The main idea of this book is to make everybody aware about impact of Alzheimer disease, present current state of research and different branches of this research, and, most of all, convince readers to support increase in funding for this research.
Preface: ‘A Peculiar Disease’
Author starts with reference to his personal encounter with Alzheimer disease observing its progress in his grandfather and how it led to author’s involvement with it as researcher. Author presents this book as history of disease, its past, present status, and future resolution that is becoming more and more important with increase of older population.
PART I: Origins
- The Psychiatrist with a Microscope
This is a narrative of the disease discovery when doctor Alzheimer started investigating brains of people who died from it. It also about live of the doctor and what led to this investigation.
- Understanding an Epidemic
This chapter is about long period of somewhat confusion between character of this as disease vs. normal process of old age dementia. At one point it even was considered that age 55 is top age limit for disease. Eventually development of microbiology left no place for controversy, clearly demonstrating that there no biological difference in process of disease that would be linked to age only.
- A Medicine for Memory
Here author goes more into details of how normal brain works and how disease impacts these processes. It follows by discussion of promising, but eventually failed hope to treat the disease with acetylcholine. Then author narrates the story of tacrine – another promising treatment that produced several approved drugs, which seems to provide some improvement, but are far from complete treatment.
PART II: Research
Here author describes a couple of real live cases of Alzheimer caused deterioration of mental abilities.
- The Alzheimer’s Gene
In this chapter author looks at some cases of genetically defined early Alzheimer onset that happens to people in their 50s and even 30s. The mutation is now well-defined and could be tested. The problem is whether people want or do not want to know what is coming.
- The Science Behind the Headlines
This is about relatively new approach to the understanding of disease with stress on formation of beta-amyloid plague in brain, which occurs continuously. The supporters of this theory are known as Baptist (from beta). They were successful in confirming this idea by using mouse, injecting them with human DNA, and artificially developing Alzheimer. The second half of chapter is about alternative suspect – APOE gene variations, positing that plague formation is not the cause, but just a symptom. These variations are actually linked to kind of local diabetes that impede energy supply to brain cells, causing their deterioration. The third part of chapter is about another group – Tautists who named for “tubulin associated unit”, which is protein that forms Alzheimer tangles in the brain. Author discusses which of these theories has higher probably to be correct, but it is still an open question.
- The Second Brain
This is about glia part of the brain that until recently was considered just filler, but now is demonstrated to be an important part of the processes necessary for brain functioning. Author describes his own research with microglia. The functioning of microglia in Alzheimer disease was similar to immune system, so the attempt was made to develop a vaccine. It demonstrated some positive results in testing, but far from being significant enough for practical use.
- Swedish Brain Power
This is about Swedish researcher who works on biomarker that would help predict Alzheimer long before it actually developed in the brain of individual. So far, they achieved 3 years before symptoms and 90% accuracy, but with very small number of objects. The final point in the chapter is that knowledge of approaching disease could prompt people to change live style to help prevent it.
PART III: Prevention
- Stress; 10. Diet; 11. Exercise; 12. Brain Training; 13. Sleep;
This part is about usual staff that considered healthy and prevents all known diseases, Alzheimer included. Interesting note about exercise – after normal amount there is no evidence of increased benefits. It also relates to cognitive training that helps to maintain mental ability in old age, but useless for younger than 50.
PART IV: Experimentation
This is about different directions of experimentation that may bring some new ways to handle the disease.
This is about experiments in molecular biology with DNA and embryonic stem cells in attempt to regenerate aging cells of human bodies. Some success was achieved in turning adult cells into stem cells – called iPS cells. In short, it provides hope that eventually neurons could be regenerated and transplanted into the brain to compensate for loses due to disease.
- Young Blood
This is about attempts to use biological materials from young people to rejuvenate old. So far, no scientifically valid results were achieved in this area.
- Seeds of Dementia
This is about mad cow and other brain diseases, some of them infectious. The point here is that even if they all are different, they still could help understanding brain functions and malfunctions.
- Looking but Not Seeing
This is about some special forms of Alzheimer when disease impacts only parts of the brain, while mechanism of disease seems to be the same -such as visual Alzheimer (PCA).
- Between the Devil and the Deep Blue Sea
This is about unexpected discovery of drag approved for skin cancer somehow had positive impact on Alzheimer patients. It also about an interesting connection – cancer patients had less occurrences of Alzheimer and vice versa. The chapter is discussion experimentation with various compounds impacting RNA with very positive results in mouse. This also prompted expansion of research on impact of different unrelated drags and substances in hope that something could work.
PART V: Discovery
This part is about what could be brought to bear in this struggle from different parts of the world.
- To the Ends of the Earth; 20. Insights from India; 21. Clues from Colombia
These chapters review: the DNA project from Island where they collect it from total population in hope to utilize it in finding all kinds of correlations, massive memory studies from India, people with genetic mutation that could have relevance from Columbia.
- Alzheimer’s Legacy
The final chapter discusses current status of disease expansion due to aging of population and as usual trying to justify more government funding its research.
MY TAKE ON IT:
To me it is quite obvious that Alzheimer is an awful disease and that its elimination requires massive effort in research and medical testing. I think that the more or less valid combination of genetic predisposition and cumulative impact of lifestyle will be identified causing this disease and in the near future some combination of measures in both areas will be developed to fix the problem. The importance of solution for this problem would grow exponentially, so amount of resources directed at supporting research in this area is practically guarantied to grow.