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Alzheimer's On The Rise
September 19, 2003


By Louis Wittig - eCureMe Staff Writer
Physician Reviewed - September 19,2003


According to a study released last month the incidence of Alzheimer's Disease (AD) - the leading cause of dementia in older Americans - is set to nearly triple from 4.5 million this year to 13.2 million by the year 2050. AD is a degenerative, progressive brain disease. Primarily found among the elderly, one in ten of those over age 65 currently have the disease, and almost half of those in the 85 and above age group are afflicted. Despite this, the exact cause of the disease remains elusive.


Tangles and Plaques

What scientists do know is that in Alzheimer's patients, bits of loose nerve endings called Neurofibrillary tangles and a sticky protein substance known as Beta Amyloid form in the brain. The tangles and Beta Amyloid plaques collect around healthy brain cells, and in the process kill them. As a result, entire areas of the brain begin to waste away. Parts of the brain that deal with learning and memory are the first affected, but eventually the wasting affects nearly every area of the brain. Whether these abnormalities cause AD or result from it is not yet known.

What these brain cell changes can do to an individual with AD is quite clear. Early symptoms of AD are quite mild. Individuals simply start to forget more than they used to. It might take them a moment to put names to faces, or remember where they put their car keys. These seemingly innocuous lapses make AD all the more difficult to diagnose, as most will assume they are a natural part of getting older.

Unnoticed, the initial symptoms will grow more severe. AD sufferers will find they are having an increasingly difficult time concentrating, remembering information they have just learned or performing simple mental exercises.

Eventually, individuals will become less aware of their environment and will act accordingly; often wearing pajamas outside, or dressing in shorts in January. Instead of just forgetting where objects are, they'll forget where they should be. They will also become more emotional and be prone to mood swings.

At this stage physicians can make a diagnosis of AD using a series of cognitive tests as well as magnetic resonance imaging (MRI) techniques that can help identify subtle brain changes. Together these allow for 90% accuracy in AD diagnoses.

After diagnosis, Alzheimer's patients live an average of eight years; though some with more gradual cases have been known to live up to 20 years after. During this period, an individual's memory will continue to decline. They may experience hallucinations and delusions as well as increased incontinence. They may also become more suspicious of their surroundings and caregivers and undergo a change in normal sleep cycles. Eventually, as more and more of a patient's brain wastes away, they may lose their ability to speak, walk and swallow. This degeneration can eventually lead to the failure of critical organs and death; however, given the slow progress of the disease, it more often occurs that the patient succumbs to other conditions associated with old age ? such as heart disease.



Risk Factors?

As doctors do not yet know the root cause of AD, risk factors for the condition aren't well-known - especially controllable risk factors. Increasing age is positively connected to an increasing risk of Alzheimer's, as is gender; AD strikes women more often than men. Some research has associated incidence of AD with a history of major head injury or low educational achievement; however the reasons behind both are unknown. Over the past several years, studies have emerged that point a finger at certain chemicals and minerals that can be absorbed into the body through diet - such as aluminum, zinc and Aspartame sweetener. However, the data to support such accusations is inconclusive. Genetics can play a role in AD, but a small one. Less than 1% of AD cases are directly linked to heredity.



The Best Defense...

With uncertain risk factors, easily dismissible symptoms and slow but devastating results AD is hard to guard against. There are a number of drugs on the market that can combat AD once it has begun, such as Cognex, Aricept, Exelon and Reminyl. However, these drugs can only slow the progression of the disease, not stop it and results vary greatly. Ongoing research holds out the promise of more effective treatments, which, given the slow course of the disease, may benefit AD sufferers today; but that could be years away.

In managing your health, preparing for the potential of AD is the most prudent course of action. Eventually, all AD patients require round-the-clock care - either by family members or in a managed-care facility. The cost of that care is not covered by most major insurance plans and can range from $40,000 to $70,000 a year. Even for patients who are cared for by family members, the costs often top $12,500 annually. pTo have those sorts of financial and human resources at hand, should they be necessary, requires forethought. As you age, developing a plan of care for yourself and your loved ones (as well as keeping close tabs on your memory abilities and discussing any unusual lapses with your doctor) ensures that should the explosion in AD touch your family, you will have the preparation in place to make the most of it.



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