Alzheimer's Disease

Alzheimer's disease:

Alzheimer's disease (AD) is perhaps one of the best-known illnesses associated with older age. A complex disease that affects the brain, it now affects roughly 4.5 million individuals in the U.S. according to the Alzheimer's Association, a national network of advocates and chapters committed to finding a cure for Alzheimer's and helping those affected by the disease.

As the U.S. population grows older, the number of people with AD is expected to increase. But AD is not a normal or an inevitable part of aging. It is a progressive disease that starts in one part of the brain and gradually invades other regions. As it progresses, AD destroys nerve cells within the brain and the connections between them, leaving behind clumps of proteins called plaques and twisted fibers. Over time, this destruction erodes the most vital abilities of human nature: language, learning, memory and reason. Personality and behavior also are dramatically affected by AD.

Alzheimer's disease is the most common causes of dementia in older people. Dementia is a medical term used to describe general mental deterioration severe enough to disrupt a person's normal activities and relationships. AD usually begins in people who are 65 or older, but it can affect individuals as young as 40, though development of AD in younger adults is considered rare. An estimated 3 percent of people between the ages of 65 and 74 have AD, and close to half of adults in the U.S. aged 85 and older are believed to have the disease.

There is no evidence that women are at greater risk than men for developing the disease. However, the fact that women live longer than men means that more women have the disease at any one time than men.

Early symptoms of the disease include forgetfulness, difficulty using or remembering words and difficulty concentrating. For some individuals, these early symptoms of AD may be mistaken for what many people consider "natural" symptoms of aging. But, symptoms caused by AD worsen over time, while the short-term memory problems that trouble many people as they age do not progress to more serious symptoms.

The severity and progression of AD symptoms do not follow any pattern and vary greatly from person to person with the condition. Some people have AD only for the last five years of life, while others may live with it for as many as 20 years.

Symptoms of Alzheimer's disease are divided into three phases: mild, moderate and severe, though the stages often overlap. Because Alzheimer's causes damage directly to the patient's brain, unpredictable and uncharacteristic behavior is common in AD patients.

Mild symptoms include:

• confusion and memory loss
• personality changes
• judgment problems
• difficulties with routine tasks
• getting lost or disoriented in familiar places

Moderate symptoms include:

• difficulty with personal care (bathing, dressing, feeding)
• anxiety, agitation, paranoia
• insomnia or sleep disturbances
• wandering and pacing
• trouble with or inability to recognize familiar faces

Severe symptoms include:

• loss of speech
• loss of appetite
• loss of bladder and bowel control
• complete dependence on caregiver

The major risk factor for AD is age. According to the Alzheimer's Association, in the general population a person's risk of developing any form of dementia, including Alzheimer's, doubles approximately every five years after age 65.

Although researchers still don't know for sure what causes Alzheimer's disease, most believe it is related to the abnormal processing of normal brain proteins, particularly amyloid precursor protein and tau, another type of protein. For some reason, later in life these proteins, which serve a normal function, begin to be abnormally processed and assemble themselves into lesions. These lesions, called neurofibrillary tangles and senile (amyloid) plaques (often simply referred to as plaques), destroy parts of the brain. Other theories link the disease's development to the death of cells critical for maintaining levels of certain brain chemicals required for cognition; chronic inflammation; accumulation of heavy metals in the brain; and vascular factors that affect the health of blood vessels in the brain. Another potential risk factor is severe head injury.

At one time, combination hormone therapy was thought to potentially reduce a woman's risk of developing dementia and Alzheimer's. However, major new research published in the Journal of the American Medical Association actually linked the use of one type of hormone therapy to an increased risk of dementia, including Alzheimer's disease. The research, released in May 2003 as part of the Women's Health Initiative Memory Study (WHIMS), found an increased risk of developing dementia in a study of women 65 and older taking Prempro, a form of estrogen plus progestin hormone therapy.

To date, there is no cure for AD or any proven way to slow it down. The good news is that scientists are learning more about the disease each day, including information about the role genes may play in the condition's development, and how to treat and manage it as it progresses.

If you think you have AD or suspect someone you know might be experiencing symptoms, it's important to consult with medical professionals as soon as possible. Early diagnosis can help rule out other medical reasons for symptoms. Because AD eventually affects an individual's ability to care for him or herself, short- and long-term planning is important. The earlier you can develop a support system, as well as review financial and medical management strategies, the better. Issues to consider include: caregiving support and establishing a power of attorney and a living will, as well as making other end-of-life decisions.

The Alzheimer's Association and related support groups can provide additional information about AD and the needs you and your family are likely to face. It's natural to feel overwhelmed by such a diagnosis. These organizations, together with your medical team, can help you cope.