Alzheimer’s disease

Alzheimer’s disease is a progressive neurodegenerative disorder that primarily affects memory, but also language, thinking, reasoning, and the ability to perform everyday tasks. It is the most common cause of dementia in older adults. The disease progresses slowly over several years and leads to a gradual loss of independence.

Alzheimer’s, memory issues, and normal aging: telling the difference

Occasionally forgetting a name or an appointment can be part of normal aging. However, when a person forgets recent events, gets lost in familiar places, or repeatedly asks the same questions, this may be a sign of a pathological disorder. Normal aging does not lead to loss of independence, unlike Alzheimer’s disease.

Why is a medical diagnosis essential?

An early diagnosis makes it possible to:

• Understand the difficulties encountered
• Better organize daily life
• Access treatments (pharmacological or non-pharmacological) to slow disease progression
• Receive support for the patient and their relatives
• Eventually participate in research protocols and clinical trials

Cognitive, behavioral, and functional symptoms

• Cognitive: memory loss, difficulty with orientation, speaking, understanding, or planning
• Behavioral: irritability, anxiety, depression, agitation, possible hallucinations
• Functional: loss of independence in daily activities (managing finances, meals, mobility, hygiene, …)
• Known biological mechanisms (proteins, neurodegeneration – simplified)
• Identified risk factors
• Role of sleep, lifestyle, and environmental factors

The disease is linked to the accumulation of two abnormal proteins in the brain: beta-amyloid, which forms plaques, and tau, which accumulates inside neurons. These deposits disrupt communication between cells and lead to their degeneration.

• Age (main factor)
• Family history and genetics (APOE ε4)
• Cardiovascular factors (hypertension, diabetes, cholesterol, obesity)
• Tobacco or alcohol use
• Sedentary lifestyle
• Social isolation
• Head injuries
• Sleep disorders or depression
• Hearing or vision loss
• Air pollution

Poor sleep quality, an unbalanced diet, physical inactivity, and exposure to pollution may contribute to the onset or worsening of symptoms. Conversely, physical activity, cognitive stimulation, and social interaction are protective.

Approximately 200,000 people are currently living with dementia in Belgium, and since 2019 it has become the leading cause of death in the country.

Alzheimer’s disease accounts for about 70% of dementia cases.

This number could double by 2050 due to population aging and increasing prevalence of risk factors. The societal impact is considerable: loss of independence, caregiver burden, and rising healthcare costs.

(sources: Sciensano, WHO).

A form occurring before age 65

Alzheimer’s disease can occur earlier, sometimes as early as the forties or fifties. This is referred to as early-onset Alzheimer’s. It affects approximately 6 to 9% of patients (source: KCE Report 2021).

Specific challenges (diagnosis, professional life, family)

• Frequent diagnostic delay (symptoms attributed to stress or depression)
• Major impact on professional and family life
• Issues with administrative recognition (pension, insurance, social rights)
• Importance of a structured and specialized care pathway

A structured, multidisciplinary, and early care approach is essential: neurologist, neuropsychologist, social worker, caregiver support, inclusion in research programs.

Our specialists

Understanding and anticipating Alzheimer’s disease

Objectives of the REMEMBER project

The REMEMBER project, led by the Integrated Memory Clinic (CIMe) at Erasme Hospital, aims to better understand the origins of Alzheimer’s disease, identify early signs even before marked memory loss appears, and develop new non-pharmacological therapeutic approaches. Concretely, this involves building a large patient cohort followed over time, with a comprehensive assessment combining brain imaging, memory testing, biological analyses, and sleep recordings.

Sleep, memory, and Alzheimer’s: an inseparable trio

We now know that sleep is not just a period of rest. It plays a fundamental role in memory consolidation and brain cleansing, particularly through a system called the “glymphatic” system, which is especially active during deep sleep. When sleep is disrupted, the brain becomes less efficient at clearing certain proteins such as beta-amyloid and tau, which accumulate abnormally in Alzheimer’s disease. The REMEMBER project specifically aims to better measure the link between poor sleep quality, memory loss, and the development of characteristic brain lesions.

Why is this important?

• To better identify at-risk individuals from the earliest signs (mild memory issues, insomnia, anxiety…) and address modifiable risk factors quickly
• To monitor disease progression in a personalized way
• To test innovative approaches such as auditory stimulation during deep sleep (CLAS) or immersive virtual reality

What does this change for patients?

• More precise cognitive and biological assessments conducted over a few days
• Faster care with a personalized treatment plan
• Opportunity to participate in clinical studies or access emerging therapies
• Better information and long-term support, including for families

A project supported by the Erasme Fund

The Erasme Fund for medical research is a key player in this project. Thanks to its support, the REMEMBER cohort has been launched in a structured, innovative, and human-centered environment. It also funds complex analyses, specialized equipment (such as portable electroencephalography), and research positions involved in the study.