Alzheimer

About the disease

Alzheimer’s Disease

Alzheimer’s disease (AD) is a progressive neurodegenerative disorder and the most common cause of dementia in older adults. It is characterized by gradual cognitive decline affecting memory, language, orientation, judgment, and other higher mental functions, significantly interfering with daily life.

Pathophysiology

Two main alterations are observed in the brains of people with Alzheimer’s:

• Beta-amyloid plaques: extracellular accumulations of amyloid protein fragments (Aβ), especially the Aβ-42 form, which interfere with neuronal communication.
• Neurofibrillary tangles: intracellular aggregates of hyperphosphorylated tau protein that disrupt the structure of neuronal microtubules, affecting stability and cellular transport.

These changes lead to synaptic loss, brain atrophy, and neuronal death, particularly in regions such as the hippocampus and cerebral cortex, which are essential for memory and thinking.

Clinical Progression

The disease typically develops in three phases:

• Preclinical phase: brain changes without evident symptoms.
• Prodromal phase: mild cognitive impairment, with measurable memory failures but no significant functional impact.
• Dementia phase: progressive loss of autonomy, affecting multiple cognitive and functional domains.

Diagnosis

Diagnosis is based on clinical evaluation, neuropsychological tests, and brain imaging studies. In recent years, blood and cerebrospinal fluid biomarkers have been developed to detect the disease in early stages, even before symptoms appear.

Treatment

Although there is currently no cure, available treatments aim to slow symptom progression and improve quality of life. These include:

• Symptomatic drugs: such as cholinesterase inhibitors and memantine.
• Disease-modifying therapies: such as anti-amyloid monoclonal antibodies, indicated in early stages.
• Non-pharmacological interventions: cognitive stimulation, psychosocial support, and personalized care.

Impact and Future

Alzheimer’s disease affects more than 600,000 people in Spain, and this figure is expected to double in the coming decades due to population aging. Current research focuses on identifying early biomarkers, developing disease-modifying treatments, and improving comprehensive patient and caregiver management.