Alzheimer’s disease is a progressive disorder that causes the death of brain cells causing memory loss and cognitive decline and disrupting a person’s ability to function independently. It is the most prevalent cause of dementia in late adult life. This disease is a multifarious neurodegenerative disorder that involves parts of the brain that control thought, memory, and language and can affect thinking skills and other mental abilities. Extracellular plaques of insoluble amyloid-β protein, intracellular neurofibrillary tangles (NFTs) of hyperphosphorylated tau protein, and loss of connections between neurons are some of the features which can characterize Alzheimer’s disease neuropathologically. Aging is one of the key reasons for this illness and its associated changes include atrophy, inflammation, vascular damage, production of free radicals, and mitochondrial dysfunction. Symptoms get severe as the condition develops including-
- Reduced ability to remember new information
- Impairments to reasoning and complex tasking
- Impaired visuospatial abilities
- Impaired speaking, reading, and writing
- Changes in personality and behavior
- Hallucinations and delusions
- Low mood or anxiety
Early-onset and late-onset are two types of Alzheimer’s. Early-onset Alzheimer’s is usually inherited mostly diagnosed in people in their 40s or 50s and moreover, people suffering from the Down-Syndrome are at high risk for this condition. Apolipoprotein E (APOE) gene on chromosome 19 is majorly responsible for late-onset Alzheimer’s and is the prevalent form of the disease. Mild, moderate, and severe are the three stages of this disease. Metal dyshomeostasis, reactive oxygen species, reactive nitrogen species, and cholinergic receptors are involved in the progression and pathogenesis of this disease. CT scan, magnetic resonance imaging, positron emission tomography of the brain are some of the diagnostic techniques used for screening purposes. Cholinesterase inhibitors including donepezil rivastigmine and tacrine work by regulating neurotransmitters and are used to treat moderate to severe Alzheimer’s. Biomarkers such as cannabinoids, galanthamine, antibodies, multi-target-directed ligand, stem cells, metals, and polyphenolic compounds provide evidence for the most optimal drug candidates that affect the fundamental pathophysiology of the disease. Common traditional Indian herbs including Ashwagandha, Brahmi, Gotu Kala, Shankapushpi, Chandan, Bhilawa, and Haldi have an ample amount of antioxidants and immunomodulatory agents and further proved to be beneficial for treating neurodegenerative, cardiovascular, pulmonary, metabolic, autoimmune, and neoplastic diseases. Epidemiological and biological evidence support that diabetes can be considered a risk factor for vascular dementia. Inadequate glucose control affects the central nervous system through defective leptin signaling. Diabetes raises the risk of heart disease and stroke which in turn damages the blood vessels leading to Alzheimer’s. High blood sugar may damage brain cells thus, triggering the disease. Insulin resistance, an important feature of type 2 diabetes mellitus arises due to decreased insulin sensitivity of cells to insulin and is responsible for the loss of synapses, neuronal apoptosis, enhancing the production and secretion of amyloid-β, generating hyperphosphorylated tau, and dysregulating the PI3K/AKT/GSK-3β signaling cascade which further culminates in Alzheimer’s disease pathology.
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