The Many Faces of Dementia: Definition of Alzheimer’s
January 29, 2013
Editors Notes: This is the first of four articles designed for those who want a more in-depth understanding of Alzheimer's disease. The series will run every other week in the Healthy Tuesday section. It is reprinted with from permission from the Alzheimer's Foundation of America.
• Alzheimer's disease is a progressive, degenerative disorder that attacks the brain's nerve cells, or neurons, resulting in loss of memory, thinking and language skills, and behavioral changes.
• These neurons, which produce the brain chemical, or neurotransmitter, acetylcholine, break connections with other nerve cells and ultimately die. For example, short-term memory fails when Alzheimer's disease first destroys nerve cells in the hippocampus, and language skills and judgment decline when neurons die in the cerebral cortex.
• Two types of abnormal lesions clog the brains of individuals with Alzheimer's disease: Beta-amyloid plaques—sticky clumps of protein fragments and cellular material that form outside and around neurons; and neurofibrillary tangles—insoluble twisted fibers composed largely of the protein tau that build up inside nerve cells. Although these structures are hallmarks of the disease, scientists are unclear whether they cause it or a byproduct of it.
• Alzheimer's disease is the most common cause of dementia, or loss of intellectual function, among people aged 65 and older.
• Alzheimer's disease is not a normal part of aging.
• Origin of the term Alzheimer's disease dates back to 1906 when Dr. Alois Alzheimer, a German physician, presented a case history before a medical meeting of a 51-year-old woman who suffered from a rare brain disorder. A brain autopsy identified the plaques and tangles that today characterize Alzheimer's disease.
• Clinicians can now diagnose Alzheimer's disease with up to 90 percent accuracy. But it can only be confirmed by an autopsy, during which pathologists look for the disease's characteristic plaques and tangles in brain tissue.
• Clinicians diagnose "probable" Alzheimer's disease by taking a complete medical history and conducting lab tests, a physical exam, brain scans and neuropsychological tests that gauge memory, attention, language skills and problem-solving abilities.
• Proper diagnosis of Alzheimer's disease is critical since there are dozens of other causes of dementia that could exhibit the same symptoms. Some of these dementias, such as those caused by vitamin deficiency, thyroid problems and depression, are reversible; of those that are irreversible, Alzheimer's disease is the most common.
• The sooner an accurate diagnosis of "probable" Alzheimer's disease is made, the easier it is to manage symptoms and plan for the future.
• Alzheimer's disease stretches from 2 to 22 years, and individuals live on average for 8 to 10 years from diagnosis.
• Individuals with Alzheimer's disease are likely to develop co-existing illnesses and most commonly die from pneumonia.
• Alzheimer's disease is the eighth leading cause of death in the U.S.
• Currently, there is no cure for Alzheimer's disease.
• Researchers are continually testing the effectiveness of various drug therapies that will control symptoms; slow, reduce and/or reverse mental and behavioral symptoms; and prevent or halt the disease.
• The U.S. Food and Drug Administration (FDA) has so far approved four drugs for the treatment of mild to moderate Alzheimer's disease. They are tacrine (Cognex®), introduced in 1993; donepezil hydrochloride (Aricept®), marketed since 1996; rivastigmine (Exelon®), available since the spring 2000; and galantamine hydrobromide (RazadyneTM-formerly called Reminyl®), approved in February 2001. These drugs inhibit the enzyme that breaks down the brain chemical acetylcholine, and thereby may help slow the worsening of symptoms.
• The FDA in October 2003 approved memantine HCI (NamendaTM) for the treatment of moderate to severe Alzheimer's disease, which can slow the decline in mental function.
• The National Institute on Aging, in concert with the FDA, tracks private- and government-sponsored clinical trials; contact the Alzheimer's Disease Education and Referral Center (www.alzheimers.org/trials or 800-438-4380).
The Many Face of Dementia articles are submitted by Tor Eckert, who has been involved with Alzheimer's disease and other dementias for nearly eight years including owning an Alzheimer's Care Home. He was designated as a "healthcare professional" by the Alzheimer's Foundation of America in 2008. He has pro-bono public forums and programs – The Many Faces of Dementia. For more information, please contact him at email@example.com