Alzheimer\'s Disease Is a Neuro-Degenerative

Alzheimer's disease is a neuro-degenerative disorder that currently affects close to 4 million people in the United States (National Institutes of Health). By 2025, the number of Alzheimer's cases is expected to increase by 44% in the United States (Alzheimer's Association, Fact Sheet). From the onset of symptoms, Alzheimer's disease can last from 30 to 20 years (Alzheimer's Association, Alzheimer's).

There are two main types of Alzheimer's disease: familial Alzheimer's, and sporadic Alzheimer's. Genes are directly linked in cases of familial Alzheimer's disease. Most cases of familial Alzheimer's occur before the age of 60, while cases of sporadic Alzheimer's mostly occur after the age of 60. Sporadic Alzheimer's disease is not linked to genes. In familial Alzheimer's disease, individuals have a mutation or abnormal variation out of one of three genes: PS1, PS2, and APP. There is a 50% chance that an individual with 1 of these genes will pass the gene onto their children. All of these three genes influence the production of beta amyloid protein, which is seen in beta amyloid plaques in the brains of Alzheimer's patients (Alzheimer's Association, Facts About). In approximately 10% of Alzheimer's cases there is a genetic link (Alzheimer's Association, Alzheimer's).

One of the greatest risk factors for Alzheimer's is age. For every 5-year age group beyond 65 years, the number of Alzheimer's patients doubles (National Institutes of Health). In addition to age, other risk factors for Alzheimer's disease include heredity, environment, head injury, degree of mental activity, hormone replacement therapy, high blood pressure, and high cholesterol (Mayo Clinic).

A mild cognitive impairment (MCI) is often one of the earliest signs of Alzheimer's disease. MCI is characterized by mild changes in orientation, concentration, and memory. It is important to consider however, that all individuals with MCI do not necessarily develop Alzheimer's (Bennett).

Alzheimer's disease brings high financial and personal costs. It costs $18,400 and $36,100 to care for an individual of Alzheimer's disease (National Institutes of Health). Caregivers of those with Alzheimer's disease often suffer from high stress, and feelings of depression and helplessness (Mace and Rabins).

Effects

Individuals with Alzheimer's disease display many symptoms of dementia. Symptoms include loss of reason, memory, judgment and language. In later stages, Alzheimer's can be completely debilitating (National Institutes of Health). The disease is often characterized by changes in personality and mood, loss of initiative, loss of learning and abstract thinking, difficulty performing familiar tasks, and disorientation (Alzheimer's Association, Alzheimer's). Early symptoms of Alzheimer's disease are often simply misinterpreted as a mild form of dementia (Seroksa).

Physical changes in the brain that occur as a result of Alzheimer's disease lead to personality and mood changes. These can include disorientation, and loss of functioning that is severe enough to lead to the complete loss of independent living (Mace and Rabins).

Given that Alzheimer's is degenerative disease, the disease progresses from early mild stages, to moderate stages, to severe stages. In early mild stages, individuals can often function relatively normally, with some mild disabilities in memory and behavior. However, late severe stages are often characterized by a virtually complete loss of memory, a bizarre behavior, and the inability to care for oneself. In later stages, all individuals with Alzheimer's disease require care (Mace and Rabins).Half of individuals with Alzheimer's are cared for in the home, and the rest are treated in different care facilities (National Institutes of Health).

Biological Causes

In Alzheimer's disease, there is a disruption in normal communication, repair, and metabolism within brain cells (neurons). These brain cells eventually lose their connections with other neurons, and die. It is this neuronal death that causes personality changes, memory failure, and other symptoms of Alzheimer's disease (National Institutes of Health).

Alzheimer's is characterized by the presence of beta-amyloid plaques and neurofibrillary tangles in the brain. These plaques in tangles are more prevalent in areas of the brain that are important in memory. Although many older people show evidence of plaques in tangles, they are more prevalent in Alzheimer's patients. However, it is unclear whether plaques in tangles are a byproduct of Alzheimer's disease, or whether they themselves cause the disease (National Institutes of Health).

Treatment

There is no known cure for Alzheimer's disease. Thus, current medications to treat the disease are designed to slow the disease, and lesson symptoms and signs. A number of medications are available, including Donepezil (Aricept), Rivastigamine (Exelon), Galantamine (Reminyl), memantine (Namenda), and Tacrine (Cognex). Donepezil (Aricept) acts by increasing neurotransmitter levels in the brain, and is the most effective in treating mild to moderate symptoms. Rivastigamine (Exelon) lessens symptoms by blocking the breakdown of neurotransmitters. Galantamine (Reminyl) improves behavior and cognition. Tacrine (Cognex) has been on the market since 1993, and is used to treat mild to moderate Alzheimer's. However, Tacrine has a number of serious side effects, which include possible liver damage. Memantine (Namenda) was approved by the Food and Drug Administration in 2003, and is indicated for moderate to severe Alzheimer's (Mayo Clinic).

Alzheimer's disease can be treated with some success using complementary medicines. Vitamin E and aromatherapy have shown some limited success in treatment, but there is no current evidence that shows the herb ginkgo is effective in treating Alzheimer's (Mayo Clinic).

While a number of medications and alternative medicines are available for treating Alzheimer's, perhaps the most effective approach is prevention and screening. Shankle and Amen recommend annual memory screening for people over 50 years of age (Shankle and Amen).

The Ronald Reagan Alzheimer's Breakthrough Act of 2004 is expected to go long way towards improving research and treatment in Alzheimer's. The act, named after former U.S. President Ronald Reagan (who suffered from Alzheimer's disease), will increase funding for the National Institutes of Health (NIH), spur a National Summit on Alzheimer's Disease, and codify existing Alzheimer's research programs into law (Office of Legislative Policy and Analysis).

Conclusion

In conclusion, Alzheimer's is a degenerative disease of the brain that has a profound impact on behavior and memory. Primarily a disease of individuals over 65 years of age, Alzheimer's impacts the significant portion of the population, either directly or indirectly. While the cause of Alzheimer's disease is unknown, and there is no cure, ongoing research and new treatments are improving the outlook for those with Alzheimer's.

Annotated Bibliography

Source: National Institutes of Health. Unraveling the Mystery. 09 November 2004. http://www.alzheimers.org/unraveling/unraveling.pdf

Type of information: This booklet describes the causes, incidence, symptoms and treatment of Alzheimer's disease, and gives an overview of how Alzheimer's impacts the brain

Specific Detail: 1. A little over half of individuals with Alzheimer's are cared for in the home, and the rest are treated in different care facilities.

2. The annual cost of caring for a person with Alzheimer's disease is between $18,400 and $36,100, based on 1996 figures.

3. The total cost of caring for individuals with Alzheimer's disease in the United States is approximately $100 billion per year.

4. Alzheimer's disease is characterized by the presence of beta-amyloid plaques and neurofibrillary tangles in the brain, especially those areas important in memory.

Alzheimer's disease affects entorhinal cortex, and the cerebral cortex, and severe cases show the presence of beta-amyloid plaques and neurofibrillary tangles throughout the brain.

Source Rating: 5. This is an excellent source for general information on Alzheimer's Disease. It is well-written and accessible for a general audience, but contains a thorough overview of the subject.

Source: Office of Legislative Policy and Analysis. The Ronald Reagan Alzheimer's Breakthrough Act of 2004. http://olpa.od.nih.gov/legislation/108/pendinglegislation/reagonalzheimer.asp

Type of information: This source gives a legislative update of the Ronald Reagan Alzheimer's Breakthrough Act of 2004, and the general overview of all summer's disease.

Specific Detail: 1. President Ronald Reagan had Alzheimer's disease.

2. Ronald Reagan's experience with Alzheimer's disease brought a great deal of attention to the disease, and resulted in the Ronald Reagan Alzheimer's Breakthrough Act.

3. In the next 50 years, the number of Alzheimer's inpatients will triple unless a cure is developed.

4. Almost half of people over 85 suffer from Alzheimer's disease.

5. The Ronald Reagan Alzheimer's Breakthrough Act will double funding for the National Institutes of Health, an increase research programs.

Source Rating:

Alzheimer's Association. ALZHEIMER'S DISEASE and RELATED DEMENTIAS FACT SHEET. 09 November 2004. http://www.alz.org/Resources/FactSheets/factrelateddisorder.pdf

Type of information: This is a good resource that examines Alzheimer's Disease and other causes of dementia.

Specific Detail: 1. Dementia is not a disease in and of itself, and simply refers to a set of symptoms that is common to a number of diseases, including Alzheimer's.

2. Dementia can be defined as "loss of mental function in two or more areas such as language, memory, visual and spatial abilities, or judgment severe enough to interfere with daily life."

3. A number of other diseases and conditions cause or mimic dementia, including Parkinson's disease, Pick's disease, depression, tumors, and infections.

4. Alzheimer's impacts as many as 4 million Americans.

5. Alzheimer's is a degenerative disease of the brain.

Source Rating: 3. A good general resource on dementia, with limited information on Alzheimer's that is easily found elsewhere.

Source: Alzheimer's Association. Fact Sheet, 2004: Alzheimer's Disease growth: The U.S. will see average 44% increase in Alzheimer's disease by 2025.

Type of information: This fact sheet describes the potential for growth in cases of Alzheimer's disease in the first quarter of this century.

Specific Detail: 1. Southeastern and Western states will see the largest increases in Alzheimer's through 2025.

2. U.S. Census data notes that the number of Americans age 65 and over will double by 2025

3. Utah will see a 127% increase in Alzheimer's disease, Alaska hundred and 26% increase, the Colorado will see 124% increase.

4. Only the District of Columbia, Pennsylvania, and Rhode Island will not see an increase in Alzheimer's disease.

5. Close to 7.7 million people are estimated to have Alzheimer's disease by the year 2025.

Source Rating: 3. At dependable source for information on increases of Alzheimer's disease.

Source: Alzheimer's Association. Facts About Genes and Alzheimer's disease. 09 November 2004. http://www.alz.org/grtrcinc/aaWhatGeneticTesting.htm

Type of information: A great overview of Alzheimer's disease and genetics. This article includes information on familial and sporadic Alzheimer's, genes, genetic testing, and a section on additional resources.

Specific Detail: 1. Family history is a risk factor for Alzheimer's Disease.

2. Genes are made up of DNA, and are the instructions that determine the body's composition.

3. Familial Alzheimer's Disease is caused by genetic disorders.

4. Sporadic Alzheimer's Disease is not caused by genes, but genes may play a role in the change that someone will get Alzheimer's.

5. A gene mutation in the APEO gene (APOE-e4) is the best-studied gene linked to Alzheimer's.

Source Rating: 4. This is a good overview of Alzheimer's and genetics.

Source: Bennett, David a. Alzheimer's Early Stages: First Steps for Family, Friends, and Caregivers. Hunter House, 2003.

Type of information:

Bennett's book is aimed at caregivers of those with Alzheimer's disease. It provides valuable and accurate information on the disease, and tips for caregivers on how to deal with those with Alzheimer's.

Specific Detail: 1. We should not resign ourselves to mental and physical decline seen simply as a symptom of old age.

2. Often, reports of absent-mindedness in older people are exaggerated.

3. A mild cognitive impairment (MCI) is simply a mild decline in brain functions like concentration, orientation, and memory.

4. A mild cognitive impairment can be one of the first early signs of Alzheimer's disease.

5. Alzheimer's can dramatically impact family relationships.

Source Rating: 4. A great resource for individuals whose family members are entering the first stage of Alzheimer's disease.

Source: Mace, Nancy L., and Rabins, Peter V. The 36-Hour Day: A Family Guide to Caring for Persons With Alzheimer Disease Related Dementing Illnesses, and Memory Loss in Later Life. Warner Books, 2001.

Type of information: This book gives a thorough review of the personal impact of Alzheimer's Disease.

Specific Detail: 1. Dementia can include Alzheimer's disease, vascular dementia, or other diseases or conditions.