Alternative TreatmentsIn this section, alternative treatments that are not in use in the medical field at the moment will be discussed. These treatments are said to prevent Alzheimer’s Disease, improve conditions for people who have the disease and/or possibly cure the disease with future research and funding. Here we will discuss the following treatments currently being investigated on how effective they may be. These alternative treatments are:The use of CannabinoidsCoconut oil- MCT, ketogenic dietCare-home InnovationWearable Cameras Cannabinoids:Cannabis is a psychoactive drug used as both a medicinal aid and a recreational experience. It contains series of compounds, some classified as cannabinoids. Cannabinoids such as tetrahydrocannabinol (THC) and cannabidiol (CBD) are used most widespread in recent years as medicinal agents. THC is the most commonly known compound due to its psychoactive effects on humans on consumption. CBD although does not have intoxicating effects like THC, it is used also as a pain reliever for ailments like multiple sclerosis. CBD and THC concentrations are dependant on what strain or species the cannabis plant is consumed. The plants species are broken into two groups called Sativa and Indica. Each strain of plants have different ratios of which can be majorly THC or CBD. THC is commonly found in plants in the Sativa group. CBD corresponds to the Indica sub group. Crossbreeding causes plants to have different ratios of both compounds than their parenting plants. Indica medicinal strains, when consumed, can cause patients to feel multiple effects. These effects include mental relaxation, increase in dopamine and muscle relaxation. These effects would help with Alzheimer’s and accompanying side effects to the disease, depression and hysteria. Sativa medicinal strains although psychoactive causing an increase in focus and creativity, it is also an antidepressant agent, anxiolytic and increases serotonin levels. Fig.30″Alzheimer’s disease (AD) is a debilitating neurodegenerative disease that is affecting an increasing number of people. It is characterized by the accumulation of amyloid-? and tau hyperphosphorylation as well as neuroinflammation and oxidative stress.”31 At this moment, there is a need for more effective pharmaceuticals in the reversal of the progression of AD. As of yet there is no cure or medication to stop AD. CBD is a non-psychoactive component of cannabis. In June 2011 a research article was published titled “Cannabidiol and Other Cannabinoids Reduce Microglial Activation In Vitro and In Vivo: Relevance to Alzheimer’s Disease”32.This, like other articles before this showed the promising possibilities of using components of cannabis as useful molecules in the fight against neurodegeneration caused by Alzheimer disease. Research around this time showed proof of CBD showing anti-inflammatory and antioxidant properties along with neuroprotective properties. These are essential in combating neurodegeneration. Results from research like this cause an article to be published in February 2017 of tests in vivo, on male lab mice, using CBD and a CBD-THC (“Sativex”34) ratios (1:1), discussing research done over the previous 25 years. “In vivo Evidence for Therapeutic Properties of Cannabidiol (CBD) for Alzheimer’s Disease”35 concludes with these main observations.In vivo results showed that mice injected with Beta Amyloid peptide (A?42) and given only CBD were tested and implied that CBD’s anti-inflammatory properties was able to slightly reverse the injections effects.Long term CBD treatment was minorly able to reduce the social recognition memory without causing changing anxiety domains.Sativex? dosages in the test samples had therapeutic benefits. The cannabinoids composition decreased gliosis which can causes a secretion of neurotoxins that affect the central nervous system. This suggests neuroprotective properties. Sativex? showed to have increased ratios of glutathione. This suggests antioxidant properties meaning a decrease in subjects being stressed during trials.Fig.31These results would all suggest that cannabinoids are ready to be moved on to human trials, moreover this could be a new, alternative treatment for AD, along with other neurodegenerative diseases. CBD is an available, with little known side effects option for future treatments of AD.Cannabinoid products are illegal in Ireland and in a majority of other countries internationally. Sativex is not an available product in Ireland, although purchasable in the United Kingdom. This may be due to the stigma the revolves around cannabis and its recreational use. Although research has shown that it has countless medicinal uses and possibilities, some groups are sceptical of its uses or what effects it would have communialy if legalised. Coconut Oil- MCT, Ketogenic dietsCoconut oil is made from the white meat of matured coconuts. It is a long process but from the natural coconut meat, copra/coconut oil is produced. Within the copra oil is a series of medium-chain triglycerides, MCTs. Fig32- MCT.MCTs are fatty acids with carbon chains of up to 6-12 carbons in length.Oils contain fats that the body uses by converting into glucose. These oils are consumed from sources such as vegetable oil. MCTS are broken down into ketone bodies which the body uses, along with glucose and other sources, for energy. The human brain uses ketone bodies as energy for cells there.It is believed that coconut oil has the possible ability to prevent Alzheimer’s Disease and manage its worsening effects. MCTS are easily absorbed into the liver where they are converted into ketones. These ketones are then used by the brain as a source of alternative energy, and are said to prevent beta amyloid peptides from developing, acting almost like a deactivator.This is not agreed by a lot of sciences as it is said that the idea of supplying a dying cell with energy would not help. This said, research is being carried out into the subject predominantly in the United States of AmericaCoconut is a highly available and is already used as cooking material as well a health product. This said, research into consumption of coconut oil in some cases can cause high cholesterol and even possible stroke in severe cases. Coconut should be consumed in moderation. Ketogenic diets are currently being used to reduce epilepsy in children. “The results of these studies are consistent in showing that some children benefit from the ketogenic diet, demonstrated by a significant reduction in seizure frequency”36. All this suggests that consumption of a ketogenic diet can reduce the risk of attaining AD.Care-home InnovationOne of the common side effects caused by Alzheimer’s disease is depression. Patients in late stages find it hard to communicate with their surroundings which can be frustrating to both the patient and family involved. In cases, people suffering from Alzheimer’s are often removed from their home settings and placed into 24-hour care, these include hospices, care-homes. This can be very stressful for people with late to even early cases of the disease causing anxiety and a more aggressive nature within the patient. A new system of care homes was set up in The Netherlands in the form of De Hogeweyk. De Hogeweyk is a gated town-like community designed and built in its entirety for caring for people with neurodegenerative diseases. Here residents are not just forgotten about and are given the opportunity to still live an active and normal-as-possible functioning life. De Hogeweyke is special because it is laid out to replicate a small town setting. It contains 23 houses of different types of accommodation (suburban and urban) along with other amenities commonly found in towns, like shops, a restaurant, a park and a theatre. The 23 types of housing are interiorly designed so as to be as suiting to the client as possible. Indian, Christian, Farmhouse styles are some of the 23 different “Lifestyle” designs of accommodations. Houses are occupied with no more than 7 occupants with similar tastes and personalities. The aim of this is to allow residents to feel comfortable in their environment. This is why each sort of housing has been designed completely for the occupant. Occupants have a better lifestyle as they can interact with people and the town as they wish. Along with this, staff carers are dressed as normal civilians of this artificial town and help patients with their routine. If a patient was to go shopping for example in the onsite supermarket and left the store without paying for goods removed from the store, the shop owner would notify the persons carer and pay back the supermarket. This avoids embarrassment for the patient which can cause an undesired effects or harm on their mental health.Residents benefit as they are not just forgotten about and are given the opportunity to still live an active and normal-as-possible functioning life in comfort. This reduces the anxiety, depression and aggressiveness that comes with Alzheimer’s patients”Around the common and familiar building blocks lifestyles are built from a social approach. Look at day to day life and create conditions for the residents so that they are challenged by recognizable incentives to remain active in daily life. In the nursing home groups of up to seven residents with shared interests and backgrounds live together in a lifestyle-group. The design and decoration of the homes and surroundings is tailored to the lifestyles.”37This has proved as a huge benefit to residents and won a Hospitality Care Award in 2010. Environments like these are useful aids of lessening the stress and traumas experienced by AD sufferers and can reduce anxiety, aggressiveness and help with depression. In Limerick, Ireland, an irish equivalent is being opened. “CareBright Community”38 is located on four acre site inside Bruff village. This is space is designed so as to establish a sense of belonging to its inhabitants without removing their independence and comfort. Although not on the same scale as De Hogeweyk, CareBright has three bungalows accommodating for 6 people each.Wearable Cameras- SenseCamFig.39A wearable camera was invented by Lyndsay Williams in Cambridge in 1998. It was named SenseCam. This device, as seen in Fig.39 captures an images throughout the day. Images are captured ass the wearer goes about their daily tasks. The camera has a wide-angle lens enabling a wider image to be captured of the wearers surroundings. An electronic sensor promotes photos to be taken on a change of surroundings, for example caused by lighting change and on time intervals. This creates a log of the wearers day which can be viewed on a PC off a simple set of software. The SenseCam was specifically designed by Williams as a way of treating Alzheimer’s Disease. It was tested in an article titled “The use of a wearable camera improves autobiographical memory in patients with Alzheimer’s disease”40In the experiments in this article 6 people with mild stage Alzheimer’s Disease were used. Between these subjects their ages were 64 to 84. They were asked to wear the SenseCam or record a daily diary to record interesting happenings that occur or non-routine events over a three and a half month period. they were then tested in the following way:”The day following the event, the experimenter/spouse asked the patient what s/he remembered of the event. One cueing question was allowed, which was “What do you remember of our trip to x?”. The patient’s responses to this cue were scored against the notes. For example, if the patient freely recalled 6 of the 10 points he had made, he gained a score of 60%. Recall was then tested in this same way every two days for two weeks, generating seven data points. Immediately following each recall test, the experimenter/spouse and the patient reviewed the images together. This was done in the first instance by looking at each of the images one by one, approximately one per second, although certain images would facilitate discussion and be paused on for longer. After this had taken place, the experimenter/spouse and the patient would look through the images in playback mode, at a rate of six images per second. The entire procedure typically took approximately 20–30 minutes. (Longer retention time of memories was also tested)The patient’s memory for the events was tested at one-month and three-month follow-up sessions. SenseCam images of the events were not reviewed during this time. The experimenter/spouse tested the patient’s memory for the event in the same way as has been described above”41The results showed that subjects autobiographical memory improved for both casses, diary and SenseCam. There was a much greater improvement seen by SenseCam users.”The mean percentage recall of autobiographical events, over two weeks, and subsequent testing at one and three months, for the baseline, written diary and SenseCam conditions.”40After analysing the data collected by the the spouses of patients and the patients themselves there was a significant difference of retention time of occurrences between the two methods with SenseCam nearly tripling the results of the final test. Out of five patients that remained for the entirety of the experiment, three of them retained a higher recall of information from using the SenseCam than manually recording there daily events on paper in a diary. The other two species showed no change between both methods. Further testing improved this result for the two non-differring patients. The data collected suggests that this was a successful way of slowing down the effects of Alzheimer’s Disease but it is not entirely conclusive because of the small test group used. If a larger group had been used for this experiment it would be much easier to say whether this was an outright success or not. A longer test would have also proved more beneficial put may have also have been impractical given that that Alzheimer’s Disease gets progressively worse with time.Although Alzheimer’s is a neurodegenerative disease and is majorly associated with huge memory loss during the progression through the stages, these results were promising. Possible rehabilitation of retention of memories could be achieved. This however does not stop the disease but enhances the well being of the patient. Patients in this study found it helpful. One patient did not like wearing the SenseCam because of it had given them unwanted attention on a matter they found embarrassing.Further research and design is needed into the benefits of SenseCam, itself as an idea and if the practically outweighs its usefulness. Conclusion:Alzheimer’s research is rapidly progressing. Advances in basic science and molecular diagnostics have provided unprecedented possibilities for drug development.If research accelerates as expected, by 2025, patient with early symptoms of Alzheimer’s disease will be treated substantially differently from how they are now. First they would be seen by their primary care doctor upon first complaints. This doctor will prescribe risk-factor management and provide personalised advice for lifestyle modification. The patient will then be referred to a specialist and undergo MRI scan and undergo amyloid and tau imaging. If the results of these scans suggest the presence of the disease, the patient might have to be put on a strict regime of anti-amyloid compounds, anti-tau drugs, synaptic enhancers, and in serious cases, even gene therapy directed as the progression to dementia would be monitored. (Scheltens, 2016)69 Medical imaging will be used to monitor the treatment in removing amyloid and tau from the brain, Biomarkers will also be used to monitor the degeneration of the synapses. As a result of the developments and research of the last few years, such advanced treatment and management systems are on the way in the near future.However, the funding needed to make this a reality is not awarded. Investors and Governments are more concerned with different fields such as cancer research and HIV vaccines. These can affect the younger generations and can be far more progressive than Alzheimer’s but recent studies suggests that people are beginning to be diagnosed with the disease earlier than ever before. So we can expect to see giant leaps forward and scientific breakthroughs in Alzheimer’s research within the next few years.