Alzheimers

John Rith
March 29, 2016

Many people suffer from Alzheimers, either directly or. There continues to be
vast amounts of research on the subject with new concepts and ideas coming out every
year. There have been many recent developments about the disease and two that spark my
interest were the drug Donepezil and the possible connection and origins with its effects
on the town of Yarumla in Columbia. This conditions cure is still decades out, but these
two article show that there is a progression in movement to better help those who are
suffers and possibly origins that may help the small town.
Since Alzheimers discovery in 1906, it has been a continual plague on society. It
continues to ravage familys lives and their loved ones. With no significant drug
developments in the last decade to stop or cure the disease as President Obama hoped
would be the goal by 2025, there is a little hope in the drug Donepezil. Like its
predecessors before, this drug does not cure the disease but does give hope to those who
are in the early stages and showing symptoms of the condition.
According to the University of London this drug has shown to slow the
progression of the disease if caught early enough. One of the major issues with the
disease, beyond the medical, is the cost to the family members dealing with the bills of a
care facility. Research conducted by the University of London found that people who
continued to take the medication after precursors of the disease were found were half as
likely to end up in care facilities that year. Now it may seem that this is not a significant
discovery but having the ability for the patient to stay at home greatly helps families deal
with the financial burden of the condition. Again it is not a cure but currently the cost in
care facilities in the UK range on annual, average between 30,000 and 34,000 per
patient; while the medication cost around 22 pounds a year. This medication can help
alleviate some of the difficulties dealing with the disease.
After a three year trial they found that within the first year only 20% of patients
needed to be moved into a facility, in comparison 37% of patients that discontinued the
medication had to be moved. The numbers may be small but it is an improvement on the
current conditions. Robert Howard of the University of London said that it could mean
thousands of patients per year not going into care homes. Currently the UK has an
estimated 530,000 people that suffer from the disease while only about 58,600 are taking
the medication, the reason being is that doctors have been told that it only helps those
with mild to moderate conditions but earlier work by Howard showed that it may help
those who have progressed to a more severe state with the disease. Doug Brown, director
of R&D at the UK Alzheimers Society, is quoted saying, With no new treatments for
Alzheimers disease in over a decade, it is absolutely crucial that we make most out of the
drugs we have available. Also he said, is it important we continue to find better ways to
support people with dementia to remain in the own homes for longer.
With the push of President Obama to find a cure for the disease this work done at
the University of London is at lease a push in the right direction. Research and science
cannot be measured with end dates as proposed by the bill with the year 2025 but with
research by Howards team and a the funds of $50 million dollars, the 5.1 million
Americans that currently suffer from the disease have some hope while they fight the
disease; with the population growth and increasing number of patients yearly, every
progression made in the battle is a big one.
Colombia had a small town that is famous for all the wrong reasons. The town of
Yarumal has the largest population of people that suffer from Alzheimers. Yurumal and

the surrounding state of Antioquia in Colombias north west region have 5000 people
who are carriers of the gene mutation for the early on-set of Alzheimers. Half of the
people will be diagnosed with the disease by the time they turn 45 and the other half will
be sufferers of it by the time they reach 65. The disease is prevalent around the villagers
and is called by locals La Bobera or the foolishness. Even though it is a part of
everyday life, the origins of the curse of Yarumal is unknown; no one is quite clear
when the mutation first appeared.
Researchers from the University of California, Santa Barbara, have concluded that
there may be a connection to the Spanish conquistadors of the early 17th century. They
have traced an ancestry of the mutation to this time period. Ken Kosik of the university
and his colleagues collected samples of blood from 102 in the Yurumal and Antioquia
areas and sequenced their genomes. Alzheimers mutation is called E280A and is found
in a gene on chromosome 14. Out of the 102 people that were sequenced it is found that
74 people had the mutation. This was research conducted by a team from University of
Antioquia; Francisco Lopera, had been working with families in the area for many
decades and is one of those who discovered these findings. With the information of the
village as well as the sequencing by Kosiks team they have come to suggest that the
mutation relates back to a common ancestor approximately 375 year ago. They used
something called identity-by-descent analysis to determine this study.
From there they took the information from the Antioquian carriers of E280A and
compared them against three other areas in nearby regions that have evidence of having
associated with Western Europe. The team concluded that the mutation is consistent with
the Spanish origin of the 17th century carriers. The conquistadors consisting of soldiers
and explorers originating from the Spanish empire began colonizing the Colombian area
in the area 16th century and the village of Yarumal was itself started in 1787. The teams
had trouble trying to figure out why the 74 out of 102 sequences were related until they
made this connection. It is hard to explain why all these people would share such a large
chunk of DNA if there had not been a common founder. says Kosik.
This article along with the previous both mention why Alzheimers has such a
hard time when it comes to trial drugs to help with the disease. The drugs are not tested
until after the disease has taken a hold of the patient. Yarumal is one of only a few places
in the world which there is a sizable portion of people that will developed Alzheimers;
this allows for more preemptive measures to take place in regards to battling the disease.
One of the common issues with dealing with the diagnosis the logistics; to diagnosis the
condition, it calls for lengthy hospital stays and expensive procedures. a simple
memory test (at) a home visit, says Mario Parra of Herriot Watt University would
make all the difference.
Having this type of information about the people of Antioquia brings a moral
obligation. Kosik now has the ability to tell whether someone will develop the condition
or not and has the moral dilemma whether to tell them or not. Kosik and his team have
chosen to withhold their results. One young man said he would kill himself if he knew he
would end up with the foolishness. It is still a continuing battle with no clear end in
sight. This research as well as Donepezil at least gives hope and direction for the future.

Literature Cited
Stix, Gary. 2012. Alzhemierss May Be Treatable by 2015. The Mind Recovery Act.
Coghlan, Andy. 2015. Alzheimers drug helps keep people out of car homes for longer.
The Lancet Neurology.
Hooper, Rowan. 2015. Alzheimers introduced to Colombian town by Spanish
conquistador. New Scientist Magazine