Kuze kube namuhla, alikho ikhambi le-Alzheimer's. Nokho, eziningana izidakamizwa ziyathuthuka futhi ziletha ithemba. I izindlela zokwelapha, okwamanje ezisesigabeni socwaningo, zihlose ukubhekana nenqubo ye-pathological yesifo ngethemba lokuselapha noma ukusimisa. Ngaphezu kwalokho, kunezidakamizwa ezinciphisa i- izimpawu futhi okuthuthukisa ukusebenza kwengqondo ngezinga elithile.

Ukuphumelela kokwelashwa kuhlolwa udokotela ngemva kwezinyanga ezi-3 kuya kweziyisi-6. Uma kunesidingo, ukwelashwa kuyashintshwa. Okwamanje, izinzuzo zokwelapha ziphansi futhi izidakamizwa azivimbeli ukuthi lesi sifo siqhubekele phambili.³⁰.

I-Foundation for Medical Research ilinganisela ukuthi ngo-2016 cishe bangu-900 abantu abahlaselwe yisifo i-Alzheimer's eFrance. (bona i-infographic)

izidakamizwa

The izidakamizwa okulandelayo kuyatholakala ngencwadi kadokotela. Ngeke sazi a priori okuzofanela kahle isiguli. Ngezinye izikhathi kuthatha izinyanga ezimbalwa ukuthola ukwelashwa okufanele. Ngokwezifundo, ngemva konyaka we-1 wemithi, i-40% yabantu ibona isimo sabo sithuthuka, i-40% inesimo esizinzile futhi i-20% ayizwakali.

I-Cholinesterase inhibitors

Ngokuyinhloko zisetshenziselwa ukwelapha izimpawu ezithambile noma ezimaphakathi. Lo mndeni wezidakamizwa usiza ukwandisa ukuhlushwa ku-acetylcholine ezindaweni ezithile zobuchopho (ngokunciphisa ukubhujiswa kwayo). I-Acetylcholine ivumela ukudluliselwa kwemizwa yezinzwa phakathi kwama-neurons. Kuye kwaqashelwa ukuthi abantu abanesifo i-Alzheimer's banenani eliphansi le-acetylcholine ebuchosheni ngoba ukubhujiswa kwamangqamuzana ezinzwa kunciphisa ukukhiqizwa kwale neurotransmitter.

Emakethe yaseCanada, kukhona ama-inhibitors angu-3 okwamanje i-cholinesterase (i-enzyme ebhubhisa i-acetylcholine):

• Le donepezil noma i-E2020 (Aricept®). Ithathwa ngendlela yamaphilisi. Inciphisa izimpawu ezithambile, ezimaphakathi nezithuthukile zesifo;
• La i-rivastigmine (Exelon®). Kusukela ngo-February 2008, ibuye inikezwe ngesimo sesikhumba sesikhumba: umuthi uthathwa kancane ngumzimba ngaphezu kwamahora angu-24. I-Rivastigmine ifanele iziguli ezinezimpawu ezithambile noma ezilinganiselwe;
• Le I-bromhydrate ye-galantamine (Reminyl®). Ithengiswa njengethebhulethi ethathwa kanye ngosuku ngezimpawu ezithambile noma ezimaphakathi.

Le mithi ilahlekelwa ukusebenza kwayo ngokuhamba kwesikhathi, njengoba ama-neurons asakhiqiza kancane kancane i-acetylcholine. Zingabangela nemiphumela engemihle, njengokucanuzela kwenhliziyo nokuhlanza, ukuphelelwa isifiso sokudla nobuhlungu besisu. Kulesi simo, kubalulekile ukubonana nodokotela wakho futhi, ozolungisa umthamo njengoba kudingeka.

E-United States nase-France, i-tacrine (i-Cognex®) isetshenziswa njenge-inhibitor i-cholinesterase. Kodwa-ke, kungabangela imiphumela emibi kakhulu futhi akuvunyelwe eCanada.

Umphikisi we-NMDA receptor

Kusukela ngo-2004, i-memantine hydrochloride (Ebixa®) inikezwe ukukhulula izimpawu ezimaphakathi noma ezinzima yesifo. Le molecule isebenza ngokubophezela kuma-NMDA (N-methyl-D-aspartate) receptors atholakala kuma-neurons ebuchosheni. Ngakho ithatha indawo ye-glutamate okuthi, uma ikhona ngobuningi endaweni ye-neurons, ibangele lesi sifo. Nokho, akukho okubonisa ukuthi lesi sidakamizwa sinciphisa ukuwohloka kwama-neurons.

Ucwaningo oluqhubekayo

Kutshalwa imizamo emikhulu ekufuneni imithi emisha. Izinjongo eziyinhloko yilezi:

• Bhubhisa amaprotheni e-beta-amyloid, ngenxa yokujova amasosha omzimba akwazi ukuwacindezela. Lawa ma-plaque, empeleni, angenye yezilonda zobuchopho ezibaluleke kakhulu kulesi sifo. I-antibody enjalo yenziwe (igama le-molecule i-bapineuzumab) futhi ingaphansi kokuhlolwa komtholampilo kubantu abanalesi sifo. Le ndlela ibizwa ngokuthi “umgomo wokwelapha”. Esinye isisombululo esihloliwe kungaba ukwenza amangqamuzana athile obuchopho (microglia) asebenze ukuze asuse ama-plaque okukhulunywa ngawo;
• Shintshanisa ama-neurons. Umphakathi wesayensi ubeka ithemba elikhulu ekuthatheni indawo, ngosizo lokufakelwa, kwama-neurons acekelwa phansi yilesi sifo. Kulezi zinsuku, abacwaningi bayakwazi ukwakha amangqamuzana afana nama-neurons avela kuma-stem cells atholwe esikhumbeni somuntu. Nokho, indlela ayikathuthukisiwe. Ayikenzi kube nokwenzeka ukwakha ama-neuron anazo zonke izici zama-neuron "zemvelo".

Ukuzivocavoca umzimba

Odokotela bakhuthaza kakhulu abantu abanesifo i-Alzheimer's ukuthi baphuzeUkuvivinya. Ithuthukisa amandla, ukukhuthazela, impilo yenhliziyo nemithambo yegazi, ukulala, ukujikeleza kwegazi nomoya, ikhulise amandla namandla. Ngaphezu kwalokho, ukuvivinya umzimba kunemiphumela enenzuzo ikakhulukazi kubantu abanalesi sifo:

• kusiza ukugcina amakhono emoto;
• kunikeza umqondo wencazelo nenjongo;
• inomphumela wokuthulisa;
• igcina izinga lamandla, ukuguquguquka nokulinganisela;
• kunciphisa ingozi yokulimala kabi uma kwenzeka ukuwa.

Abantu abanakekela abagulayo bangabulala izinyoni ezimbili ngetshe elilodwa ngokujima kanye neziguli zabo¹⁷.

Ukusekelwa komphakathi

Kubhekwa njengengxenye yokwelashwa, i ukwesekwa komphakathi ukulethwa kwabagulayo kubalulekile. Odokotela beluleka amasu ahlukahlukene ukuze umndeni futhi abanakekeli iziguli.

• Zivakashele njalo iziguli ukuze uzinikeze ukwesekwa, ngokwezidingo zazo;
• Banikeze izinsiza zokukhumbula;
• Dala isakhiwo sokuhlala esizinzile nesizolile endlini;
• Misa umkhuba wokulala;
• Qinisekisa ukuthi indawo yabo eseduze iveza ingozi encane;
• Qiniseka ukuthi bahlale benekhadi (noma isongo) ephaketheni labo elinenkomba yesimo sabo sempilo, kanye nezinombolo zocingo uma kwenzeka belahleka.

Izinhlangano ziphinde zinikeze ukwesekwa ngezindlela ezahlukene. Bheka ingxenye ethi Amasayithi Athakaselayo.