Scientists warn: Alzheimer's is far from curable. Experts call for better patient care
Even though Alzheimer's research has brought about a huge increase in knowledge in recent years, it is unclear from a scientific point of view whether and when an Alzheimer's medication will be available to cure the most common form of dementia, the experts emphasized during a symposium of the Hirnliga e.V.
Several experts presented and discussed the current state of research on Alzheimer's disease at the symposium of the Brain League on Tuesday in Frankfurt am Main. They pointed out that despite intensive research, Alzheimer's will not be curable in the long term, which is why the focus should be on the options for early detection and treatment. The opportunities must be used to delay the onset and progression of the disease for the benefit of the patient as long as possible, instead of continuing to hope for research into a panacea, the experts explained. The scientists not only keep an eye on everyone's health, but also see the growing increase in Alzheimer's disease as a growing threat to “our social security systems” every year.
27 million Alzheimer's diseases worldwide The number of Alzheimer's diseases has increased rapidly in recent years. According to the deputy head of the Brain League, Hans Gutzmann, around 27 million people worldwide are currently affected. Around one million people in Germany currently suffer from Alzheimer's disease, with around 200,000 new people annually, the expert continues. More recent studies assume that the number of Alzheimer's patients in Germany could double or even triple by 2050. However, a large number of the diseases remain undetected and are therefore not treated, said Gutzmann. Only about ten percent of those affected would be examined by a specialist in the course of their illness.
Alzheimer's affects the entire family The director of the Clinic for Psychiatry, Psychosomatics and Psychotherapy at Goethe University in Frankfurt, Harald Hampel, explained that Alzheimer's is a "highly complex and chronic" disease, which is due to progressive memory loss and the loss of other higher brain functions up to complete loss of independence. In the later stage of the illness, those affected are often dependent on care around the clock, which means that the illness usually affects the entire family, added Gutzmann. According to the expert, the high levels of physical and mental strain are hardly sustainable for relatives, so that around a third of the caring relatives suffer from depression, burnout and similar disorders.
Better care for Alzheimer's patients required As part of the Hirnliga symposium, the experts also called for improved care for Alzheimer's patients. The scientists complained that people with dementia often received inappropriate medication. At the symposium, geriatric psychiatrist Ralf Ihl emphasized that less than 20 percent of dementia patients who are members of the statutory health insurance company are prescribed appropriate medication. Ihl explained that there are twice as many of the privately insured patients. The expert also cited a study that found that almost 90 percent of neurologists would prescribe a relatives inhibitor acetylcholinesterase, a drug that blocks the breakdown of nerve cells, when symptoms appear. 64 percent of general practitioners surveyed would do the same. In the context of his contribution, the gerontopsychiatrist emphasized that in reality the neurologists only prescribed 44 percent of the patients with corresponding symptoms with an acetylcholinesterase inhibitor, and the general practitioners only did so in nine percent of the patients. The reason given by the specialists and family doctors for the study included budget restrictions as the most important cause.
Early detection of Alzheimer's significantly improved The Frankfurt psychiatrist Harald Hampel also emphasized that despite the considerable research success, Alzheimer's will still not be curable. However, significant progress has been made in the diagnosis and identification of risk genes, so that the current efforts of the researchers are more focused on improving early detection and developing drugs to delay the course of the disease, explained Hampel. One of the main research results of recent years is that the pathological processes in the brain, which are considered to be the cause of Alzheimer's disease, can be demonstrated decades before, the Frankfurt psychiatrist emphasized. For example, early detection using magnetic resonance imaging and biomarkers is possible.
Numerous risk factors for Alzheimer's disease known In addition, a number of genes have been discovered, the changes of which one can detect an increased risk of Alzheimer's, said Hampel. In addition, according to the scientist, current findings indicate that "fat and cholesterol metabolism and the immune system" play an "important role" in Alzheimer's disease. According to the Frankfurt-based pharmaceutical researcher Gunter Eckert, other risk factors for the development of Alzheimer's include high blood pressure, a high level of the metabolic intermediate homocysteine, diabetes, obesity and smoking. Preventing Alzheimer's has proven to be a healthy, Mediterranean diet and physical and mental activity, said Eckert.
Drug treatment for Alzheimer's diseases insufficient The Krefeld geriatric psychiatrist Ralf Ihl addressed several subject areas in his contribution. The expert commented on the current methods of medication and cited five substances that can currently be used to treat Alzheimer's disease - such as preparations made from ginkgo leaves. According to Ralf Ihl, the approved medications can sometimes also be successful if they are combined, but this should not be done without medical approval. The Krefeld gerontopsychiatrist also criticized in his lecture the unequal treatment of statutory insured and private patients. As shown, only about 20 percent of those insured by law receive appropriate anti-dementia drugs, and private patients are treated twice as often with adequate medication. The main problem is that the family doctors and specialists do not prescribe medication for fear of budget overdrafts, but with the help of which expensive home care could be delayed by up to a year.
Dementia plan and merger of nursing and health insurance companies required In order to avoid the "financing dilemma" in the medical treatment of Alzheimer's diseases, Ralf Ihl also called for the merger of the nursing and health insurance companies. Because the health insurance companies would consider dementia diseases more as a care problem and less as a medical problem, according to the statements at the symposium of the Brain League. Adequate therapy would not only delay the need for care, but would ultimately also save considerable costs, emphasized Ralf Ihl and therefore called for a national dementia plan, such as is already used in France or in the USA. According to the expert, all actions against dementia need to be coordinated, from the politico-local level to the research level, whereby in addition to drawing up a dementia plan, the necessary financial means must also be provided to successfully counter the growing number of Alzheimer's diseases. Ihl emphasized that there was an urgent need for action at the European level.
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