Life expectancy in most Western countries is rising, which means that people now live longer than ever before. It is likely that this pattern will slowly continue. This is great news for all of us, but there is the other side of the coin. With longer life expectancy comes aging, which is the biggest risk factor for various neurodegenerative disorders, such as Alzheimer’s disease (AD).
That is why majority patients with AD are 65 and older. AD accounts for a large proportion (between 60-80%) of dementia cases and over 47.5 million people worldwide suffer from AD or other types of dementia. AD is therefore a major public health affecting patients and their families.
AD is a very complex, progressive motor neuron disease which is linked to different causes. Alzheimer’s risk factors are physical inactivity, smoking, diabetes, obesity, hypertension and depression. Its complexity is not fully understood and despite some great recent advancements in medicine, there is still no single cure for this debilitating disease.
A lot of money is being invested in research of AD so that root causes can be identified thereby helping to find a cure for it. Some great recent studies demonstrate that scientists are constantly searching for medication and treatments against AD.
For example, one of the latest science discoveries in this field shows that high doses of resveratrol (a naturally occurring compound in various types of food) is an effective cure to prevent further deterioration in patients with AD when compared to placebo. Although, it was the largest and longest clinical trial of resveratrol in humans, more research is needed to determine its effectiveness in treating mild to moderate AD.
Another recent study from Canada has linked fatty acid deposits in the brain with an increased risk of AD. Researchers discovered that accumulation of fat droplets produced by the brain that occurs with normal aging process may predispose individuals to AD. These studies demonstrate the complex nature of AD and difficulties studying it.
A number of theories have been proposed to explain the onset of AD. One of the theories suggests that AD is caused by the accumulation of beta-amyloid (a protein fragment) in the brain. Accumulation of beta-amyloid is known as amyloid plague, which subsequently damages neurons and leads to a gradual death of brain cells.
Damage to neurons, specifically synapses, prevents effective communication and signal transmission between neurons in the brain. Lack of effective communication between nerve cells results in a loss of brain function.
“Healthy neurons are involved in numerous functions, like storing memories, processing thoughts and emotions, planning and initiating body movements.”
Therefore, it is crucial to maintain neurons fully functioning and in good health for as long as possible. Otherwise, there may be negative cognitive and behavioural consequences.
Pharmacological strategies studied in the treatment and management of AD include psychostimulants, neuropeptides, anti-inflammatory agent, cholinergic enhancers and nootropics. Most of these strategies help with the symptoms of AD.
AD has been associated with the abnormalities of several neurotransmitter systems in the brain. It is well-known that patients with AD have seriously low levels of acetylcholine neurotransmitter. Furthermore, degeneration of the cholinergic system underlies memory loss associated with AD. Therefore, a number of pharmacological treatments have focussed on delaying and minimising cholinergic neurodegeneration in order to maintain cognitive function. This is sometimes called “cholinergic hypothesis” of cognitive dysfunction.
Alzheimer’s disease and nootropics:
“Nootropics is a safe class of compounds specifically designed to improve memory and learning capacity.”
Originally, the term nootropic derived from two Greek words: “noos”, meaning “mind”, and “tropein”, meaning “towards”. Nootropics are also known as “smart pills” and cognitive enhancing agents that are designed to prevent cognitive decline and facilitate cognitive functions. Various nootropics have been studied in the treatment of cognitive diseases, including Alzheimer’s disease.
For example, Piracetam has been originally developed to treat chronic neurodegenerative disorders, such as Alzheimer’s disease. Similarly, Noopept an neuroprotective dipeptide has been shown to have significant normalising effects in cognitive deficiency in rats. Nootropics exert their effects via different systems in the body and cholinergic system is one of them.
Cholinergic system and its main neurotransmitter – acetylcholine underpin a number of very important cognitive functions, such as learning, memory, focus, decision making and sensory perception. The human body cannot produce enough acetylcholine without the sufficient levels of choline. Although, this nutrient is naturally found in our diet, the consumed levels are very low. This places a lot of people at risk of choline deficiency. Therefore, high quality choline supplements, such as Alpha GPC, CDP-Choline (aka Citicoline), Centrophenoxine and Choline Bitartrate can prevent the choline deficiency.
For full benefits of acetylcholine precursors, they should be taken in combination with agonists. This induces a synergistic effect. Nootropics of the racetam family are known to be acetylcholine agonists. They stimulate the synapses, but do not produce extra acetylcholine. When the acetylcholine agonists are stacked with a choline source, the synergistic effects can be additive and very powerful.
Thus, Coluracetam, Phenylpiracetam and Pramiracetam play an important role in the regulation of acetylcholine levels. As one nootropic increases the number of synapses, another nootropic boosts the production of the neurotransmitter. Such combination of nootropics is beneficial for the synaptic plasticity. Similarly, acetylcholinesterase (AChe) inhibitors or anti-cholinesterase, like Huperzine A may also bring positive improvements by inhibiting the cholinesterase enzyme from breaking down acetylcholine.
Needless to say that more controlled studies are needed to investigate the effects of nootropics in the treatment and prevention of AD, but the potential of nootropics is very promising. Nootropics can have some great therapeutic implications in patients with AD.
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