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. 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.
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.
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.
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.
Other diseases with cognitive dysfunction
There are several other diseases in which cognitive functions such as memory and learning are affected; in addition to the classic neurodegenerative diseases such as Alzheimer’s and Parkinson’s
disease, other indications include sleep disorders (e.g. sleep apnea) and traumatic brain injury.
An estimated 100 million people worldwide suffer from sleep apnea, the majority of whom are undiagnosed. In Sweden, about 300,000–400,000 people (10 percent of all women and 20 percent
of all men) between the ages of 30 and 60 suffer from the condition, which is strongly associated with overweight. As the population gradually becomes more overweight, the incidence of
sleep apnea is also expected to increase. There is also a hereditary component associated with the condition. One consequence
of suffering from sleep apnea is that the patient suffers from extreme fatigue, since the body reflexively wakes up when breathing stops. The body also suffers oxygen insufficiency since breathing
is absent for long periods and the body does not get a chance to recover. This fatigue also leads to impaired cognitive ability. The patients’s symptoms are somewhat similar to Alzheimer’s,
where memory, learning and other cognitive abilities are negatively impacted by sleep apnea.
Traumatic brain injury (TBI)
Traumatic brain injury (TBI) is caused by external trauma where the nerve cells in the brain are immediately damaged. TBI is a major global health and socioeconomic problem and is a common cause of death, especially among young adults, and can cause lifelong injuries among those who survive. Every year about 10 million people suffer from TBI worldwide. In North America, TBI affects about 1.7 million individuals annually, with total medical costs of more than SEK 600 billion. The global market for treatment of TBI is expected to grow from SEK 970 billion in 2017 to SEK 1,350 billion in 2024. The two most common causes of TBI are traffic accidents and falls. The majority of other causes of cases of TBI are violence or work or sports-related. The increase in TBI is due in part to the increased use of motor vehicles in low and middle-income countries.
According to the Glasgow Coma Scale, TBI is divided into three
categories as follows:
- Mild TBI – loss of memory, confusion or disorientation
for a maximum of 30 minutes
- Moderate TBI – loss of memory for 20 minutes – 6 hours
- Severe TBI – loss of memory for more than 6 hours
AlzeCure is focusing on improving cognitive ability in people with mild TBI. TBI has been shown to increase the risk of developing dementia-related diseases, such as Alzheimer’s disease and other neurodegenerative diseases, e.g. Parkinson’s disease. Studies show that a person who sustains a TBI has an approximately 24 percent increased risk of suffering from dementia. The symptoms of TBI may be both physical and mental, and vary depending on the severity of the injury. Symptoms include loss of memory, headache, fatigue and mood swings, as well as sleep and concentration difficulties. About 30–70 percent of those who suffer from TBI also suffer from depression.
Geographic distribution and expected growth of prevalence of dementia.