Alzheimer’s Disease and Forget-Me-Nots

DEANA TRUONG – September is World’s Alzheimer’s Month, and this year’s campaign focuses on post-diagnostic support. The events leading up to a diagnosis of Alzheimer’s, and the major shift in living that proceeds, prove to be a difficult and challenging time for many people. According to the most recent annual report released by the Alzheimer’s Association, more than 6 million Americans are living with Alzheimer’s disease. For many of us in the midst of trying to excel in academics and further our career prospects in college, the difficulties those with Alzheimer’s disease deal with in remembering who they are, and who their loved ones are, are impossible to imagine, but are an everyday reality facing many. 

The disease was named after the German pathologist and psychiatrist, Alois Alzheimer who delivered a lecture to the 37th Congress of Psychiatrists in 1906. In this talk, Alzheimer presented a case study of a woman by the name of Auguste D who experienced symptoms of memory loss, disorientation, and hallucinations up to the day of her early death at 50 years of age. The post-mortem autopsy revealed various brain abnormalities, including an atrophied cerebral cortex, senile plaque, and neurofibrillary tangles. Four years after Dr. Alzheimer’s lecture, the disease was named Alzheimer’s disease in the 8th edition of the Handbook of Psychiatry. 

Previously, the neurofibrillary tangles had never been described, but later research on Alzheimer’s finding attributed these tangles to tau proteins that are responsible for stabilizing microtubules, which abnormally aggregate to form threads and then tangles, which inhibits synaptic connection by blocking the neuronal transport system. In turn, this breakdown of the neuronal network leads to associated atrophy of the cerebral cortex. As a result, there is no capacity to recall memories, and the inability to do so is incredibly exasperating and depressing for the afflicted. It is not difficult to imagine why many people with Alzheimer’s disease suddenly display sudden outbreaks of anger to express their inner frustrations. 

Currently, there are no cures for Alzheimer’s, however, there are treatments available for slowing down the progression of the disease. The difference in treatment is divided into two categories: the first is between cases of mild to moderate and the second is from moderate to severe. The treatment for mild to moderate cases includes cholinesterase inhibitors such as galantamine, rivastigmine, and donepezil. Alzheimer’s has been observed to produce less and less acetylcholine as the disease progresses, and these medications take a focused approach to targeting acetylcholine before the toll is taken in difficulties remembering and thinking. However the side effects of these medications can vary in the patient’s experience of headaches and confusion. Treatment of moderate to severe cases includes the continuation of the cholinesterase inhibitors, as well as memantine,  an NMDA antagonist that regulates glutamate. Again, the side effects can lead to dizziness, headaches, and confusion. In fact, none of these medications are without their side effects, which raises the question of alternative treatments as a better option and the growing support for alternative treatments. 

With growing support for alternative treatments, stimulants that were previously prescribed to those with the attention-deficit hyperactive disorder (ADHD) have been found to reduce apathy in those with Alzheimer’s disease. Specifically, Ritalin had been observed to modestly but potentially significantly uplift the mood of patients over a six-month, randomized trial. Mintzer et al. conducted a study with 200 participants where improvements in mood were first observed two months after treatment and continued over the course of the experiment. 

On the other hand, the literature on the interactions between Alzheimer’s disease and exposure to natural settings is limited and heterogeneous, despite its potential benefits for long-term patient outcomes across human development. However, an observational study conducted by White et al. from 2012 that took place at a dementia care facility in the United Kingdom found that short exposure to nature was associated with an increase in the mood of patients up to 80-90 minutes at a time. 

The Alzheimer’s Society acknowledges the forget-me-not, also known as Myosotis, as the symbol of the disease and the loss of memory that patients can experience. The flowering time of these perennial and biennial plants occurs from May through October. Though they grow best in damp, shady areas, such as bogs and ponds, some species are able to tolerate full-sun exposure. Currently, there are 74 different species of the genus Myosotis growing all over the world, including Georgia. 

It may be worth considering the propagation of forget-me-not flowers for supporting the awareness of Alzheimer’s disease in the future. The UGA campus is characteristic of being an extension of the State Botanical Gardens, and vice versa. Across campus, there are designated areas and multiple signs that tag the name of specific plants, so perhaps the flower can find a place somewhere on campus as well. Though most of us on campus don’t have to worry about the effects of Alzheimer’s disease taking its toll on our memories, having the symbol present would serve as a reminder to foster our well. 

Copy editor – Elizabeth Conner

Photography source – https://www.farmersalmanac.com/forget-me-not-blue-flowers