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What is Alzheimer’s disease (AD)?

Alzheimer’s disease (AD) is the most common form of dementia (a brain disorder that seriously affects a person’s ability to carry out daily activities) among older people. It involves the parts of the brain that control thought, memory, and language.

What are the Symptoms of AD?

AD begins slowly. At first, the only symptom may be mild forgetfulness. People with AD may have trouble remembering recent events, activities, or the names of familiar people or things. Simple math problems may become hard to solve. Such difficulties may be a bother, but usually they are not serious enough to cause alarm

What Causes AD?

Age is the most important known risk factor for AD. The number of people with the disease doubles every 5 years beyond age 65. Family history is another risk factor. Scientists believe that genetics may play a role in many AD cases. For example, familial AD, a rare form of AD that usually occurs between the ages of 30 and 60, can be inherited. However, in the more common form of AD, which occurs later in life, no obvious family pattern is seen. One risk factor for this type of AD is a protein called apolipoprotein E (apoE). Everyone has apoE, which helps carry cholesterol in the blood. The apoE gene has three forms. One seems to protect a person from AD, and another seems to make a person more likely to develop the disease. Other genes that increase the risk of AD or that protect against AD probably remain to be discovered.

Areas affected

AD is named after Dr. Alois Alzheimer, a German doctor. In 1906, Dr. Alzheimer noticed 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, these plaques and tangles in the brain are considered hallmarks of AD. Scientists also have found other brain changes in people with AD. There is a loss of nerve cells in areas of the brain that are vital to memory and other mental abilities. There also are lower levels of chemicals in the brain that carry complex messages back and forth between nerve cells. AD may disrupt normal thinking and memory by blocking these messages between nerve cells

How is AD Diagnosed?

Today, the only definite way to diagnose AD is to find out whether there are plaques and tangles in brain tissue. To look at brain tissue, doctors must wait until they do an autopsy, which is an examination of the body done after a person dies. Therefore, doctors must make a diagnosis of possible or probable AD.

How long can a person live with AD?

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. 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.

Ten Warning signs are:

1. Recent memory loss that affects job skills.
2. Difficulty performing familiar tasks
3. Problems with language
4. Disorientation of time and place
5. Poor or decreased judgment
6. Problems with abstract thinking
7. Misplacing things
8. Changes in mood or behavior
9. Changes in personality
10. Loss of initiative

Ten Ways to Help an Alzheimer Family

1. Keep in touch. Maintain contact with family members. It’s a simple, yet important way to show you care.
2. Do little things — they mean a lot. If you’re on your way out to do an errand, check with a family member to see if there’s anything they need.
3. Give them a break. All caregivers need a little time for themselves. Offer to stay with the Alzheimer person so family members can run errands, attend a support group meeting, or take a short trip
4. Be specific when offering assistance. Figure out what you can do, and then dedicate some time on a weekly or monthly basis to help the family tackle some of these tasks.
5. Be alert. Learn about Alzheimer’s disease and how it impacts the family. Know how to recognize a problem and respond. Take time to learn about other common behaviors and helpful care techniques.
6. Provide a change of scenery. Plan an activity that gets the whole family out of the house. Make a reservation at a restaurant and ask for a table with some privacy. Be sure to include the person with Alzheimer’s, if the caregiver feels it is appropriate.
7. Learn to listen. Be available when the caregiver is free to talk without interruptions. You don’t need to provide all the answers, just be a compassionate listener. Try not to question or judge, but rather, support and accept.
8. Care for the caregiver. Encourage caregivers to take care of themselves. Pass along useful information and offer to attend a support group meeting with them.
9. Remember all family members. The person with Alzheimer’s will appreciate your visits, even if unable to show it. Talk with the person the way you’d want to be talked to.
10. Get involved. There are many things you can do to help families today and prevent further devastation tomorrow. Make a difference.

Tau theory of AD

In this theory, tau deforms and loses its ability to support the cell, eventually aggregating into neurofibrillary tangles-the other hallmark Alzheimer brain lesion. Although no therapies targeting tau have reached clinical trials, many experts remain convinced that understanding tau will reveal crucial clues about Alzheimer’s devastating effects on nerve cells as well as chemical steps vulnerable to intervention.

Reference

Edwards, J., Handy, R., Lancaster, M., Turnbull, J. & Mosby (1998) Alzheimer’s disease: A Handbook for Caregivers

Fleiger, K. (1992) Despite New Clues, Alzheimer’s Mystery Remains Unsolved. FDA Consumer, Vol. 26

Knopman, D.S. (1998) Current pharmacotherapies for Alzheimer’s disease Geriatrics Sep; 53 Suppl 1: s31-4.

Small, G.W. (1998) Treatment of Alzheimer’s disease: current approaches and promising developments. American

Journal of Medicine, Apr 27; 104 (4A): 32s-38s, discussion 39s-42s.

Useful Websites

http://www.alzheimers.org/

http://www.psych.org/public_info/alzheim.cfm

http://www.ahaf.org