Is Alzheimer's Disease?
Michele Simon, JD, MPH
Bennett, MS, CGC
Last updated April 12, 2001
disease is a progressive, degenerative disorder that attacks the brain
and results in disorientation, with impaired memory, thinking, and judgement.
People with Alzheimers also undergo changes in their behavior. This combination
of symptoms is also called dementia.
Who Gets Alzheimer's Disease?
About four million
Americans have Alzheimer's disease, with men and women affected almost
equally. Most people diagnosed with Alzheimer's disease are older than
age 65 and the risk increases with age. However, it can also occur in
people as young as in their 30s. One in ten people over age 65 and nearly
half of those over age 85 have Alzheimer's disease. In a national survey,
19 million Americans said they had a family member with Alzheimer's disease.
The only established
risk factors for Alzheimer's are older age, family history of dementia,
and inheriting mutations
in certain genes.
In most cases, Alzheimer's disease isn't caused by any one factor. Instead,
it is usually a result of genes and environmental factors that researchers
have not yet identified. (For recent news about risk factors for Alzheimer's disease and who develops the disease, see Related News below.)
Are the Signs and Symptoms?
Contrary to what many
people believe, memory loss, confusion, and disorientation are not part
of the normal aging process. The trick is to be able to distinguish normal,
everyday forgetfulness from a disease process that could be Alzheimer's
disease. Symptoms of Alzheimer's disease can include:
in ability to perform routine tasks
in language skills
begins slowly. The first symptoms may only be mild forgetfulness. As the
disease progresses, symptoms become more noticeable. For example, someone
with Alzheimer's may forget how to do simple tasks, such as brushing their
teeth or combing their hair. They no longer think clearly and begin to
have problems speaking, reading, or writing. People with Alzheimer's can also experience drastic changes in personality, mood, or behavior. They can also become extremely confused, suspicious, fearful, or quite passive. Eventually, people with Alzheimer's disease become completely incapable of caring for themselves. (For recent news about signs of Alzheimer's disease, see Related News below.)
Is Alzheimer's Disease Diagnosed?
Symptoms for Alzheimer's
disease can also be caused by other conditions, some of which are treatable.
These include thyroid gland problems, drug reactions, and severe depression.
No single test exists to diagnose Alzheimer's disease, but a series of
tests can rule out other illnesses and help doctors make their diagnosis.
However, the only way to conclusively diagnose Alzheimer's disease is
by examining the brain tissue after death for the brain alterations that
are the hallmark of Alzheimer's disease.
A doctor will conduct
a comprehensive evaluation that will likely include:
and mental assessments
and urine analysis
and chest x-rays
Also, keeping a written
diary of symptoms and behaviors over time will help your health care providers
understand your disease (or the disease of a loved-one). Your doctor may
order additional tests such as computerized tomography
(CT scan) and magnetic resonance imaging (MRI) to
diagnose other possible disorders. In addition, some medical centers are
beginning to offer genetic
testing to individuals with a family history that is suggestive of
Does Alzheimer's Disease Progress?
In people with Alzheimer's disease, changes to nerve fibers accumulate in the brain. These changes reduce the number and effectiveness of nerve cell connections. Short-term memory is affected first, followed by those sections of the brain that control other intellectual and physical functions. The rate of progression in Alzheimer's disease varies with each individual. Some people become rapidly worse, while others remain stable for a long time. Traditionally, researchers believed that people survived an average of 8 years after being diagnosed with Alzheimer's, but a recent study in the New England Journal of Medicine found that the average survival was only about 3.5 years. However, some people have been known to live as long as 20 years after diagosis. When death does come, it usually results from a related infection, such as pneumonia.
Treatment Is Available?
Although there is no cure available for Alzheimer's disease, certain interventions and medication can help treat the symptoms of the disease.
Two FDA-approved drugs
used to treat Alzheimer's disease are tacrine and donepezil. Both of these
drugs help maintain levels of the brain chemical acetylcholine, which
is produced at much lower levels in people with Alzheimer's disease. They
work by suppressing the enzyme that breaks down acetylcholine in the brain.
However, they don't work for everyone and they do have significant side
effects. Additional promising drugs are being developed, some of which
may be available within the next few years.
Also, some medications may help control behavioral problems associated with Alzheimer's disease, such as insomnia, agitation, anxiety, and depression. Proper nutrition, exercise, and stimulating social activities are all important. People with Alzheimer's disease should be in a familiar environment that includes daily routines, maintains links with the outside world, and encourages communication. Effective management of Alzheimer's disease also includes education, counseling, and support for caregivers and other family members. (
For more information about research into Alzheimer's disease treatment, see Related News below.)
McConnell, LM. (1999). Understanding Genetic Testing for Alzheimer's disease:
Medical and Epidemiological Background. Genetic Testing 3(1): 21-27.
National Institutes of Health, Alzheimer's Disease Education and Referral
Wolfson, C. (2001). A Reevaluation of the Duration of Survival After the Onset of Dementia. NEJM 344(15):1111-1116.
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