Alzheimer's Disease

Common Name: Alzheimer's Disease, AD, Senile dementia/Alzheimer's type (SDAT)

Age of Onset: The prevalence of Alzheimer's disease increases with age. AD is most prevalent in people older than 60 years old. However there are a few forms of familial early-onset Alzheimer’s disease can appear as early as in the victim's 30s, but this represents a subgroup of the less than 10% of all familial cases of Alzheimer’s disease.

Duration: Patients can live for many years with Alzheimer's and 20 years or more from the time of diagnosis. After the onset of symptoms, the average length of time for the victim is 4 - 8 years.

Males/Females/Equal: Although AD affects both men and women, studies have shown that Alzheimer's is significantly higher in women than in men.

Particular Ethnic Group: Alzheimer's Disease does not affect a certain ethnic or racial group, and more evidence would have to be collected and obtained in order to make such otherwise conclusions. Studies however do show that African Americans are more likely to develop Alzheimer's than Caucasians, but additional studies have shown that the quality of education and socioeconomic factors that affect a person's access to an education could explain this discrepancy.

Cause: Alzheimer's Disease does not have a singular, proven, determined cause. Instead, the theory that scientists believe is that it may take a combination of genetic, lifestyle and environmental factors to trigger the onset of such diverse symptoms. While the causes of AD are not understood, the physiology of AD and its effect on brain tissue is clear. Alzheimer's disease damages and kills brain cells in 2 ways:

1. Plaques- clumps of a normally harmless protein called beta-amyloid may interfere with communication between brain cells. Evidence suggests that the abnormal processing of beta-amyloid protein, maybe a significant cause of Alzheimer's Disease.
2. Tangles- the internal support structure for brain cells depends on the normal functioning of a protein named tau. In people with Alzheimer's, threads of tau protein undergo alterations that cause them to become twisted---which could lead to the neuron deterioration.

Symptoms: Although Alzheimer's is a progressive disease and affects individuals at different rates, the symptoms grows intolerably worse over time, such as:

• gradual loss of short-term memory
• anxiety, suspiciousness, agitation
• confusion
• difficulties with activities of daily living, such as dressing and bathing
• difficulty recognizing family and friends
• forgetting how to use simple, ordinary things like a fork or brush or pencil
• inability to recognize objects
• social withdrawn
• loss of appetite, weight loss
• routinely misplace things, by placing them in illogical places
• loss of bladder or bowel control
• problems finding or speaking the right word
• loss of speech
• repetitive speaking or actions
• sleep disturbances
• total dependence on a caregiver
• wandering and pacing

Prognosis (progression of the disease): Although "neurofibrillary tangles" (twisted fragments of protein within nerve cells that clog up the cell), "neuritic plaques" (abnormal clusters of dead and dying nerve cells, other brain cells, and protein), and "senile plaques" (areas where products of dying nerve cells have accumulated around protein) are found in the brains of most elderly people, victims suffering from Alzheimer's have many more of these changes present on their brain masses. These tangles and plagues lead to the destruction of neurons, which leads to a decrease in neurotransmitters; thus upsetting the brain's critical balance of neurotransmitters. By causing both structural and chemical problems in the brain, AD appears to disconnect areas of the brain that normally work together. These disconnections lead to the numerous mental and behavioral symptoms associated with AD; ultimately most AD victims die of infection.

Treatment Options (Rx): As of right now there is no cure for Alzheimer's disease. Doctors will sometimes choose the approach of treating and lessening Alzheimer's many symptoms, such as anxiety, depression, wandering, sleeplessness, and agitation, by prescribing drugs to improve these signs and symptoms. Doctors also often times prescribe one of only two varieties of medications to slow the cognitive decline with Alzheimer's Disease.

1. Cholinesterase inhibitors: medications that improve the levels of neurotransmitters in the brain, which includes donepezil (Aricept), rivastigmine (Exelon) and galantamine (Razadyne). These medications do not work for everyone, for 50% show no improvement. Some patient quit taking these drugs because of the side effects, which include diarrhea, nausea and vomiting.
2. Memantine (Namenda): protects brain cells from damage caused by the chemical messenger glutamate and sometimes used with a cholinesterase inhibitor. Memantine's most common side effect is dizziness, but other side effects include increased agitation and delusional behavior.

Doctors also have to take into account the family of the victim with AD because modes of caregiving affect the entire family. Relaxation is an important approach and aim for the caregiver, and exercises such as massages, walks, breathing techniques, and calming music can improve sleep, ease anxiety, and improve the victim's overall behavior.

Links:

• http://www.alz.org/alzheimers_disease_alzheimers_disease.asp
• http://emedicine.medscape.com/article/1134817-overview
• http://www.topnews.in/health/files/alzheimers-brain.jpg
• http://www.dshs.state.tx.us/alzheimers/qanda.shtm
• http://www.mayoclinic.com/health/alzheimers-disease/DS00161
• http://health.nytimes.com/health/guides/disease/alzheimers-disease/overview.html