Alzheimer’s Disease

What is Dementia? A brain disorder that seriously affects a person’s ability to carry out daily activities

Dementia The term “dementia” describes a group of symptoms that are caused by change in brain function. Symptoms may include: – asking the same question repeatedly –Becoming lost in familiar places –Unable to follow directions –Disoriented about time, people, and places, and –Neglecting personal safety and nutrition.

People with dementia lose their abilities at different rates.

Dementia Caused by many conditions – some that can be reversed and others that cannot. Two most common forms are irreversible (cannot be cured): –Alzheimer’s Disease –Multi-Infarct Dementia (often called vascular dementia)

Reversible conditions with symptoms of dementia can be caused by: –A high fever –Dehydration –Vitamin deficiency –Poor nutrition –Bad reactions to medicines –Problems with the thyroid gland –Minor head injury

Sometimes older people have emotional problems that can be mistaken for dementia. Feeling sad, lonely, worried, or bored may be common for people facing retirement or coping with the death of a spouse. Adapting to these changes leaves some feeling confused or forgetful. And, mistaken for dementia.

Multi-Infarct Dementia In MID, a series of small strokes or changes in the brain’s blood supply may result in the death of brain tissue. The location in the brain where the small strokes occur determines the seriousness of the problems and the symptoms that arise.

MID Symptoms that begin suddenly may be a sign of this kind of dementia. People with MID are likely to show signs of improvement and remain stable for long periods of time, then quickly develop new symptoms if more strokes occur. For many, high blood pressure is to blame. One of the most important reasons for controlling high blood pressure is to prevent strokes.

What is Alzheimer’s Disease? The most common form of dementia among older adults. It initially involves the parts of the brain that control thought, memory and language. We do not know what causes AD and there is no cure.

Alzheimer’s Disease Named after Dr. Alois Alzheimer, a German doctor. In 1906, Dr. Alzheimer noted changes in the brain tissue of a woman who had died of an unusual mental illness. He found abnormal clumps (now called amyloid plaques) and tangled bundles of fibers (now called neurofibrillary tangles). Today, we know that these plaques and tangles in the brain are considered signs of AD.

Other Changes in People with AD Nerve cells die in areas of brain that are vital to memory and other mental abilities and connections between nerve cells are disrupted. Lower levels of some of the chemicals in brain that carry messages back and forth between nerve cells. AD may impair thinking and memory by disrupting these messages.

Symptoms of AD AD begins slowly. At first, the only symptom may be mild forgetfulness, which can be confused with age- related memory change. Most people with mild forgetfulness do not have AD. In the early stage of AD, people may have trouble remembering recent events, activities, or the names of familiar people or things.

Symptoms – cont’d People may not be able to solve simple math problems. Such difficulties may be a bother, but usually they are not serious enough to cause alarm. As the disease progresses, symptoms are more easily noticed and serious enough to cause people with AD or their family to seek help. Forgetfulness begins to interfere with daily activities.

Symptoms – cont’d People in the middle stages of AD may forget how to do simple tasks like brushing their teeth or their hair. They can no longer think clearly. They can fail to recognize family and places. They begin to have problems speaking, understanding, reading or writing. Later on, they may become anxious or aggressive. Eventually, patients need total care.

What Causes AD? Probably not a single cause. Age is the most important known risk factor for AD. The number of people with disease doubles every 5 years beyond age 65. Family history or genetics may play a role in AD. Early onset familial AD, a rare form of AD that usually occurs between the ages of 30 and 60 is inherited. More common form is late onset.

Causes – cont’d No obvious inheritance pattern is seen in most families. Although, several risk factor genes may interact with each other and with non-genetic factors to cause the disease. Only risk factor gene identified so far for late onset AD is a gene that makes one form of a protein called apolipoprotein E. Everyone has ApoE, which helps carry cholesterol in the blood.

Seven Warning Signs of AD Asking the same questions over and over again Repeating the same story, word for word, again and again. Forgetting how to cook, or how to make repairs, or how to play cards (activities that were previously done with ease and regularity). Losing one’s ability to pay bills or balance one’s checkbook. Getting lost in familiar surroundings, or misplacing household objects. Neglecting to bathe, or wearing the same clothes over and over while insisting that they have taken a bath or that their clothes are clean. Relying on someone else, such as a spouse, to make decisions or answer questions they previously would have handled themselves.

How Many Americans Have AD? Scientists think that up to 4.5 million Americans suffer from AD. Disease begins after age 60 and risk goes up with age. Younger people do have AD, but it is much less common. About 5% of men and women ages 65 AD and nearly ½ of those age 85 and older may have the disease. AD is not a normal part of aging.

How Long Can a Person Live with AD? AD is a slow disease, starting with mild memory problems and ending with brain damage. The course the disease takes and how fast changes occur differ from person to person. On average, AD patients live from 8 to 10 years after they are diagnosed, though the disease can last for as many as 20 years.

How is AD Diagnosed? Today, the only definite way to diagnose AD is to find out whether there are plaque and tangles in brain tissue. To look at brain tissue, the patient must already be dead. Therefore, doctors can only make a diagnoses of “possible” or “probable” AD while the person is still alive.

Diagnosis At specialized centers, doctors can diagnose AD correctly up to 90% of the time. They use several tools to diagnose “probable” AD: –Questions about the person’s general health, past medical problems, ability to carry out daily activities; –Tests to measure memory, problem solving, attention, counting, –Medical Tests such as tests of blood, urine, or spinal fluid –Brian scans

Treatments There is not a treatment available that can STOP Alzheimer’s. Drugs are available, however, for people in the early and middle stages of the disease that may help to prevent some symptoms from becoming worse for a limited time (Cognex, Aricept, Exelone, Razadyne) Some medications are available to control behavioral symptoms of AD such as sleeplessness, agitation, wandering, anxiety, and depression.

Potential New Treatments Neuroimaging: AD Neuroimaging Initiative (ADNI)—is a large study that will determine whether magnetic resonance imaging (MRI) and positron emission tomography (PET) scans, or other imaging or biological markers, can see early AD changes or measure disease progression.AD Neuroimaging Initiative (ADNI) The NIA is sponsoring the AD Genetics Study to learn more about risk factor genes for late onset AD.AD Genetics Study

Treatments, cont’d: Antioxidants: Several years ago, a clinical trial showed that vitamin E slowed the progress of some consequences of AD by about 7 months.

How can family help patient? Get involved with local organizations that serve Alzheimer’s community Learn about programs and services available in community Join a support group for caregivers, or participate in Internet support networks. Ask your doctor to help locate services appropriate to your loved one or ask for recommended programs Visit local library or book store for information