it is not cheap and its coverage will surely arouse controversy”, the experts predict. In addition, in each filtering intervention, the plasma must be “replaced”, and the abundant production of this input is not completely solved by the industry.
Besides, details are yet to be discerned. Because while it has shown results, it still remains to be determined for how long to do it, when it is recommended and when it is not, and in which patients and with what stage of progress is it beneficial. Beyond the fine tuning ahead, the experts agree: “For the first time, we have an option that appears to be a true ‘game changer‘ to change the course of an incurable disease that generates a huge economic, social and affective impact”.
soccer vs. memory loss
When a person’s mind is cognitively impaired, the key to “endurance” – autonomy and long-term memory – lies in the brain’s “cognitive reserve.” The more ‘reserves’ there are, the better you can deal with the situation. For generate these reserves in Alzheimer’s, it is possible to resort to mental stimulations that generate an emotional impact and that have demonstrated their therapeutic effectiveness. It is the case of soccer project vs. alzheimers, that resorts to reading and viewing and listening to journalistic materials about matches, finals and football championships that left traces in the collective memory; added to some specific exercise. “It is an effective, inexpensive technique that anyone can apply with up to eight patients simultaneously,” Taragano summarized. “In the first edition that we did, we verified concrete improvements, in men and women, by stimulating and restoring identity and memory to people with certain cognitive impairment.” In the first edition, made in September 2019, they verified with subsequent quantitative studies that 66.4% of the patients who used it had a positive impact, for having been able to stimulate their reminiscences.
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