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Dementia is a neurological condition manifested by reduced cognitive and psychological functioning, altered behaviour and decreased autonomy for social and professional performance in activities of daily living. Dementia is one of the most important causes of disability in the elderly. The number of dementia patients is increasing, as the population is growing older. Recent epidemiological evidence suggested a 2001 prevalence of 24.3 million cases of dementia worldwide. Alzheimer’s disease (AD) remains the most common cause of dementia, responsible for 60–70% of cases in Europe. There are 4.6 million new cases of dementia reported every year – that’s one new case every 7 seconds. Patients with AD gradually lose the ability to function independently and interest in life and many experience changes in personality, social withdrawal, uninhibited behaviour, and psychotic symptoms such as delusions, hallucinations and aggressive behaviour. The associated likely impact on the health and quality of life of persons with AD, their families, and societal healthcare and welfare resources, have led many authors to describe the condition as a “ticking bomb”. The depression prevalence in later life is 8 to 15%. Suicide in the elderly represents an immensely important and often overlooked medical problem. Based on its many distinct features, age-specifi c risk factors could be identifi ed. Proper diagnosis and treatment of affective disorders – contributing greatly to the pathogenesis of suicide in the elderly – could lead to a major decline in the suicide rate in this population.
Aggregation of Aβ peptides is a seminal event in Alzheimer’s disease. Detailed understanding of Aβ assembly would facilitate the targeting and design of fibrillogenesis inhibitors. Here comparative conformational and aggregation studies using CD spectroscopy and thioflavine T fluorescence assay are presented. As a model peptide, the 11–28 fragment of Aβ was used. This model peptide is known to contain the core region responsible for Aβ aggregation. The structural and aggregational behaviour of the peptide was compared with the properties of its variants corresponding to natural, clinically relevant mutants at positions 21-23 (A21G, E22K, E22G, E22Q and D23N). In HFIP (hexafluoro-2-propanol), a strong α-helix inducer, the CD spectra revealed an unexpectedly high amount of β-sheet conformation. The aggregation process of Aβ(11–28) variants provoked by water addition to HFIP was found to be consistent with a model of an α-helix-containing intermediate. The aggregation propensity of all Aβ(11–28) variants was also compared and discussed.
A small number (1-5%) of Alzheimer's disease (AD) cases associated with the early-onset form of the disease (EOAD) appears to be transmitted as a pure genetic, autosomal dominant trait. To date, three genes responsible for familial EOAD have been identified in the human genome: amyloid precursor protein (APP), presenilin 1 (PS1), and presenilin 2 (PS2). Mutations in these genes account for a significant frac­tion (18 to 50%) of familial cases of early onset AD. The mutations affect APP pro­cessing causing increased production of the toxic Aβ42 peptide. According to the "amyloid cascade hypothesis", aggregation of the Aβ42 peptide in brain is a primary event in AD pathogenesis. In our study of twenty AD patients with a positive family history of dementia, 15% (3 of 20) of the cases could be explained by coding sequence mutations in the PS1 gene. Although a frequency of PS1 mutations is less than 2% in the whole population of AD patients, their detection has a significant diagnostic value for both genetic counseling and treatment in families with AD.
Basic research into neurodegenerative disorders, like Alzheimer’s disease, is heavily focused on understanding genetic susceptibility and biochemical triggers of pathology, as well as disturbances to the intrinsic electrophysiological properties of affected neurons. Often overlooked is the role of mechanics, particularly mechanical properties and mechano‑sensitivity/‑responsiveness of neurons and glia. Recent evidence confirms that mechanical signals regulate CNS development and pathophysiology. In this talk, I will discuss the role of mechanics in both physiological and pathophysiological brain ageing. A defining pathophysiological hallmark of Alzheimer’s disease is the amyloid plaque; an extracellular deposit of aggregated fibrillar Aβ1‑42 peptides. Amyloid plaques are hard, brittle structures scattered throughout the hippocampus and cerebral cortex and are thought to cause hyperphosphorylation of tau, neurofibrillary tangles, and progressive neurodegeneration. Glia are highly mechanosensitive cells and can sense the mismatch between the normally soft mechanical environment of the brain and very stiff amyloid plaques via mechanosensing ion channels. Both ageing and peripheral infection augment amyloid plaque‑induced upregulation of mechanoresponsive ion channels in astrocytes. Further research is required to investigate whether modulating mechanically-gated channel opening will protect or exacerbate the disease state, and most importantly, if they are novel drug targets for age‑related dementia
With a projected rise in the percentage of elderly people in the population of Poland, the incidence of neurodegenerative diseases, including dementia, will increase. The aim of this paper is to present dementia as an increasing health and social problem in the aging Polish population. In 2015, the number of people with dementia of the Alzheimer’s type in Poland was estimated to be between 360,000 and 470,000, which indicates a growth of almost 20% compared to 2005. The onset of dementia symptoms causes a relatively rapid impairment of patients’ daily functioning, creating the need for assistance by others. In Poland, caring for an elderly person with dementia is primarily non-institutional and provided by the closest family members in a home setting. Due to the shrinking care potential of Polish families, one should expect a growing need for formal forms of support to ensure proper care for elderly individuals with dementia. At present, Poland has a poorly developed system of formal assistance for dependent elderly people and the existing infrastructure of formal care services includes only a small proportion of potential beneficiaries. The prospect of further aging of the Polish population along with the growing risk of dementia and the shrinking family care potential justify the development and implementation of a comprehensive Alzheimer’s Plan at the central and local level of our country.
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