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Hope for loved ones lost to Alzheimer's
Published in The Saudi Gazette on 07 - 03 - 2015

Amal Al-Sibai
Saudi Gazette

Cindy is losing her mother, day by day, but not physically. Cindy says about her mom, “I open the door and see my mom in her wheelchair, scooting to various locations about the room.
It has become increasingly difficult to visit, as she no longer recognizes me and her speech has been replaced by very bizarre utterances.
My mom has Alzheimer's disease, and she is in its final stage. My dream at this time is a more effective treatment for Alzheimer's. A cure would be incredible, but I would settle for a better treatment.”
Recently, news reports have announced that there seems to be a glimmer of hope, if not for Cindy's mom, at least for Alzheimer's disease patients in the early stages, whose condition has not progressed. A new treatment is just on the horizon.
To understand how this touted treatment works, the physical changes that occur in the brain of an Alzheimer's disease patient must be understood first.
Certain protein structures are seen in higher concentrations in MRI images of the brains of Alzheimer's disease patients, far more than in the brains of healthy (dementia-free) patients.
These structures called amyloid fibrils are proteins that have the tendency to clump together in the brain, they fold into the wrong shape and form into twisted, tangled structures.
These tangles, also called amyloid plaques, block the supply of nutrients and other essential supplies to nerve cells, and the nerve cells eventually die.
Tangles spread, appearing in larger numbers as the dementia gets worse. In the beginning the victim of Alzheimer's disease may have problems remembering where he left his car keys or recalling the names of familiar people.
But as the amyloid fibrils spread to other parts of the brain, the patient deteriorates. They may get confused and have trouble handling money, speaking, and organizing their thoughts, and they may experience personality changes. They lose basic social skills and the ability to care for themselves.
What has excited the scientific community is the finding of a molecular chaperone which can interfere with the step that produces these amyloid fibrils, possibly stopping the toxic chain reaction that leads to the death of brain and nerve cells.
Not a very easy concept to understand, but in simple terms, a molecular chaperone is a protein that assists in the folding or unfolding and in the assembly or disassembly of other normal structures on the cellular level.
When chaperones are present, these structures will perform normal biological functions, and no mishaps will occur in the development of these structures.
How is this going to slow down the progression of Alzheimer's disease? Well, the molecular chaperone is like the monitor to make sure that protein structures are synthesized correctly, eliminating the step where things could go wrong.
When things go wrong, proteins can develop into an abnormal structure, like amyloid fibrils, which is closely linked to Alzheimer's disease.
So, if scientists could pinpoint a molecular chaperone that can keep protein synthesis operating smoothly and normally, chances are they could reduce the formation of amyloid fibrils in the brain, thus treating or at least preventing Alzheimer's disease.
And this discovery was made by an international team of academics from the Department of Chemistry at the University of Cambridge, the Karolinska Institute in Stockholm, Lund University, the Swedish University of Agricultural Sciences, and Tallinn University.
Dr. Samuel Cohen, researcher and lead author of the report in the Natural Structural & Molecular Biology journal, said, “A great deal of work in this field has gone into understanding which microscopic processes are important in the development of Alzheimer's disease; now we are starting to reap the rewards of this hard work.
Our study shows, that for the first time, one of these critical processes being specifically inhibited, and reveals that by doing so we can prevent the toxic effects of protein aggregation that are associated with this terrible condition.”
“We were able to identify a molecule that produced exactly the results that we were hoping to see in experiments,” added Cohen.
Researchers identified the molecule, Brichos, which inhibits the step that leads to the out-of-control protein folding that produces the tangles in the brain, which have been shown to be so toxic in Alzheimer's disease sufferers.
The report further stated that Brichos is a molecular chaperone; it is like housekeeping molecules that help proteins avoid mis-folding and aggregation into structures that are toxic to brain cells, and are implicated in Alzheirmer's disease.
Although it may not be a miracle cure, scientists are hopeful and optimistic, that relief for Alzheimer's disease sufferers is on its way.
“A good tactic now is to search for other molecules that have this same highly targeted effect and to see if these can be used as the starting point for developing a future therapy,” said Cohen.
Sadly, Alzheimer's causes not only memory loss and loss of mental functions, but the person is lost as well.
It is extremely difficult on the caregivers and family members to see their loved ones slipping away from them, mentally and emotionally.
How to cope
The following are tried steps from the caregiver of an Alzheimer's victim, which he shared on the American Alzheimer's Association web-site, to help others cope, who are caring for a loved one with Alzheimer's.
1. It is vitally important for people with Alzheimer's disease to maintain a consistent daily routine. The daily life of an Alzheimer's patient must be maintained on a schedule with minimal or no changes if possible.
2. If still in the early stages of dementia, the more the exercise the mind can get, the slower the progression of the disease.
Encourage your loved one to read the newspaper, do a crossword puzzle, play a game of chess, state the date and day of the week each day, and read about and discuss current events.
3. Buy a calendar and nail it to the wall. With a red marker, write any appointments necessary: doctor, haircut, social visit, to help all family members keep up to date on important appointments.
4. If your family member suffering from Alzheimer' is on medications, make sure she takes them at the proper time and at the same time each day. Preferable medicines should be taken with meals.
5. When your loved one does remember an appointment or remembers to wash up in the morning or makes herself a sandwich, positive reinforcement is vital when she completes what once used to be an easy task.
For people with Alzheimer's, doing some things on their own makes them feel more in control. They need to feel that they can still do things.
They need to be told you are proud of them as they complete tasks. When they say they do not want to do something, tell them you can't do it without their help or say, “Let's do it together.”
6. Resist the temptation to do everything for them just because it is easier or quicker. Patiently be firm that they still perform some tasks on their own. Again, positive reinforcement is vital.
The person with Alzheimer's needs to feel wanted, appreciated and, most of all, complimented when they find the courage to go on.
7. Give yourself some time to rest and accept help from supportive people when they offer.

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