Alzheimer’s disease

Alzheimer’s disease

Alzheimer’s is the most common form of dementia, with around 60-70 percent of all dementia cases stemming from this illness. It is a deadly disease that has a huge impact on sufferers and their relatives alike. Yet despite this, there is currently a lack of preventive and disease-modifying treatments.

Alzheimer’s disease causes nerve cells in the brain to die. The parts of the brain usually affected are the hippocampus (the brain’s memory center), the temporal and parietal lobes. The disease starts with amyloid beta (Aβ) protein beginning to clump in the brain, which ultimately form the amyloid plaques so characteristic of the illness. These have a negative impact on nerve cell function and lead, inter alia, to changes in the levels of neurotransmitters in the brain. These neurotransmitters, such as acetylcholine and glutamate, are necessary for nerve cells to communicate with each other and for the normal operation of the brain. With time, the ability of nerve cells to survive also deteriorates. The reasons why some individuals develop the disease while others do not are as yet unknown, but it is clear that accumulations  of Aβ amyloid in the brain play a central part in Alzheimer’s. The most common risk factors for developing Alzheimer’s are old age and heredity. The disease may appear early, between the ages of 40 and 65 for the hereditary form, but is most common after 65.

The video below gives a brief introduction to Alzheimer’s disease

Today, substantial sums are invested in medical research into Alzheimer’s due to the extensive human suffering, and the costs  to healthcare and society are considerable. Total global costs fordementia-related illnesses are estimated at around USD 1 trillion, which is expected to triple by 2050. The lack of effective symptomatic treatments and efficacious treatments for the course of the disease represent an urgent medical need. The few approved drugs sold in today’s market only have a limited symptom-relieving effect and entail problematic side effects. Thus there is a very urgent medical need for new symptomatic and disease-modifying treatments. A disease-modifying therapy for Alzheimer’s is considered capable of generating more than USD 10 billion in annual sales.

Symptoms
Usually, the first signs of Alzheimer’s are impaired memory, difficulties in finding words, expressing oneself and understanding. Difficulties with the concept of time are also common. Eventually, sufferers experience orientation problems in their surroundings, and difficulties reading, writing and counting or managing practical tasks. Some have problems with perception and difficulty in recognizing what they see, and reasoning and planning become more difficult. With the passage of time, sufferers become more and more dependent on help from relatives and/or care services. Because a characteristic of the disease is its gradual onset, it can be difficult to identify when the problems actually began. Symptoms may also vary from person to person.

Prevalence
It is estimated that around 150,000 people in Sweden are living with dementia diseases, a figure that is expected to double by 2050. Every year, around 25,000 people are affected, resulting in major care and healthcare costs for society. The direct costs in Sweden are greater than those caused by cancer and cardiovascular diseases together. As previously mentioned, Alzheimer’s is the most common form of dementia, and worldwide over 50 million people were estimated to be living with dementia-related diseases in 2020, a figure that is expected to rise to 82 and 152 million sufferers by the years 2030 and 2050 respectively. Geographical distribution and the anticipated increase in dementia is shown in the figure below.

Treatment
Today there are two classes of symptomatic drugs for the treatment of Alzheimer’s disease. Cholinesterase inhibitors: The drug allows the neurotransmitter acetylcholine to be active longer in the brain and thus boost nerve cell communications. The drug does not slow down progression of the illness, it only relieves the symptoms. NMDA inhibitors: The drug affects glutamate signaling, which plays an important part in nerve cell communications. However, the effect of cholinesterase and NMDA inhibitors is usually limited and associated with side effects. The need for alternative drugs with better symptom-relieving effect and fewer side effects is thus urgent. AlzeCure’s NeuroRestore and Alzstatin platforms act in a completely different manner in their treatment of the disease than the drugs described above. NeuroRestore seeks to improve communication between nerve cells by means of a unique mechanism so that memory function is improved in the patient while also avoiding difficult side effects. Alzstatin is aimed at preventing the very occurrence of the illness by reducing production of toxic amyloid in thebrain and thereby preventing the formation of amyloid aggregates such as oligomers and plaque in the brain.

 

Geographic distribution and expected growth of prevalence of dementia.

Infographics from AR2020 ENG7-cut

 

The figure below shows the expected growth in the number of cases of dementia between 2015 and 2050. The largest increase in number of cases of dementia and Alzheimer’s is expected to accur in low and medium income countries (LMIC), since these countries are expected to demonstrate a higher relative improvement in quality of life than high-income countries (HIC), which leads to an increased life expectancy. The need for treatment continues to be very high since there are currently no satisfactory treatment options for such patients.