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Tracking mind killer Alzheimer's

india Updated: Sep 19, 2006 17:08 IST

World Alzheimer's Day this Thursday marks the 100th anniversary of when a brain-destroying disorder that many might call the most cruel disease of all entered the medical books.

In a study in 1906 that broke new ground in knowledge about dementia, German doctor Alois Alzheimer presented the case history of a 51-year-old woman, Auguste D.

Five years earlier, Auguste D had started to suffer memory loss. She developed problems with speaking, became confused, paranoid and agitated. By the time she died, she had become incontinent, bedridden and oblivious to her surroundings.                                                                                        

In a study in 1906 that broke new ground in knowledge about dementia, German doctor Alois Alzheimer presented the case history of a 51-year-old woman, Auguste D.

Carrying out an autopsy on his former patient, Alzheimer found Auguste D.'s brain had shrunk through loss of neurons and was clogged with fibrous tangles and plaques.

Alzheimer presented his findings at a conference in the university of Tuebingen in November 1906. But for the next eight decades, knowledge of the disease that bore his name stayed to a large degree unchanged.                      

Alzheimer's became a byword for dread of ageing -- but also bafflement as to its cause, and despondency about how to treat it.

Today, though, the news about this darkest of diseases burns with a flame of hope.

Alzheimer's is being attacked on so many fronts that some researchers, while balking at talk of a cure, believe a treatment to slow or possibly stop its clinical advance is tantalisingly within reach.

"If you look at beta amyloid formation alone, there are three or four approaches and all can bear fruit within 10 years," said Bengt Winblad, a professor of geriatrics at Sweden's Karolinska Institute in Stockholm.

Beta amlyoid formation refers to the plaques of proteins that clump outside the brain cells. They are a hallmark of Alzheimer's, as are the tangles of so-called tau protein inside the neurons. It is still unclear, though, whether tau is a cause or an effect of Alzheimer's.

Two research areas that could yield a marketable drug "within three to five years" focus on interfering with the molecular cascade that allows the plaques to form and stick together, said Winblad.

"Even if there is no cure, if you delay progression or halt disease, that is something that the relatives of the patients [with Alzheimer's] would be very happy with indeed," he said.

Another approach is to clear the brain of the plaque deposits. This could be achieved by an "active vaccine" in which part of the beta amyloid would be injected into the body in order to prime the immune system against it, or by injecting antibodies directly.

Much of this encouraging research has already left the lab and is undergoing early human trials, a long, costly three-phase approach to test a new molecule for safety and effectiveness.

In addition, more and more is known about telltale pre-stages of Alzheimer's and about conditions such as smoking, obesity, diabetes and high blood pressure that appear to contribute to it, while mental exercise and a diet rich in fruit and vegetables appear to have a protective effect. There is also an indication that some people may be genetically more susceptible to it than others.