Parting with the Concept of Alzheimer’s Disease in Senium

Abstract

The understanding of mental deterioration associated with old age has undergone several changes over the past two centuries, and has spurred major scientific debates. In the 19 th century, this disorder was still considered an inevitable part of aging. The beginning of the 20 th century offered a histological explanation for presenile dementia, and Alois Alzheimer was credited as the discoverer of a new disease that bears his name to date. In the last quarter of the 20 th century, findings of Alois Alzheimer were applied massively to late-onset dementia as well, thereby virtually excluding natural intellectual impairment as an explanation to dementia. In contradiction to the original concept provided by Alzheimer, amyloid plaques and neurofibrillary tangles are now being considered as the cause of psychological depreciation at all ages, and the presence of these is interpreted as a disease. The present review is aimed at disputing these common views and suggests that continuing with this approach may prove to be increasingly counterproductive. Instead, the present review offers an unbiased view without any preconceived ideas, which considers a long list of natural biological failures that inevitably accompany every human life, such as micro-injuries, microinfarcts, leukoaraiosis, as a consequence of partial failing of the cerebral blood flow, microbleeds, glycemic fluctuations in diabetics, influences of alcohol and toxins, decreasing anisotropy, increasing mean diffusivity on MRIs, and others.

The Construct of Alzheimer’s Disease Matured for Retirement

“…The authors were thus able to declare AD as no longer a singular disease process but most commonly the result of mixed pathologies [194]. Such an opinion is also in full agreement with our own understanding for senile dementia [195].…”

Brain Ischemia as a Prelude to Alzheimer's Disease

“…(4) Soluble amyloid and amyloid plaques in the brain are not a warning sign of impending dementia. Novel discoveries have demonstrated that amyloid and neurofibrillary tangles do not initiate Alzheimer's disease as these are only two among a multitude of degenerative changes that occur in this disease (Gauthier et al, 2018 ; Kalvach and Vogner, 2019 ). Our review aims to challenge these shared views and suggests that continuing this approach may be counterproductive.…”