Imagine you are chatting with friends on a quiet afternoon. Suddenly, he realizes that he is not able to follow the group’s reasoning. Words run out of your head, and expressing yourself feels like a challenge. When it’s time to say goodbye, she ends up forgetting the name of one of them, although they’ve known each other for years. Afterwards, when he goes home, he feels disoriented, not knowing how to get to where he lives.
Forgetfulness, mental confusion and communication difficulties are some of the symptoms of Alzheimer’s, a disease that affects 1.2 million Brazilians, according to the Ministry of Health.
Disease affects 1.2 million Brazilians, according to data from the Ministry of Health, and occurs mainly in older peopleFonte: Freepik
Yet that there is no curethe drugs available today can stabilize the patient’s condition. That’s what explains Ivan Okamoto, a neurologist at the Memory Center (Nemo) at Hospital Israelita Albert Einstein.
“We don’t have current medications that reverse this process in the brain, but they can minimize the impact of the disease. Before, between patient independence and dependence, it took 8 to 10 years. Today we talk about between 14 and 18 years old, ”she says.
How is Alzheimer’s treatment today?
Therapy varies according to the stage of the disease. In mild and moderate cases, the patient must take drugs such as donepezil, galantamine and rivastigmine, which help in the communication between neurons and are able to temporarily reduce the symptoms.
In the severe phase, in which the patient usually has difficulties even eating, memantine is prescribed. The remedy acts on a neurotransmitter responsible for storing information in the brain, which improves memory and can help with performing simple tasks.
The disease also affects the patient’s behavior, which may become more aggressive or irritable. In these cases, it is recommended to use remedies for specific symptoms, according to Okamoto.
Treatment is done with prescription drugs.Fonte: Freepik
In Brazil, the last approval of drugs for Alzheimer’s occurred 20 years ago, in 2003. In two decades, researchers have tried to develop new therapies for Alzheimer’s, but still without success.
Some treatment possibilities have emerged in the United States, where, in the last two years, the approval of two drugs for Alzheimer’s by the FDA – an institution equivalent to Anvisa in that country.
In January of this year, the American agency gave the green light for the use of lecanemab in patients. Research published in November 2022 in the scientific journal New England Journal of Medicine showed that the medicine reduced the cognitive decline of people with Alzheimer’s. But the FDA warned that lecanemab still carries risks, including brain bleeding.l.
The agency also approved, in June 2021, aducanumab. According to Norberto Frota, professor of medicine at Unifor (University of Fortaleza), the medicine was considered controversial by the medical community, since there was not enough evidence about its effectiveness.
Exams and lifestyle-focused therapies are also part of the treatment
Despite the lack of up-to-date remedies, new tests can increase the accuracy of the diagnosis, helping to treat milder cases. According to Norberto Frota, early diagnosis increases the chances of cognitive rehabilitation, reducing deficits caused by the disease.
One of these exams is the amyloid PET, which arrived in Brazil last year. This is a brain scan that detects beta-amyloid proteins, which are associated with Alzheimer’s.
But the new tests are restricted to private networks and are not yet funded by health plans, since they have not been incorporated into the list of the ANS (National Agency for Supplementary Health).
Those who are attended only by the SUS may have more difficulties in detecting the disease in the initial phase. According to Norberto Frota, patients usually arrive at the public network with a mild to moderate condition.
“When access to medical care is difficult, it takes longer to arrive at a diagnosis. In a supplemental network, you have a complaint and then you can make an appointment. at UBS [Unidades Básicas de Saúde], in milder cases, you may only be able to take the exams after a year”, he says. On the other hand, all medicines to treat Alzheimer’s are available in the public network.
Another challenge for the SUS is treatment focused on quality of life, which involves healthy eating, physical exercise and occupational therapy, according to the professor.
Lifestyle care is an important part of Alzheimer’s treatmentFonte: Freepik
Access is more difficult for those who depend on the public network, both due to the lack of specialists in the health units and the difficulty in maintaining the consultation routine.
But treatment that doesn’t require drugs can change the course of the disease. This is what the Finger study, carried out in 2015 in Finland, showed. The conclusion was that physical exercises, nutrition and intellectual activities (such as organizing photos of family and friends) can slow down the progress of the disease.
There is still no cure for Alzheimer’s, and the possibility remains distant, according to Professor Frota. “But, in the future, we may have more mechanisms that delay the evolution of the disease”, he says.
