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Understanding Alzheimer's Disease

Dementia is a brain disorder that adversely affects the ability to carry out daily activities. Alzheimer's is the most common form of dementia. Alzheimer’s disease (AD) initially involves the parts of the brain that control thought, memory, and language. Although scientists are learning more every day, right now they still do not know what causes AD, and there is no cure.

AD is a slow disease, starting with mild memory problems and ending with severe brain damage. The course the disease takes and how fast changes occur vary from person to person. Most AD patients live from 8 to 10 years after they are diagnosed, though the disease can last up to 20 years.

History

Alzheimer's disease is named after German doctor, Alois Alzheimer. In 1906, Dr. Alzheimer found abnormal clumps and tangled bundles in the brain tissue of a woman who died of an unusual mental illness. These plaques and tangles are now considered signs of AD. In addition, scientists have found that nerve cells vital to memory and other mental abilities and connections between the nerve cells are disrupted. Also, there are lower levels of some chemicals in the brain that carry messages back and forth between the nerve cells, which impairs thinking and memory.

Prevalence

It is estimated that up to 4.5 million Americans suffer from Alzheimer's Disease. The disease usually begins after age 60, and risk goes up with age. Younger people may be able to get AD, but this is very uncommon. About 5% of people ages 65 to 70 have AD, and nearly half of those age 85 and older may also have the disease.

Signs of Dementia

The disease often starts very slowly, and is overlooked as "forgetfulness because of old age." Over time, memory problems get worse and those affected loose the ability to do daily routines and things they have been able to do their whole life.

Early Signs:

• Trouble remembering recent events.
• Problems remembering names of people and places.
• Trouble solving simple math problems.

Later Signs:

• Forget how to brush your teeth or comb your hair.
• Cannot remember the names of common things such as desk, house, apple, etc.
• Wander away from home.

Conditions with Similar Symptoms

There are some conditions and illnesses that may cause similar symptoms, but are not Alzheimer's. These include:

• Bad reaction to certain medicines
• Depression
• Not eating enough healthy foods, or too few vitamins and minerals in your body
• Brain tumors
• Blood vessel disease
• Thyroid problems

Many of these problems can be treated. Don't let fear keep you from seeing your doctor.

Diagnosing Alzheimer's

Not so long ago, any elderly person with memory problems was simply called "senile." Now we know that Alzheimer's and other dementia related diseases are distinct diseases that need to be treated in a specific manner.

The earlier the diagnosis, the better the outlook is for the patient. Many conditions cause symptoms that mimic those of Alzheimer's disease. Finding out early that the problem isn't AD, but is something else can spur people into getting treatment for the real condition. For the small percentage of dementias that are treatable or even reversible, early diagnosis increases the chances of successful treatment. Even if it turns out to be Alzheimer's disease, it's good to find out sooner rather than later. There are drugs now available to treat AD that can help some people maintain their mental abilities for months to years. Also, the sooner the person with AD and family know, the more time they have to make future living arrangements, handle financial matters, establish a durable power of attorney, deal with other legal issues, create a support network, or even make plans to join a research study. It is important for people affected with AD to be able to participate for as long as possible in making decisions about their future.

Currently, the only way to make a 100% certain diagnosis is after death, when the tangles and plaques in the brain can actually be seen. However, experienced physicians can make a confident diagnosis by looking at:

• Patient History: Looking at the patient's family medical history, discussing symptoms, assessing the emotional state of the patient, talking with friends and family about the changes they may have noticed.
• Computerized Tomography (CT) scans and Magnetic Resonance Imaging (MRI) tests can reveal changes in the brain's structure.
• Neuropsychological Testing: tests that measure memory, abilities, and skills related to brain functioning.

Treatment for Alzheimer's

There are several drugs that slow the process of the Alzheimer’s disease, which are called acetylcholinesterase inhibitors. The acetylcholinesterase inhibitors donepezil (Aricept), rivastigmine (Exelon), and galantamine (Reminyl) have been proved effective in clinical trials. Generally, 20 percent of treated patients experience a one year delay in cognitive deterioration.

Some studies found that the antioxidant Vitamin E, 1000 IU taken twice daily, delayed disability and nursing home placement, but did not slow cognitive deterioration.

Another prescription drug, selegiline (Eldepryl), a selective monoamine oxidase inhibitor, was found to improve cognition, behavior, and mood in some clinical trials.

According to some studies, postmenopausal women who take estrogen have a lower incidence of Alzheimer’s. Estrogen may have a protective effect on the brain, but it does nothing for those already affected with Alzheimer’s.

Inflammation among brain neurons is thought to be one of the key factors in the progress of Alzheimer’s. Observational studies have shown that people who regularly use nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, aspirin, nambumetone, naproxen, diclofenac, and etodolac, have a lesser incidence of Alzheimer’s. However, NSAIDs have not been shown to benefit in treating Alzheimer’s in patients already affected by it.

Ginkgo Biloba was recently found to have shown modest improvements in cognitive function, however pharmaceutical quality ginkgo is not yet available in the United States.