ALZHEIMERS DISEASE

Introduction
Alzheimers disease is a brain disorder named for German physician Alois Alzheimer, who first described it in 1906. Scientists have learned a great deal about Alzheimers disease in the century since Dr. Alzheimer first drew attention to it. Today we know that Alzheimers:

Is a progressive and fatal brain disease. More than 5 million Americans now have Alzheimers disease. Alzheimer's destroys brain cells, causing problems with memory, thinking and behavior severe enough to affect work, lifelong hobbies or social life. Alzheimers gets worse over time, and it is fatal. Today it is the seventh-leading cause of death in the United States. Is the most common form of dementia, a general term for the loss of memory and other intellectual abilities serious enough to interfere with daily life. Vascular dementia, another common type of dementia, is caused by reduced blood flow to parts of the brain. In mixed dementia, Alzheimers and vascular dementia occur together. Has no current cure. But treatments for symptoms, combined with the right services and support, can make life better for the millions of Americans living with Alzheimers. Weve learned most of what we know about Alzheimers in the last 15 years. There is an accelerating worldwide effort under way to find better ways to treat the disease, delay its onset, or prevent it from developing.

Alzheimer's and the brain

Just like the rest of our bodies, our brains change as we age. Most of us notice some slowed thinking and occasional problems remembering certain things. However, serious memory loss, confusion and other major changes in the way our minds work are not a normal part of aging. They may be a sign that brain cells are failing. The brain has 100 billion nerve cells (neurons). Each nerve cell communicates with many others to form networks. Nerve cell networks have special jobs. Some are involved in thinking, learning and remembering. Others help us see, hear and smell. Still others tell our muscles when to move. To do their work, brain cells operate like tiny factories. They take in supplies, generate energy, construct equipment and get rid of waste. Cells also process and store information. Keeping everything running requires coordination as well as large amounts of fuel and oxygen. In Alzheimers disease, parts of the cells factory stop running well. Scientists are not sure exactly where the trouble starts. But just like a real factory, backups and breakdowns in one system cause problems in other areas. As damage spreads, cells lose their ability to do their jobs well. Eventually, they die.
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The role of plaques and tangles

Two abnormal structures called plaques and tangles are prime suspects in damaging and killing nerve cells. Plaques and tangles were among the abnormalities that Dr. Alois Alzheimer saw in the brain of Auguste D., although he called them different names.

Plaques build up between nerve cells. They contain deposits of a protein fragment called beta-amyloid (BAY-tuh AM-uh-loyd). Tangles are twisted fibers of another protein called tau (rhymes with wow). Tangles form inside dying cells. Though most people develop some plaques and tangles as they age, those with Alzheimers tend to develop far more. The plaques and tangles tend to form in a predictable pattern, beginning in areas important in learning and memory and then spreading to other regions.

Scientists are not absolutely sure what role plaques and tangles play in Alzheimers disease. Most experts believe they somehow block communication among nerve cells and disrupt activities that cells need to survive.

Early stage and early onset

Early-stage is the early part of Alzheimers disease when problems with memory, thinking and concentration may begin to appear in a doctors interview or medical tests. Individuals in the early-stage typically need minimal assistance with simple daily routines. At the time of a diagnosis, an individual is not necessarily in the early stage of the disease; he or she may have progressed beyond the early stage. The term early-onset refers to Alzheimer's that occurs in a person under age 65. Early-onset individuals may be employed or have children still living at home. Issues facing families include ensuring financial security, obtaining benefits and helping children cope with the disease. People who have early-onset dementia may be in any stage of dementia early, middle or late. Experts estimate that some 500,000 people in their 30s, 40s and 50s have Alzheimer's disease or a related dementia.

History
At a scientific meeting in November 1906, German physician Alois Alzheimer presented the case of Frau Auguste D., a 51-year-old woman brought to see him in 1901 by her family. Auguste had developed problems with memory, unfounded suspicions that her husband was unfaithful, and difficulty speaking and understanding what was said to her. Her symptoms rapidly grew worse, and within a few years she was bedridden. She died in Spring 1906, of overwhelming infections from bedsores and pneumonia. Dr. Alzheimer had never before seen anyone like Auguste D., and he gained the familys permission to perform an autopsy. In Augustes brain, he saw dramatic shrinkage, especially of the cortex, the outer layer involved in memory, thinking, judgment and speech. Under the microscope, he also saw widespread fatty deposits in small blood vessels, dead and dying brain cells, and abnormal deposits in and around cells.
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The condition entered the medical literature in 1907, when Alzheimer published his observations about Auguste D. In 1910, Emil Kraepelin, a psychiatrist noted for his work in naming and classifying brain disorders, proposed that the disease be named after Alzheimer.

Symptoms of Alzheimer's
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Some change in memory is normal as we grow older, but the symptoms of Alzheimers disease are more than simple lapses in memory. People with Alzheimers experience difficulties communicating, learning, thinking and reasoning problems severe enough to have an impact on an individual's work, social activities and family life. The Alzheimer's Association has developed a checklist of common symptoms to help you recognize the difference between normal age-related memory changes and possible warning signs of Alzheimers disease. Theres no clear-cut line between normal changes and warning signs. Its always a good idea to check with a doctor if a persons level of function seems to be changing. The Alzheimers Association believes that it is critical for people diagnosed with dementia and their families to receive information, care and support as early as possible.

10 warning signs of Alzheimer's:

1. Memory loss. Forgetting recently learned information is one of the most common early signs of dementia. A person begins to forget more often and is unable to recall the information later. What's normal? Forgetting names or appointments occasionally. 2. Difficulty performing familiar tasks. People with dementia often find it hard to plan or complete everyday tasks. Individuals may lose track of the steps involved in preparing a meal, placing a telephone call or playing a game. What's normal? Occasionally forgetting why you came into a room or what you planned to say. 3. Problems with language. People with Alzheimers disease often forget simple words or substitute unusual words, making their speech or writing hard to understand. They may be unable to find the toothbrush, for example, and instead ask for "that thing for my mouth. What's normal? Sometimes having trouble finding the right word. 4. Disorientation to time and place. People with Alzheimers disease can become lost in their own neighborhood, forget where they are and how they got there, and not know how to get back home.

What's normal? Forgetting the day of the week or where you were going. 5. Poor or decreased judgment. Those with Alzheimers may dress inappropriately, wearing several layers on a warm day or little clothing in the cold. They may show poor judgment, like giving away large sums of money to telemarketers. What's normal? Making a questionable or debatable decision from time to time. 6. Problems with abstract thinking. Someone with Alzheimers disease may have unusual difficulty performing complex mental tasks, like forgetting what numbers are for and how they should be used. What's normal? Finding it challenging to balance a checkbook. 7. Misplacing things. A person with Alzheimers disease may put things in unusual places: an iron in the freezer or a wristwatch in the sugar bowl. What's normal? Misplacing keys or a wallet temporarily. 8. Changes in mood or behavior. Someone with Alzheimers disease may show rapid mood swings from calm to tears to anger for no apparent reason. What's normal? Occasionally feeling sad or moody. 9. Changes in personality. The personalities of people with dementia can change dramatically. They may become extremely confused, suspicious, fearful or dependent on a family member. What's normal? Peoples personalities do change somewhat with age. 10. Loss of initiative. A person with Alzheimers disease may become very passive, sitting in front of the TV for hours, sleeping more than usual or not wanting to do usual activities. What's normal? Sometimes feeling weary of work or social obligations.

Risk factors
Age The greatest known risk factor for Alzheimers is increasing age. Most individuals with the disease are 65 or older. The likelihood of developing Alzheimers doubles about every five years after age 65. After age 85, the risk reaches nearly 50 percent. Family history Another risk factor is family history. Research has shown that those who have a parent, brother or sister, or child with Alzheimers are more likely to develop Alzheimers. The risk increases if more than one family member has the illness. When diseases tend to run in families, either heredity (genetics) or environmental factors or both may play a role.
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Genetics (heredity) Scientists know genes are involved in Alzheimers. There are two categories of genes that can play a role in determining whether a person develops a disease. Alzheimer genes have been found in both categories: 1) Risk genes increase the likelihood of developing a disease, but do not guarantee it will happen. Scientists have so far identified one Alzheimer risk gene called apoliprotein E-e4 (APOE-e4). APOE-e4 is one of three common forms of the APOE gene; the others are APOE-e2 and APOE-e3. APOE provides the blueprint for one of the proteins that carries cholesterol in the bloodstream. Everyone inherits a copy of some form of APOE from each parent. Those who inherit one copy of APOE-e4 have an increased risk of developing Alzheimers. Those who inherit two copies have an even higher risk, but not a certainty. Scientists do not yet know how APOE-e4 raises risk. In addition to raising risk, APOE-e4 may tend to make symptoms appear at a younger age than usual. Experts believe there may be as many as a dozen other Alzheimer risk genes in addition to APOE-e4. 2) Deterministic genes directly cause a disease, guaranteeing that anyone who inherits them will develop the disorder. Scientists have found rare genes that directly cause Alzheimers in only a few hundred extended families worldwide. When Alzheimers disease is caused by deterministic genes, it is called familial Alzheimers disease, and many family members in multiple generations are affected. True familial Alzheimers accounts for less than 5 percent of cases. Genetic tests are available for both APOE-e4 and the rare genes that directly cause Alzheimers. However, health professionals do not currently recommend routine genetic testing for Alzheimers disease. Testing for APOE-e4 is sometimes included as a part of research studies.

Risk factors you may be able to influence

Age, family history and heredity are all risk factors we cant change. Now, research is beginning to reveal clues about other risk factors we may be able to influence. Head injury: There appears to be a strong link between serious head injury and future risk of Alzheimers. Protect your head by buckling your seat belt, wearing your helmet when participating in sports, and fall-proofing your home. Heart-head connection: Some of the strongest evidence links brain health to heart health. Your brain is nourished by one of your bodys richest networks of blood vessels. Every heartbeat pumps about 20 to 25 percent of your blood to your head, where brain cells use at least 20 percent of the food and oxygen your blood carries. The risk of developing Alzheimers or vascular dementia appears to be increased by many
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conditions that damage the heart or blood vessels. These include high blood pressure, heart disease, stroke, diabetes and high cholesterol. Work with your doctor to monitor your heart health and treat any problems that arise. General healthy aging: Other lines of evidence suggest that strategies for overall healthy aging may help keep the brain healthy and may even offer some protection against developing Alzheimers or related diseases. Try to keep your weight within recommended guidelines, avoid tobacco and excess alcohol, stay socially connected, and exercise both your body and mind.

Alzheimer Myths Myth 1: Memory loss is a natural part of aging.

Reality: In the past people believed memory loss was a normal part of aging, often regarding even Alzheimers as natural age-related decline. Experts now recognize severe memory loss as a symptom of serious illness. Whether memory naturally declines to some extent remains an open question. Many people feel that their memory becomes less sharp as they grow older, but determining whether there is any scientific basis for this belief is a research challenge still being addressed.

Myth 2: Alzheimers disease is not fatal.

Reality: Alzheimer's disease will kill you. It destroys brain cells and causes memory changes, erratic behaviors and loss of body functions. It slowly and painfully takes away your identity, ability to connect with others, think, eat, talk, walk and find your way home.

Myth 3: Only older people can get Alzheimer's

Reality: Alzheimer's can strike people in their 30s, 40s and 50s. Of the 5 million Americans living with Alzheimer's disease, some 500,000 people under age 65 have Alzheimer's or a related disorder.

Myth 4: Drinking out of aluminum cans or cooking in aluminum pots and pans can lead to Alzheimers disease.
Reality: During the 1960s and 1970s, aluminum emerged as a possible suspect in Alzheimers. This suspicion led to concern about exposure to aluminum through everyday sources such as pots and pans, beverage cans, antacids and antiperspirants. Since then, studies have failed to confirm any role for aluminum in causing Alzheimers. Experts today focus on other areas of research, and few believe that everyday sources of aluminum pose any threat.

Myth 5: Aspartame causes memory loss.

Reality: This artificial sweetener, marketed under such brand names as Nutrasweet and Equal, was approved by the U.S. Food and Drug Administration (FDA) for use in all foods and beverages in 1996. Since approval, concerns about aspartame's health effects have been raised. According to the FDA, as of May 2006, the agency had not been presented with any scientific evidence that would lead to change its conclusions on the safety of aspartame for most people. The agency says its conclusions are based on more than 100 laboratory and clinical studies.

Myth 6: Flu shots increase risk of Alzheimers disease

Reality: A theory linking flu shots to a greatly increased risk of Alzheimers disease has been proposed by a U.S. doctor whose license was suspended by the South Carolina Board of Medical Examiners. This doctor also claims to cure autism, a childhood neurological disorder causing delays in language, the ability to socialize, and other developmental areas, with a treatment prepared from his own bone marrow.

Myth 7: Silver dental fillings increase risk of Alzheimer's disease

Reality: According to the best available scientific evidence, there is no relationship between silver dental fillings and Alzheimer's. The concern that there could be a link arose because "silver" fillings are made of an amalgam (mixture) that typically contains about 50 percent mercury, 35 percent silver and 15 percent tin. Mercury is a heavy metal that, in certain forms, is know to be toxic to the brain and other organs.

Myth 8: There are treatments available to stop the progression of Alzheimer's disease
Reality: At this time, there is no treatment to cure, delay or stop the progression of Alzheimer's disease. FDA-approved drugs temporarily slow worsening of symptoms for about 6 to 12 months, on average, for about half of the individuals who take them.