Tangled Up

The only guide for the public to the science and history of Alzheimer’s disease. This book can help you if you fear that you have Alzheimer’s disease or if a friend or family member has Alzheimer’s disease.

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The only comprehensive guide to the history and science of Alzheimer’s disease. This book will help you understand how the disease was discovered, why it is affecting our memory, what actually happens in the brain and how we can reduce our risk for Alzheimer’s disease.



With vivid examples, Professor Michael Hornberger takes you on a whistle-stop tour of every aspect of the most common form of dementia, from its origins to modern diagnosis and treatment.



You can discover scientifically proven Alzheimer’s disease prevention strategies and lifestyle changes.



You can understand why people with the disease are often ‘living in the last’ and get disoriented as to where they are.



And you can learn more about the rare forms of Alzheimer’s disease that are often mistaken for other conditions.



Written for the general public, this book deals with:





What causes Alzheimer’s disease?
Why Alzheimer’s often affects our memory first
The role of genetics in raising and lowering risk for the disease
What new treatments are emerging
The chances you will inherit Alzheimer’s from your parents
The practical steps you can take to reduce your future risk for Alzheimer’s disease


One in 14 people over 65 will get dementia and Alzheimer’s disease accounts for around 70% of all people with dementia.



Professor Michael Hornberger, a neuroscientist who has been researching people with Alzheimer’s for decades, has the key answers to help you and your family to understand the disease and reduce your risk for Alzheimer’s disease.



He starts by looking at the very first patient who was diagnosed with ‘Alzheimer’s’ disease -  Auguste Deter. A German doctor, Alois Alzheimer, not only described her symptoms in meticulous detail but also reported after her death specific changes which are now the hallmark features of Alzheimer’s disease – so called tangles.



Tangled Up recounts Alzheimer’s intriguing interviews with Auguste Deter and the subsequent discovery of what was happening in the newly-named Alzheimer’s disease.



In essence, Alzheimer’s disease emerges when two proteins, amyloid and tau, build up in our brains. Once the proteins start accumulating, they start becoming toxic to the nerve cells which eventually start dying. The loss of those nerve cells affect people’s memory and spatial orientation in the early stages of the disease, since those memory regions seem to be most vulnerable to the accumulation of the proteins. It can cause people with the disease to be ‘living in the past’, as their old memories remain intact while newer memories are increasingly difficult to create. However, the disease has many variants and Professor Hornberger goes into the symptoms of lesser-known ones, such as Posterior Cortical Atrophy, which do not affect memory early on.



He also explains the role that inherited genes play in transmitting the disease, including the difference between risk genes, which only increase or decrease our risk, and familial Alzheimer’s disease genes, which make the development of the disease a near certainty.



Finally, the book looks at new ‘biomarkers’ and blood tests to detect, diagnose and monitor Alzheimer’s, and which new medications are emerging to treat the disease.



In the absence of a cure, prevention becomes ever more important. Making modest lifestyle changes can make a big difference and the book gives realistic tips on looking after your heart, blood sugar and body mass. While other popularly touted techniques, Professor Hornberger explains, may not be worth your time or money.



About the author



Michael Hornberger is Professor of Applied Dementia Research at Norwich Medical School at the University of East Anglia in the UK.



He regularly meets patients with Alzheimer’s disease as part of his research aimed at improving diagnosis, disease tracking and symptom management.  



Michael is originally from Germany and studied at the universities of Osnabruck and Vienna. He gravitated to England where he did his PhD at University College London before working at Cambridge University. He spent six years in Sydney, Australia, before returning to Cambridge. He finally arrived at UEA in November 2015.  



Introduction



This is not a book about dementia. This is a book about Alzheimer’s disease.



What’s the difference, you might ask?



The difference is that dementia is an umbrella term for all types of dementia, with Alzheimer’s disease being the most common form.



Why would one need a book on Alzheimer’s disease and not a book on dementia?



There are already many excellent books on dementia available. However, to my knowledge there is none on the science behind Alzheimer’s disease specifically.



Why does it matter?



If we want to understand the science behind dementia, we need to look at each type of dementia specifically, as the science for each type of dementia is quite different. We need to understand how a particular type of dementia develops in the brain, what changes it causes in the brain and how this results in the symptoms we see for this type of dementia. In essence, what is the science behind each type of dementia? 



What is this book about?



This book focuses on the science (and history) of Alzheimer’s disease. Specifically, we will explore in detail how the brain changes in Alzheimer’s disease cause the symptoms of the disease and how new, upcoming treatments will deal with these brain changes. We will also explore the risk factors for Alzheimer’s disease and how we can potentially reduce them. We will start by travelling back in history to find out how Alois Alzheimer and Oskar Fischer ‘discovered’ the disease. 



Who is this book for?



For everyone, and I mean everyone, who is interested in the science behind Alzheimer’s disease. No prior scientific knowledge should be required to understand the book, as I have gone to great lengths to explain the scientific concepts behind each important aspect. So, if you are an interested lay person, a person with dementia, a paid or unpaid carer, a family member, a dementia advocate, a healthcare professional or even a clinician, this book is for you. However, although this book will cover the basic science behind Alzheimer’s disease, it will not go into the science of dementia care, for which there are already some excellent books available by lay and professional carers. But if you are curious about how the changes in the brain cause the disease and its consequent symptoms and how we can potentially prevent them, then this book is for you.



Why this book now?



Communication of science has been a passion of mine for nearly two decades. The reason I became interested was that I noticed how little scientific information was out there to provide people with detailed, but understandable scientific information on Alzheimer’s disease. What I found instead was a choice between either very generic scientific information, of the sort provided by websites, such as ‘it causes changes in the brain affecting your memory’; or scientific publications filled to the brim with jargon and acronyms, making it impossible for lay people to understand what these articles were discussing. 



I think there is a compromise between these two extremes, which allows a general reader to get a more detailed understanding of the science behind Alzheimer’s disease. Of course, I am not the first to think of that. Most dementia charities and organisations already provide such lay-friendly dementia science information. However, I could not find a book which compiled all the information in one place. So, I decided to write my own.



Buy the book and carry on reading!