To understand what happens to the neurons in the brain of someone with Alzheimer’s, let’s look at the neuron unit – the nerve cell itself. A battle is on-going. In different sections of the brain, clumps of neurons are slowly being destroyed. It’s the bad army versus the good. The bad is associated with Alzheimer’s Disease. The good cells keep your thoughts and actions and memory going until the bad begins winning more and more of the battles. The ultimate diagnosis is made at an autopsy where the brain is dissected and sliced into thin strips that can be looked at under the microscope. There are two pathological findings that make up the diagnosis of Alzheimer’s. One marker is located outside the neuron and one within. As these two markers accumulate in the brain, symptomatic changes begin to occur that are noticeable to the individual. The person goes from forgetting where the keys are to not being able to balance the checkbook to not being able to express in words what is being thought in the mind. They start a sentence but pause half way through or say, “Let me tell you what happened two weeks ago. It was on a Thursday and I was getting ready to… no, wait a minute. It was on Friday and I was going to make… No, it was Thursday because that is when we took some friends out to eat – last Thursday. Now, what was I telling you? Oh yes, – two Thursdays ago….” And even though you stand and listen, you don’t realize that something is happening to those little neurons inside their brain.
But if you study a little deeper into the makeup of those nerve cells, you can understand what happens in Alzheimer’s. And that knowledge will make it easier to take action to help you prevent your brain’s nerve cells from going through the same destructive process.
The beta-amyloid protein is the primary marker entity used in making the diagnosis of Alzheimer’s. If you look at a single normal neuron, you will see a small micro-artery carrying blood that is filled with all the oxygen and nutrients needed to keep that cell healthy and functioning normally. And that small artery runs right up to the wall of the brain cell where it can exchange the good nutrients into the cell area in return for picking up the waste products the cell needs to get rid of. This exchange of goods passes through a partition between the micro-artery and brain cell itself. That partition controls what can get in and out of the brain cell area.
Beta-amyloid is one of the two factors that were seen the first time the condition of Alzheimer’s was diagnosed. That was back in 1906 when Alois Alzheimer identified the first Alzheimer’s patient. He had a patient who progressed from difficulty with memory to the point where the patient was completely dependent on others to take care of her. She had become very agitated at times and finally became withdrawn from those around her. Alois Alzheimer performed an autopsy on her brain when she passed away. After slicing minute sections of brain tissue and looking at them under a microscope, he discovered clumps of beta-amyloid protein within the tissue. When he further studied the inside of those neuron nerve cells, he found that the protein inside, called tau protein, had become twisted into tangles. These outside beta-amyloid plaques and inside tau protein tangles became the hallmark for making the diagnosis of Alzheimer’s disease. These plaques and tangles usually show up initially in the regions of the brain that are responsible for memory. The nerve cells he examined had died. They had undergone irreversible changes.
Such knowledge made me sadly realize that if Mrs. Dell was beginning to show the symptoms of Alzheimer’s – it would be permanent. If her neurons die, the memory problem is not reversible. If the time came that she had to be spoon fed, she would never go back to feeding herself. Once she had to be dressed each morning, she would never dress herself again. And once her personal care had to be done for her, she would simply lie there and be completely taken care of. It is such a wretched disease to have or to watch someone else go through.
We have learned a lot since 1906 but I knew that if Alzheimer’s was developing in Mrs. Dell, no medication was going to bring those cells back to life. Realizing all this made me almost hope for her symptoms to be the result of a stroke or even a removable brain tumor. Anything other than one of the most commonly disabling disease I could think of. Alzheimer’s seems almost like a tiny cancer growing within each of the brain cells. A cancer that is so slow in progressing – so harmful, so long, before it reaches mortality.
