And now for the good news
Alzheimer’s research is making steady ground, reports TOM STUTTAFORD
THE LAST FEW months of 2015 weren’t memorable for a plethora of good-news stories. The Christmas period was heralded by murder and mayhem in Paris, chaos and genocide in the Middle East and a breakdown of the political structure that in earlier generations had made Westminster the envy of the world. Little wonder that the news that it was just possible that Metformin, a commonly prescribed, cheap and relatively free of sideeffects preparation to treat type 2 diabetes, might also have anti-ageing properties that might (a big might) enable people to live to well over 100 and to retain their intellects as they did so, has caused such widespread press speculation.
There have been reports for several years about the power of Metformin to lengthen the lifespan and improve the memory and the intellect of ageing rats and mice as well as suggestions by Belgian scientists that Metformin does wonders for the vitality and longevity of some forms of parasitic worm. But there have been only anecdotal accounts of Metformin possibly having similar powers in humans. However, there is now the great news that this may change. The American licensing authority, the US Food and Drug Administration, has agreed that trials will be allowed in America to explore the possibility of using Metformin to slow the ageing process in humans, with special reference to its influence on such degenerative diseases as Alzheimer’s and Parkinson’s.
Alzheimer’s disease is the most common cause of progressive dementia, accounting for more than 65 per cent of cases. Vascular dementia, whereby small, barely noticeable strokes may produce similar symptoms, is the second most common type. Both conditions may, and often do, co-exist, giving rise to the diagnosis of a mixed dementia, such as troubled Aunt Annabel.
Stuttaford Christmases were never the same once Aunt Annabel died. Annabel never married but rather became an additional grandmother to several branches of my late wife’s family. She was wonderful with children and the more eccentric she became the greater they loved her. She could be guaranteed to make the true but better-left-unsaid remark that silenced adult conversation but left the children roaring with laughter.
Annabel lived into her eighties and indisputably developed dementia eventually, but this was never commented on. She was happy and her family were always pleased to see her. The first symptom of Alzheimer’s is usually short-term memory loss but often there is also a change in personality. In Alzheimer’s this is traditionally characterised by existing personality traits being either altered by accentuation or changed beyond recognition. The socially rather difficult patient may become disagreeable and paranoid. A previously easy-going person may start to become increasingly pernickety. The phlegmatic may become over-emotional, or someone famed for a stiff-upper-lip detachment may start to weep easily. The long-suffering and patient person may become easily irritated and display temper tantrums. In some occasional cases the sexually reticent may become fast and loose.
Loss of memory makes life difficult and as this becomes more pronounced the nuances of conversation may be hard for someone with early Alzheimer’s to follow. Little wonder that many people with early Alzheimer’s become suspicious, even paranoid. Aunt Annabel retained her composure but as her troubles became more pronounced she became increasingly apathetic and detached. At our last Christmas dinner together, now more than 35 years ago, her mind was so far away that she eventually dozed off. I heard one of my sons say to his brother ‘Look at Aunt Annabel, do you think she has died? Should we tell Daddy?’
Annabel received no specific diagnosis because forty years ago there was no treatment for early Alzheimer’s dementia. She had one or two coronary arterial incidents in middle age and these had the best possible treatment then available.
Times have changed: there are now, and have been for some years, several drugs that can be used to treat early Alzheimer’s. These drugs won’t cure the disease but they may improve memory and energy and enhance enthusiasm for life for several years. They used to be very costly but are now less expensive, and at last there is a campaign to diagnose Alzheimer’s early as it is far cheaper and more acceptable for the patient to be kept at home than to think in terms of long-term hospital care. Despite this change in outlook, 48 per cent of Alzheimer’s cases go undiagnosed.
The association of arterial disease, whether coronary or cerebral, with dementia is less likely to be overlooked. Coronary arterial disease is more commonly missed by doctors when treating women than men and is also more difficult to treat in women than in men.this, however, is improving. And, most importantly, other drugs are now being studied to endeavour to find preparations that will actually remove the protein deposits that destroy the neurones and cause the dementia in the first place.
Alzheimer’s Research UK, 3 Riverside, Granta Park, Cambridge CB21 6AD (www.alzheimersresearchuk.org); The Alzheimer’s Society, 58 St Katharine’s Way, London E1W 1LB (www.alzheimers.org.uk)