Alzheimer's Disease

The most common form of dementing illness, Alzheimer's Disease (AD) is a progressive, degenerative disease that attacks the brain, causing impaired memory, thinking and behavior. The person with AD may experience confusion, personality and behavior changes, impaired judgment, and difficulty finding words, finishing thoughts or following directions. It eventually leaves its victims incapable of caring for themselves.

The nerve cells in the part of the brain that controls memory, thinking, are damaged, interrupting the passage of messages between cells. The cells develop distinctive changes that are called neuritic plaques (clusters of degenerating nerve cell ends) and neurofibrillary tangles (masses of twisted filaments which accumulate in previously health nerve cells). The cortex (thinking center) of the brain shrinks (atrophies), The spaces in the center of the brain become enlarged, also reducing surface area in the brain.

Alzheimer's Disease is a dementing illness which leads to loss of intellectual capacity. Symptoms usually occur in older adults (although people in their 40s and 5Os may also be affected) and include loss of language skills -- such as trouble finding words, problems with abstract thinking, poor or decreased judgment, disorientation in place and time, changes in mood or behavior and changes in personality. The overall result is a noticeable decline in personal activities or work performance.

Alzheimer's Disease knows no social or economic boundaries and affects men and women almost equally. The disease strikes older persons more frequently, affecting approximately 10% of Americans over age 65 and 47% of those over age 85.

The cause of Alzheimer's Disease is not known. Researchers are investigating suspected causes such as neurological damage, chemical deficiencies, viruses, genetic abnormalities, environmental toxins and malfunctions in the body's disease defense systems.

There is a slightly increased risk that children, brothers, and sisters of patients with Alzheimer's Disease will get it, but most cases are the only ones in a family. Some patients who develop the disease in middle age (called early onset) have a "familial" type -- more than one case in the family. It is important to note that AD can only be definitively diagnosed after death through autopsy of brain tissue. Thirty percent of autopsies turn up a different diagnosis. Families are encouraged to ask for an autopsy as a contribution to learning more about the genetics of AD.

Presently, there is no definite cure or treatment for Alzheimer's Disease. Unfortunately, there are many unscrupulous individuals who market so-called "cures." These treatments are often expensive and they don't cure AD. However, since senility is such a scary problem and because families are desperate to find help for loved ones, these bogus treatments continue to sell. Most of them have no scientific proof of effectiveness.

There is no single clinical test for Alzheimer's Disease. It is diagnosed by ruling out all other curable or incurable causes of memory loss. A positive diagnosis of Alzheimer's Disease can only be made by microscopically studying a small piece of brain tissue after death. The cerebral cortex of an Alzheimer brain will have characteristic abnormalities -- cells marred by plaques and tangles. However, a working diagnosis can be made through various testing procedures that include a thorough physical as well as neurological and psychological examinations.

People diagnosed with Alzheimer's Disease may live from two to 20 years after the onset of memory loss symptoms. It shortens one's expected life span, but given appropriate care and medical attention, patients often survive for many years at home or in a nursing home. Death can't usually be predicted until the very terminal stages. It is common for patients in terminal-stage Alzheimer's to lose weight, and to have difficulty swallowing, controlling bladder and bowels, walking and speaking. They may curl into a fetal position. Alzheimer victims often succumb to a series of repeated infections such as bladder infections or pneumonia.

Alzheimer's afflicts approximately 4 million Americans and it's estimated that one in three of us will face this disease in an older relative. More than 100,000 die annually, making Alzheimer's Disease the fourth leading cause of death among adults. Half of all current nursing home patients are affected, making AD a costly public health and long term care problem. An estimated $80 billion is spent annually on the care of AD, including costs diagnosis, treatment, nursing home care, at-home care and lost wages. Alzheimer's also affects the patient's caregivers, who become the second victims. Persons with AD often require 24-hour care and supervision, most of which is provided in the home by family and friends. In addition to the tremendous stress of providing care, families also bear most of the financial burdens of the disease as well.

Benign, or normal, forgetfulness is part of the normal aging process and usually begins in early middle age. Most people have some experience forgetting names, appointments or where they left their keys. However, normal forgetfulness differs from Alzheimer's Disease in some very important ways. The Alzheimer patient will frequently become lost in familiar surroundings; forget names of familiar people; have problems handling money; forget how to dress, read or write; and lose the ability to use the tools of daily living such as a key or radio.