Notable Advances Reported in Alzheimer's Treatment

Notable Developments in Alzheimer's Treatment Prof. Dr. Başar Bilgiç, President of the Turkey Alzheimer's Association, made important statements regarding the treatment of Alzheimer's disease and discussed new medications showing successful results in early-stage Alzheimer's patients. Noting that a new era may be beginning in Alzheimer's treatment, Prof. Dr. Bilgiç made the following remarks: "In mid-2021, the U.S. Food and Drug Administration (FDA) granted conditional approval for a drug called 'aducanumab' for use in early-stage Alzheimer's patients. The drug in question effectively clears from the brain a protein called 'amyloid' that begins accumulating in the brain in Alzheimer's disease before patients even develop symptoms. However, in early-terminated Phase 3 studies of this drug, only partial clinical benefit was observed in a specific group receiving high-dose medication. In addition to this development, within the current year, another drug acting through the same mechanism has been shown to have partial efficacy in early-stage Alzheimer's patients," he said. Emphasizing that with these two important studies, a different era in Alzheimer's disease treatment has begun when considering the partial clinical effect of these drugs, Prof. Dr. Bilgiç also conveyed the discussions generated by these new therapeutic developments. Noting that circles believing the amyloid protein accumulating in the brain is not harmful expressed opposition to drug approval, Prof. Dr. Bilgiç stated that the discussions will end once the relationship between this protein and the disease is clarified. While these heated discussions continued, the World Alzheimer's Congress announced the successful completion of Phase 3 studies for another drug called 'masitinib'. Prof. Dr. Başar Bilgiç noted that all these developments can be counted as the most important developments regarding Alzheimer's disease in recent years. Nurettin Tan, Deputy Mayor of Şişli Municipality, who attended the press conference, expressed his support by saying: "As Şişli Municipality, I want to state that we have always been supporters of the Şişli Day Care Home that we have implemented together with the Turkey Alzheimer's Association. You are performing a very sacred duty. I was very pleased to be with you. I offer my respect and affection to my teachers and our health teams." Prof. Dr. Işın Baral Kulaksızoğlu: The Pandemic Increased Stress Among Caregivers Prof. Dr. Işın Baral Kulaksızoğlu, Board Member of the Turkey Alzheimer's Association, provided information during the meeting about how individuals caring for dementia patients were affected during the pandemic. Noting that this period further increased stress among patient relatives, Prof. Dr. Kulaksızoğlu stated: "Particularly Alzheimer's patients in advanced stages and their relatives experienced more pronounced stress increases during the COVID-19 period. Because going to hospitals carried risk, routine examinations were interrupted and patients' mobility capacity significantly decreased, especially due to skipping physiotherapy," she said. Emphasizing that studies showed stress increased in 92% of patient relatives during the pandemic, Prof. Dr. Kulaksızoğlu identified the fear of bringing COVID-19 to patients from outside and difficulty in getting patients to comply with disinfection and isolation rules as the main stress-causing factors. Prof. Dr. Türker Şahiner, Board Member of the Turkey Alzheimer's Association, who spoke about the effect of air pollution on Alzheimer's at the meeting, shared important information. Emphasizing that increasingly growing air pollution worldwide is scientifically becoming more widely accepted as a serious risk factor for dementia, Prof. Dr. Şahiner presented a study with follow-up results spanning more than 10 years that was presented at the World Alzheimer's Congress: "This research showed that if we can keep levels of toxic gases from motor vehicles (NO2) and very small particles suspended in the air (PM 2.5) low for at least 10 years, we can reduce the risk of Alzheimer's disease by 14%. Similarly, another study conducted in France showed that with only very small particles (PM 2.5) decreasing in the air, all dementias can be reduced at the level of 15%," he said. Stating that toxic wastes released into the air bind to the blood-brain barrier and cause non-microbial inflammatory reactions in the brain and increase the levels of Beta-Amyloid protein accumulating in Alzheimer's patients' brains, Prof. Dr. Şahiner stated: "All these results show that we need to breathe clean air to reduce our dementia risk and we need to replace internal combustion engines with electric motors and move toward environmentally friendly energy sources." Prof. Dr. Barış Topçular: We Witnessed Important Developments in Alzheimer's Diagnosis Prof. Dr. Barış Topçular, Board Member of the Turkey Alzheimer's Association, emphasized that important developments facilitating Alzheimer's diagnosis occurred in the past two years and conveyed the following: "Cerebrospinal fluid markers are currently being used in the diagnosis of Alzheimer's disease. A procedure called lumbar puncture is required to reach this clear fluid, and this is the most fundamental factor limiting the widespread use and application of this diagnostic method. For this reason, currently work is ongoing, especially with tests performed from serum, i.e., blood, to be able to diagnose the disease and monitor its progression, and we have witnessed important developments in this field in the past two years. The most prominent method in this field is examining the levels of a protein called Tau in patients' serums," he said. In addition to these, Prof. Dr. Topçular noted that the detection of a protein called neurofilament in blood also provides important information, particularly for differential diagnosis and disease progression, and emphasized their expectation for the widespread use of these methods in the near future in the disease diagnosis stage. Prof. Dr. Nil Tekin, Board Member of the Turkey Alzheimer's Association, emphasized the need for a national strategic plan for dementia diseases in Turkey, where the elderly population is increasing. Emphasizing the necessity of planning that includes prevention of dementia disease, early diagnosis, information provision, provision of quality care, and support services to be provided to improve the quality of life for patients and their families, Prof. Dr. Tekin conveyed their work on the subject as follows: "The National Strategic Plan Study aims to increase disease awareness, develop approaches specific to our country, and create national actions and effective change. Within this purpose, the study report prepared by the Turkey Alzheimer's Association Dementia Working Group was submitted to the relevant institutions as of October 2020, and collaboration processes continue," she said. Dr. Lecturer Bedia Samancı: "COVID-19 Negatively Affected Dementia Patients" Prof. Dr. Lecturer Bedia Samancı, Board Member of the Turkey Alzheimer's Association, expressed that COVID-19 infection, which is discussed in relation to many diseases, negatively affected Alzheimer's patients and the human brain, and presented research conducted on the subject. Many studies showed that COVID-19 infection progresses more severely and fatally in advanced age, especially in those with comorbidities. Noting that dementia patients are therefore significantly affected by COVID-19, Dr. Samancı pointed out the negative impact of these patients' isolation from the social environment they needed and were accustomed to during the pandemic and many of them being unable to use technological tools used for socialization. "This situation leads to dementia patients withdrawing into themselves and deteriorating cognitively and behaviorally. For these reasons, providing timely and appropriate healthcare support and psychological support to dementia patients and their relatives and vaccinating them for infection control are of great importance," said Dr. Samancı, continuing as follows: "In a recent study conducted at New York University's Grossman School of Medicine, it was reported that in COVID-19 infection patients with neurological symptoms receiving hospital treatment, plasma biomarkers related to neuroinflammation and neuronal damage were significantly elevated compared to those without neurological symptoms, and these biomarker results were found to correlate with serum biomarker results related to Alzheimer's disease. Based on these results, researchers suggested that Alzheimer's disease symptoms and pathology may be accelerated in individuals with COVID-19 infection and accompanying neurological findings. However, more studies with larger numbers of patients and longer-term follow-up of patients are needed to reach definitive conclusions," she said. Providing information also about "Long COVID," another condition of greater concern to the elderly age group, Dr. Samancı emphasized that memory impairment, difficulty thinking and concentrating, brain fog, and orientation deficits are seen in many healthy individuals following COVID infection. Füsun Kocaman, General Director of the Turkey Alzheimer's Association, speaking about the association's activities during the pandemic, conveyed the following: "Since March 2020, when the pandemic began, our association transferred all services to online channels and continued to support patients and caregivers using digital communication channels and social media. This support includes information about health measures related to COVID-19 and dementia, guidance on social and legal matters such as pandemic-related restrictions, emergency applications, and economic/psychological assistance applications," she said. Kocaman additionally noted that three booklets titled 'Frequently Asked Questions and Answers About Alzheimer's Disease and Other Types of Dementia and COVID-19', 'COVID-19 Recommendations for Alzheimer's Patients and Caregivers', and 'Home Activity Guide for Alzheimer's Patients' were also published on both the association's and the European Alzheimer's Association's websites. Highlighting that patients greatly benefited from digital tools during this process to have good time and be informed, Kocaman emphasized that with innovative applications such as 'Digital Tea Time', 'Digital Grandchild', and 'Tell Me A Story', they did not leave patients alone during this period.