Demensia dan Penyakit Alzheimer

By Dr Choo

APA ITU DEMENSIA?

Demensia adalah istilah umum dan suatu sindrom yang terdiri dari kumpulan gejala akibat proses degeneratif otak yang mendasarinya, namun bukan merupakan diagnosis tersendiri. Diagnosis demensia sering kali menunjukkan bahwa gejala yang dialami pasien sangat memengaruhi aktivitas sehari-harinya, misalnya tidak mampu mengelola keuangan, menghadiri janji temu, atau bahkan menyiapkan makanan.

PREVALENSI DEMENSIA DI MALAYSIA

In the year of 2020, about 204,000 people in Malaysia was diagnosed with dementia and needs 24-hour care. This number is projected to go up to 637,500 in 2050. About 14.3 % of the population above 60 years old has dementia. According to statistics from the US, this number goes up to 32 % in the population aged 85 years and above. In China, in the year 2019, Alzheimer’s disease and dementia was ranked 5th in the top causes of death.

APA JENIS DEMENSIA YANG UMUM?

Penyakit Alzheimer (PA) adalah penyakit neurodegeneratif yang menyebabkan 60-70% dari 50 juta kasus demensia di seluruh dunia. Hal ini ditandai dengan kematian sel saraf, penyusutan jaringan otak, dan gangguan kognitif, motorik, dan perilaku yang progresif, yang seringkali menyebabkan kematian.

Sekitar 60-70% dari semua demensia disebabkan oleh penyakit Alzheimer. Demensia tersering kedua adalah demensia vaskular, yang terkadang juga terjadi bersamaan dengan penyakit Alzheimer, sehingga disebut demensia campuran. Jenis demensia lainnya meliputi: Lewy body dementia, frontotemporal lobe degeneration, and dementia due to other causes (nutritional/electrolyte, thyroid, tumour, poison/medication induced). AD is a neurodegenerative disease characterized by the accumulation of extracellular amyloid plaques primarily composed of amyloid-beta (Aβ) peptides and intracellular neurofibrillary tangles (NFTs) of hyperphosphorylated tau protein.

Sumber: Asosiasi Alzheimer

APA SAJA GEJALA DEMENSIA?

Gejala khasnya meliputi: 

·  Memory lapses
·  Forgetfulness
·  Visual-spatial dysfunction
·  Aphasia
·  Loss of concentration
·  Vision dysfunction

APAKAH DEMENSIA DAPAT DIUBAH?

Saat ini, pengobatan pemodifikasi penyakit yang mampu mengubah patologi penyakit yang mendasari Penyakit Alzheimer belum tersedia.

APA YANG DAPAT ANDA LAKUKAN UNTUK MENCEGAH DEMENSIA?

Strategi pencegahannya antara lain dengan tidur yang cukup dan nyenyak (deep sleep), memupuk hobi yang menstimulasi otak, melakukan interaksi sosial yang bermakna secara teratur, menjalani pola makan yang seimbang, berolahraga secara teratur, menghindari konsumsi alkohol yang berlebihan, pengelolaan penyakit tidak menular secara optimal dan mencegah cedera kepala.

TIDUR NIKMAT – MENGURANGI RISIKO DEMENSIA DAN KEMATIAN

Sebuah penelitian di Harvard Medical School menemukan that individuals that slept 5 hours or less were twice as likely to get dementia and die. A multinational study (France, UK, Netherlands, Finland) found that sleeping 6 hours or less increased risk for dementia by 30 %. One study from Toronto and Chicago even found that in those at higher genetic risk for Alzheimer’s, just by having enough sleep was enough to reduce the likelihood of getting the disease, and was correlated with reduced density of neurofibrillary tangles.

TERAPI STEM CELL & TERAPI ELEKTRIK POTENSIAL UNTUK DEMENSIA

Saat ini, studi klinis sedang menyelidiki peran Stem Cell Mesenchymal (MSCs), eksosom, dan terapi medan elektrik dalam pencegahan Penyakit Alzheimer, demensia, dan gangguan neurodegeneratif lainnya dengan hasil yang menjanjikan.

MESENCHYMAL STEM CELLS MEMPERLAMBAT PERKEMBANGAN DEMENSIA

Mesenchymal stem cells (MSCs) are a group of multipotent stem cells capable of differentiating into nonmesenchymal lineages. MSCs are considered a very promising approach to stimulate neuroregeneration due to their immunomodulatory properties and high biosafety but also because of their ability to synthetize neurotrophic and proangiogenic factors. In AD, stem cell therapies have attempted to replace neurons that have been impaired or lost. MSC-based therapies have shown potential to restore damaged neural tissue as well as slow disease progression. In AD models, the reduction of Aβ plaques, β-secretase, and tau hyperphosphorylation as well as the reversal of microglial inflammation, and the stimulation of anti-inflammatory cytokines are among the mechanisms postulated to have a therapeutic effect in MSC therapy.

STEM CELL MESENCHYMAL MERUPAKAN SEL MULTIPOTEN YANG DAPAT BERDIFERENTASI MENJADI BERBAGAI MACAM SEL SEPERTI SEL LEMAK, SEL SARAF, SEL HATI, SEL OTOT, SEL JANTUNG, SEL TULANG, DAN SEL TULANG TULANG.

TERAPI MEDAN ELEKTRIK – MEMBANTU TIDUR DAN MENGURANGI RISIKO DEMENSIA

Electric Field Therapy was shown to disrupt the process of amyloid aggregation, which is a substance that accumulates in the brain of those with Alzheimer’s disease, hence potentially slowing down disease progression. Electric field therapy has also been shown to improve sleep in those with sleep disorders, indirectly also mitigating those individuals’ risk for Alzheimer/dementia.

SUMBER: PUBLIKASI ACS

Kesimpulannya, kombinasi MSCs dan Terapi Medan Elektrik mungkin merupakan pendekatan baru untuk pencegahan dan pengobatan Penyakit Alzheimer atau demensia.

Sumber:
  1. MOHAMAD ANUAR, Mohamad Fuad et al. Prevalence of Dementia in Malaysia: A Systematic Review. Journal of Health Management, [S.l.], v. 18, n. 1, p. 78-86, july 2022. ISSN 1823-5735. Available at: <https://myjms.mohe.gov.my/index.php/johm/article/view/18908>. Date accessed: 07 feb. 2023.
  2. Andrew E. Budson, M.D. (2021) Sleep well – and reduce your risk of dementia and death, Harvard Health. Available at: https://www.health.harvard.edu/blog/sleep-well-and-reduce-your-risk-of-dementia-and-death-2021050322508 (Accessed: February 7, 2023).
  3. Hernández AE, García E. Mesenchymal Stem Cell Therapy for Alzheimer’s Disease. Stem Cells Int. 2021 Sep 1;2021:7834421. doi: 10.1155/2021/7834421. PMID: 34512767; PMCID: PMC8426054.
  4. Ohtsuki T, Nabeta T, Nakanishi H, Kawahata H, Ogihara T, Morishita R, Aoki M. Electric Field Exposure Improves Subjective Symptoms Related to Sleeplessness in College Students: A Pilot Study of Electric Field Therapy for Sleep Disorder. Curr Med Chem. 2017 Apr;17(1):37–48. doi: 10.2174/1871522217666170815163329. Epub 2017 Apr. PMCID: PMC5740494.
  5. Jahnu Saikia, Gaurav Pandey, Sajitha Sasidharan, Ferrin Antony, Harshal B. Nemade, Sachin Kumar, Nitin Chaudhary, and Vibin Ramakrishnan. Electric Field Disruption of Amyloid Aggregation: Potential Noninvasive Therapy for Alzheimer’s Disease. ACS Chemical Neuroscience 2019 10 (5), 2250-2262
    DOI: 10.1021/acschemneuro.8b00490
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