Articles Review: Alzheimer

Articles Review: Alzheimer Disease

Semester 2, 2015/2016

Department of Psychology

International Islamic University Malaysia

Summary of Article: Apolipoprotein E, cholesterol metabolism, diabetes, and the convergence of

risk factors for Alzheimers disease and cardiovascular disease

Authors: IJ Martins, E Hone, JK Foster, SI Sunram-Lea, A Gnjec, SJ Fuller, D Nolan, SE Gandy

and RN Martins

Published in 2006, featured in Journal of Molecular Psychiatry

As cited in Carlson, Physiology of Behavior 11th edition, page 555, line 26-29, first column.

Objectives of the research

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This reviewed articles intended for a comprehensive explanation of how obesity,

dyslipidemia, hypertension and metabolic syndrome linked with Alzheimer disease (AD) at

cellular levels since the metabolism and regulations of abnormality of biological substances

involved in these conditions are interrelated. By bringing the evidences of the mentioned

conditions with respect to AD, it is hope it will provide a higher understanding of how obesity,

dyslipidemia, hypertension and metabolic syndrome predispose to AD as that to provide

appropriate treatment and intervention, and more importantly to raise further questions and

issues on direction of future research.

Methods

Multiple researches and studies were reviewed and analysed in the area of physiological

and biological changes involved in obesity, dyslipidemia, hypertension and metabolic syndrome,

and how it is linked to AD. These included: cholesterol metabolism, coronary artery disease

(CAD) as AD risk factors; how statin reduce risk of getting AD; glucose regulation, insulin

resistance, diabetes and AD; apolipoprotein E function, alleles and its role cerebral cholesterol

homeostasis; and ApoE and AD

Findings

It was found that altered or abnormal cholesterol metabolism which lead to

hypercholesterolaemia and CAD may also triggered or disrupt the APP (precursor of beta

amyloid) metabolism causing abnormal beta amyloid accumulation and formation of senile

plaques in the brain. In conjunction with this, it was also concluded that statins, as cholesterol

lowering drugs is proven to reduce risk of AD. High dietary fat intake may increase risk of AD

although there are variation in terms of physical exercise and other lifestyle habits. Apart from
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that, it was also identified that metabolic syndrome and diabetes as one of the risk factor of

getting AD and this association is stronger in diabetic patients who carry APOE e4 carrier. ApoE

also was found to be involved in the process of beta amyloid degradation, clearance and

deposition in the brain

Conclusion

Apart from re-acknowledging the facts as mentioned in the findings above, the review

concluded by re-establishing the importance to practice healthy lifestyle, exercise and eat proper

diet in order to prevent not just the occurrences of the systemic medical conditions as previously

discussed, but for brain-localized AD as well.

Summary of Article: Non-Steroidal Anti-Inflammatory Drugs as a Treatment for Alzheimers

Disease: A Systematic Review and Meta-Analysis of Treatment Effect

Authors: Marina Miguel-A lvarez, Alejandro Santos-Lozano, Fabian Sanchis-Gomar, Carmen

Fiuza-Luces, Helios Pareja-Galeano, Nuria Garatachea, Alejandro Lucia

Published in 2015, featured in Drugs Aging Journal

Objectives of the research

This study intended to evaluate the efficacy of NSAIDs in the treatment of Alzheimer disease

(AD) using a meta-analysis method.

Methods
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Numerous online databases were employed which included: MEDLINE, Web of Science,

Science Direct, and the Cochrane Library to search all the randomized controlled trials that have

evaluated the efficacy of NSAIDs as a treatment for AD (up to 1 October 2014). The overall

effect of NSAIDs versus placebo was analysed using a random effects model meta-analysis

where the changes (i.e., mean differences pre- vs. posttreatment) between the two conditions in

test scores indicative of cognition, disease severity, and related outcomes were determined.

Findings

This meta-analysis had included seven studies after various criteria selection processes.

The NSAIDS used were: Diclofenac/misoprostol, nimesulide, naproxen, rofecoxib, ibuprofen,

indomethacin, tarenflurbil, and celecoxib. Scores after measurement from instruments: AD

Assessment Scalecognitive subscale (ADAScog), the Clinical Dementia Rating Scale sum-of-

boxes (CDR-SOB), and the Mini-Mental State Examination (MMSE) were analysed and the

results showed no statistical or clinical significance of NSAIDs treatment compared with

placebo.

Conclusions

NSAIDS has no effect on treatment, however it may beneficial in the prevention of AD.

Further study should be conducted to explore this issue.

Benefits from these articles

Both articles discussed in terms of different pharmacological aspects on treating the AD,

beside providing us an insight of its pathogenesis at cellular level. It is quite obvious that AD is

a subject that has been widely researched and explored from various point of view; the cellular

pathways and how it fits into clinical presentation, history and diagnosis, management, either its
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drug or non-pharmacological. Apart from obtaining the knowledges as mentioned above, it

makes us realizes the importances or the need to take care of our physical health and practicing

healthy lifestyles. This fits into the fact that various medical conditions including hypertension,

obesity, high cholesterol level and diabetes are already proven to certain extent predispose to

AD. As of that, if we still carry the innate or gene part of the disease, we still able to control it by

measures discussed above. This practices and beliefs are in parallel with the Islamic teaching and

by doing something good that is encourage by our religion, we hope to attain the pahala and

Allahs approval, InsyaAllah.