09/21/2021 at 8:30 AM CEST
Alzheimer’s disease is the leading cause of cognitive decline in the world and a health and economic problem of the first magnitude. According to the WHO, it is already one of the 10 main causes of disability, dependency and mortality worldwide.
It is not for nothing that Alzheimer’s has been classified as the true structural epidemic of the 21st century. The latest Alzheimer’s Disease International report in 2015 estimated that in the world there was 46 million people with dementia and it projected that this number would rise to 131.5 million in 2050.
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More than 60% of the cases of dementia diagnosed in the world correspond to Alzheimer’s disease is the main cause of dementia (more than 60% of the cases of dementia diagnosed in the world), and each year about 10 million of new patients.
The Alzheimer’s is a neurodegenerative disease characterized by the loss and death of neurons, which produces a persistent deterioration of cognitive functions, which alters functional capacity and conditions disability and dependence in a gradual and progressive way.
The Spanish Society of Neurology (SEN) estimates that in Spain there are about 800,000 people who suffer from this disease.
Is it possible to prevent it?
«In recent years, the prevalence of Alzheimer’s has increased considerably, in parallel with the increase in life expectancy and the aging of the population.
Age is the main risk factor for suffering from the disease.
It affects between 5 and 10% of adults over 65 years of age, figures that double every 5 years until reaching a prevalence of approximately 50% in the population over 85 years of age ”, explains Dr. Juan Fortea, Coordinator of the SEN Behavior and Dementia Study Group.
«In any case, age is not the only factor. Alzheimer’s is a pathology of multifactorial origin, conditioned by genetic and / or environmental factors, which is also influenced by others such as high blood pressure, hypercholesterolemia, obesity, sedentary lifestyle, smoking or diabetes », explains the specialist.
«Many of them are modifiable, so you have to do physical exercise regularly, not smoke, avoid alcohol abuse, control your body weight, follow a healthy diet and keep your blood pressure, blood sugar and cholesterol at low levels. adequate treatment reduces the risk of suffering from this disease & rdquor ;, he emphasizes.
It is estimated that a reduction of at least 25% in these modifiable risk factors could help prevent between 1 and 3 million cases of Alzheimer’s in the world.
However, a study recently published in the Neurology Journal indicates that less than 50% of the Spanish population is aware of the risk factors for the disease.
“Increasing the level of knowledge of Alzheimer’s disease is essential not only so that the population can adopt measures that can help prevent cognitive deterioration: those with greater knowledge of the disease are better able to identify it early and seek treatment.
This is very important because we estimate that in Spain more than 50% of the cases that are still mild (prodromal forms) are still undiagnosed. In addition, detecting the disease early allows better planning of care and a better quality of life, ”says Dr. Juan Fortea.
New treatments: there are reasons for optimism
There are also reasons to be optimistic about this neurodegenerative disease. And it is that, in the last two decades, enormous advances have been made in the knowledge of the pathophysiology and the development of biomarkers to help in the diagnosis of the disease.
“We must highlight the development in the last 5 years of plasma markers, markers that will revolutionize the way we diagnose the disease since they will allow massive screening of the population and a much earlier diagnosis of the disease,” says Dr. Fortea.
The most important thing, however, is that we are on the verge of a paradigm shift in the treatment of the disease.
Currently available drugs for Alzheimer’s disease do not slow down the progression of the disease, although they do improve symptoms, and these are even more effective at the onset of the disease.
But this scenario will change in the coming years. “Today many of the new approaches to pharmacological therapies against Alzheimer’s disease are based on the use of monoclonal antibodies,” says the expert.
Two drugs, in phase 3
«This year the first of these was approved in the United States, which, although it has been approved despite having controversial evidence regarding its clinical benefits, is the first sign that it is already possible to modify key pathophysiological processes of the disease, “he says.
“In addition, phase 3 studies are currently being carried out with two other drugs with very similar characteristics and which are expected to have results by the end of 2023 and 2024 respectively,” says Fortea.
The SEN is therefore hopeful that new treatments will emerge in the coming years that will manage to modify the course of the disease.
For this reason, he insists on the need to design an Alzheimer’s Plan with adequate financing that allows the necessary resources to be available to offer early diagnoses with certainty, as well as so that these treatments can be accessed with equity throughout our country.
Something that, today, is still far from being achieved.