Neurologist on Alzheimer's: Symptoms occur about 20 years after the onset of the disease

Alzheimer's disease is a difficult disease. The heart of the problem is indicated by a single number: if the symptoms occur, if oblivion becomes obvious, the actual onset of the disease is about 20 years old!

And that is precisely why it is so difficult to find the cause of the disease and to develop an effective treatment: simply because the first changes that you could possibly treat or prevent occurred several decades ago.

A migratory disease

What you know: In the brains of the affected people, several "fake" proteins are deposited. In addition, the activity of nerve cells in certain brain regions decreases. Both occur many years before the first symptoms become visible.

Dr. Magnus Heier is neurologist and author.

We also know that the disease "walks" – from one part of the brain to another. This explains the typical course: first, the short-term memory is lost, later the long-term memory. But all the oversights are not equal to Alzheimer's disease.

Neurological practice is full of unstable people who are afraid of illness – but who are usually wrong! Faced with tormenting uncertainty, it would be important to diagnose the disease. And there are finally some approaches: you can mark certain substances radioactively, inject them and then detect them in the brain (always very expensive and very coarse).

Or we examine the nerve water, the spinal cord and the brain washed (to unpleasant disconnect). Both surveys are always prone to errors.

It is also possible to simply look at the patient in the eyes. The idea behind this: the retina is biologically a part of the brain. If the brain changes, as in Alzheimer's disease, the retina should also change. In fact, she does it too. Using a special technique, researchers look for typical changes: fewer blood vessels in the retina, a thinner nerve layer, deposits.

But even these changes are not (yet) sufficiently reliable. Another chance: In the blood, specifically activatable immune cells can be detected – and thus the disease. It seems that Alzheimer's disease will soon be diagnosed reliably. More reliable than before, where we rely on surveys and written tests.

Exclude from other diseases

Reliable diagnosis as early as possible is not only important for calming uncertain patients. With their help, you can also rule out other diseases that have similar symptoms and impair memory: they include, for example, an insufficient thyroid or the side effects of certain medications.

And when it comes to Alzheimer's disease, you can change the course of the disease. For example, by stress reduction, memory training, exercise, social contacts – factors that seem simple and yet surprisingly effective.