Could Alzheimers begin in the gut

Alzheimer’s may be caused by the abnormal build-up of a protein in the gut that gradually spreads to the brain, according to studies

Alzheimer’s disease is the most common cause of dementia. Still incurable, it directly affects nearly one million people in Europe, and indirectly millions of family members as well as society as a whole. In recent years, the scientific community has suspected that the gut microbiota plays a role in the development of the disease, according to a recent study published by University of Geneva.

The study confirms an association between an imbalance in gut bacteria and the development of amyloid plaques in the brains of humans.“Alzheimer's disease also called senile dementia once a disease of the west is slowly increasing in India. According to latest statistics there are at least four crore diagnosed patients in our country and this is just the tip of the iceberg... there are many more undiagnosed cases. Due to lack of awareness many are yet to be diagnosed... more common in men than women... it is also related to age of the patient. Older people are prone  Alzheimer's... there is also genetic predisposition,” says Dr I Bharatkumar Reddy Senior Consultant Psychiatrist, Apollo Hospitals.

The disease was first identified by a German psychiatrist by name Alois Alzheimer...he identified symptoms of forgetfulness in a woman. “The cardinal symptoms of the illness are forgetfulness especially problems in immediate and recent memory where as their remote memory would be intact associated with behavioral issues, personality changes, mood symptoms and psychological symptoms like delusions and hallucinations. Over the course of illness it progresses in seven stages. When it reaches seventh stage they will be bed ridden with loss of bladder and bowel control. They may even forget how to swallow,” says Dr Bharatkumar. In the brain you will find what's called amyloid plaques and neurofibrilatory tangles. The brain cells slowly degenerate and die.

It’s not just plaques and tangles in the brain that differentiate people with dementia from cognitively normal people — a new study shows that people with dementia have different gut bacteria, too. Now, scientists are questioning whether the “bugs” in our gut might have something to do with the disease. Proteins produced by certain intestinal bacteria, identified in the blood of patients, could indeed modify the interaction between the immune and the nervous systems and trigger the disease, according to Journal of Alzheimer’s Disease. The study makes it possible to envisage new preventive strategies based on the modulation of the microbiota of people at risk.

The link between the microbiome and dementia has been getting a lot of attention in recent years. What was once considered a weak association is now being pursued as a potential treatment path. “Treatment involves early detection and supportive management associated with exercises to improve cognitive functioning and social skills...they are started on medication predominantly with what's called Acetylcholinesterase inhibitors. psycho education to the family along with establishment of career support services,” says Dr Bharatkumar.

Book Appointment: Dr I Bharatkumar Reddy Senior Consultant Psychiatrist, Apollo Hospitals.