9 octobre 2019

Jamais on n’aura autant entendu parler de la maladie d’Alzheimer que ces dernières années. La maladie d’Alzheimer et les maladies neurodégénératives[1] suscitent, après le cancer, le plus d’inquiétude au sein de la population nord-américaine. Elles arrivent d’ailleurs en tête des maladies qui préoccupent les personnes âgées de plus de 55 ans. Mais savons-nous réellement de quoi il s’agit ?

Près de 40 % des personnes de plus de 65 ans éprouvent une forme quelconque de perte de mémoire liée à un processus normal de vieillissement. Cette perte de mémoire peut se manifester de différentes manières, comme ne pas se rappeler les détails d’une conversation ou d’un événement ayant eu lieu il y a un an, ne pas se rappeler le nom d’une connaissance, ou encore, oublier occasionnellement des événements. L’impact sur votre vie quotidienne est mineur, sans que cela vous préoccupe ou inquiète notre entourage. C’est la grande distinction à faire avec la maladie d’Alzheimer et les maladies neurodégénératives qui touchent actuellement près de 141 000 Québécois et plus d’un demi-million de Canadiens. (Source : Fédération québécoise des Sociétés Alzheimer)

Les causes de la maladie d’Alzheimer ne sont pas bien comprises ou connues, mais deux protéines sont impliquées dans le processus de dégénérescence. La première est la protéine bêta-amyloïde, qui, en s’accumulant dans le cerveau, forme des plaques et empêche le transfert d’informations entre les neurones, causant ultimement la mort neuronale. La deuxième protéine impliquée dans le processus est la protéine Tau. Tau joue un rôle crucial dans le maintien de la structure des neurones en s’associant aux microtubules. En se détachant des microtubules, Tau forme des neurofilaments toxiques aux cellules du cerveau. Les personnes qui reçoivent un diagnostic de maladie d’Alzheimer, ou d’une maladie apparentée, présentent ainsi plusieurs symptômes tels qu’une perte de mémoire à court terme, des difficultés avec les tâches familières, des problèmes de langage et d’attention, des difficultés avec les notions abstraites ou une désorientation dans l’espace et dans le temps. Contrairement au vieillissement normal, ces difficultés sont fréquentes et touchent les fonctions exécutives ainsi que la mémoire épisodique de la personne.

Malgré les efforts considérables de la recherche, il n’existe actuellement aucun médicament qui puisse stopper, ralentir ou renverser le déclin cognitif. Les médicaments actuellement approuvés par Santé Canada permettent de soulager certains symptômes liés à la maladie, tels que la perte de mémoire ou les troubles du langage, mais leurs effets restent modérés, avec des effets secondaires qui peuvent être difficiles à supporter pour certains patients.

Même si nous n’avons aucun contrôle sur les deux principaux facteurs de risque de la maladie d’Alzheimer, à savoir l’âge et les antécédents génétiques, il n’en demeure pas moins que la prévention demeure la meilleure mesure à mettre en place pour essayer de retarder l’apparition des premiers symptômes, mais aussi de ralentir l’évolution de la maladie. Les facteurs de risque associés à la maladie d’Alzheimer sont bien connus et plusieurs d’entre eux sont des facteurs modifiables, sur lesquels nous pouvons agir individuellement, mais aussi collectivement. Cela passe notamment par une meilleure prise en charge et un meilleur contrôle des maladies cardiovasculaires, du diabète, de l’hypertension, de l’obésité, de la dépression, ou encore, du tabagisme. C’est aussi et surtout en favorisant de saines habitudes de vie, à travers une alimentation saine et équilibrée, en pratiquant une activité physique, en réalisant des activités liées à la stimulation cognitive, et en assurant un réseau social autour de la personne pour briser l’isolement que l’on peut arriver à ralentir le déclin cognitif.

Nouha Ben Gaied, PhD
Directrice recherche et développement, qualité des services

[1] Les maladies apparentées sont la démence vasculaire, la démence frontotemporale, la maladie de Creutzfeld-Jakob et la démence à corps de Lewy. Dans le texte lorsque maladie d’Alzheimer est mentionnée, cela inclut les maladies apparentées.

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