Combined-Therapy Approach Offers Best Treatment for Alzheimer’s Disease

Alzheimer’s disease involves the death of neurons due to the malfunction of several biochemical processes.The current review consolidates the suggested hypotheses for the physiology of Alzheimer’s disease and the advantages and shortcomings of different treatments. These consist of pharmacology, nutrition, botanical and stimulatory therapies. The multi-target approach was found to be the most effective owing to the nature of the disease.

There are many complex ways that Alzheimer’s disease manifests itself. Hence, treatment modules for Alzheimer’s cannot be drawn out linearly or symptomatically. A complete understanding of the physiology underlying the disease is essential before deciding on the therapy to be administered. There are several routes to nerve cell death that occur in Alzheimer’s disease, arising out of different dysfunctions in both internal and external processes of the cells. Although pharmaceuticals offer relief, they come with the disadvantages of side effects, cost and short-term effects. Alternate therapies, like nutrition or natural/plant-based products or other stimulatory therapies, including music, physical exercise or cognitive methods, have not been researched thoroughly. Hence, treatment strategies that judiciously incorporate aspects of both pharmacological intervention, as well as alternate therapy, seem to be the most valuable solutions for Alzheimer’s disease. This review aims at highlighting the importance of such combined therapy. It is also critical to understand the requirement of therapy from the perspective of practitioner and patient, rather than that of a researcher.

The pathology of Alzheimer’s disease was studied in detail in this review. Drugs used for the treatment of Alzheimer’s disease, both U.S. Food and Drug Administration (USFDA)-approved and those available over-the-counter and used for many years, were analyzed for efficacy, safety and cost. Details of clinical trials on all the relevant drugs were collected. Similarly, the mechanism of action of plant and herbal extracts, nutrients, vitamins, minerals and hormones was elucidated, and at the same time clinical tests were also gathered on these. Information on stimulatory alternate therapies, including music, cognitive programs, physical exercise and socialization, was put together and examined as effective co-therapies.

Results/Key findings
* Low levels of acetylcholine (ACh) in the brain, as a result of hard protein plaques, leads to the disruption in neurotransmission, which leads to inflammation and the death of nerve cells.
* Studies that verified the role and efficiency of the following treatments for Alzheimer’s disease were collected:
1) Pharmaceuticals, including ACh-inhibitors, N-methyl-D-aspartic acid (NMDA) antagonists, insulin, anti-hypertensive and anti-inflammatory drugs.
2) Botanical products, like Gingko biloba, polyphenols.
3) Nutrients, like omega-3 fatty acids, vitamins, minerals.
4) Hormones, like melatonin.
5) Stimulatory therapies, including physical exercise, music and cognitive methods.
* Relevant aspects of all the above strategies were incorporated to draw out a holistic therapeutic module for Alzheimer’s disease.

Next steps/Shortcomings
A safety profile for drugs used for treatment of Alzheimer’s disease needs to be established. Over-the-counter and generic use of FDA-approved medicines needs to be evaluated. Further research is necessary on the alternate therapy modules because of their significance as non-invasive and harmless approaches. Because every patient is different, individual treatment programs could be worked out for the treatment of each case.

The conventional way to treat any disease is using pharmaceutical products specific to the disease physiology. However, in Alzheimer’s disease, the response from patients to such prescribed drugs is very poor or short-lived. Owing to the harmful side-effects and cost factor involved, the use of drugs alone is not a feasible solution. Several other natural products like herbal extracts and plant derivatives have been found useful, but not effective enough as single therapy. Nutritional products, like omega-3 fatty acids, vitamins and minerals, are also helpful; but, again, cannot be used effectively as a single therapy. Substantial results have emerged out of stimulatory approaches using cognitive therapy programs, social interactions, exercises for physical stimulation and music for brain stimulation. However, there is insufficient evidence to support the efficacy of all these approaches. Thus, an integrated protocol that includes all, or selected treatment strategies would be an ideal answer to the Alzheimer’s disease challenge.

For More Information:
Alzheimer’s Disease: A Review on the Pros and Cons of Therapeutic Strategies
Publication Journal: Alternate Medicine Review, 2010
By Keith A. Wollen, PhD; Washington State University, Port Angeles, Washington

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