What is Alzheimer's disease?

 

                 ALZHEIMER'S DISEASE: AN OVERVIEW

                  What is Alzheimer's disease?

     Alzheimer's disease (pronounced Altz-hi-merz) is a

progressive, degenerative disease that attacks the brain and

results in impaired memory, thinking and behavior.  It affects an

estimated 2.5 million American adults.

     When it was first described by German physician Alois

Alzheimer in 1907, Alzheimer's disease was considered a rare

disorder.  Today, it is recognized as the most common cause of

dementia.

     Dementia is not a disease itself but a group of symptoms

that characterize certain diseases and conditions.  In the case

of Alzheimer's disease, the dementia includes a decline in

intellectual functioning that is severe enough to interfere with

the ability to perform routine activities.

     The second most common form of dementia is multi-infarct

dementia, which is caused by vascular disease and strokes.  Other

causes of dementia are Huntington's disease, Parkinson's disease,

Pick's disease and Creutzfeldt-Jakob disease.

     There also are a number of conditions that cause dementia-

like symptoms:  depression, drug reactions, thyroid disorders,

nutritional deficiencies, brain tumors, head injuries,

alcoholism, infections (meningitis, syphilis, AIDS) and

hydrocephalus.

     Alzheimer's disease is distinguished from other forms of

dementia by characteristic changes in the brain that are visible

only upon microscopic examination.  

     At autopsy, Alzheimer's disease brains show the presence of

tangles of fibers (neurofibrillary tangles) and clusters of

degenerating nerve endings (neuritic plaques) in areas of the

brain that are important for memory and intellectual functions.

     Another characteristic of Alzheimer's disease is the reduced

production of certain brain chemicals, especially acetylcholine

and somatostatin.  These chemicals are necessary for normal

communication between nerve cells.

             Who is affected by Alzheimer's disease?

     Alzheimer's disease is more likely to occur as a person gets

older.  Although less than one percent of people age 65 are

affected by Alzheimer's disease, it is present in an estimated 25

percent of those age 85 or older.  Alzheimer's disease can occur

in middle age as well.  The youngest documented case is that of a

28-year-old individual.

     Alzheimer's disease also affects the family of an Alzheimer

patient.  The emotional, social and financial costs of caring for

an Alzheimer patient are high.  Family members also often risk

their own health in order to care for the Alzheimer patient at

home.  

                     What are the symptoms?

     Alzheimer's disease has a gradual onset.  Symptoms include

difficulty with memory and loss of intellectual abilities severe

enough to interfere with routine work or social activities.  The

Alzheimer patient also may experience confusion, language

problems (such as trouble finding words), poor or decreased

judgment, disorientation in place and time and changes in

behavior or personality.

     How quickly these changes occur in an Alzheimer patient will

vary from person to person.  Eventually, the disease leaves its

victims totally unable to care for themselves.  The course of the

disease averages eight years from the time symptoms first appear,

although Alzheimer's disease has been known to last as long as 25

years.

             How is Alzheimer's disease diagnosed?

     At this time, there is no single diagnostic test for

Alzheimer's disease.  A complete physical, psychiatric and

neurologic evaluation by a physician experienced in the diagnosis

of dementing disorders should be obtained when symptoms are

noticed.

     The examination should include a detailed medical history,

mental status test, neuropsychological testing, blood work,

urinalysis, chest x-ray, electroencephalography (EEG),

computerized tomography (CT scan) and electrocardiogram (EKG). 

Such an evaluation is essential to determine whether the dementia

is the result of a treatable illness.

     When this kind of a detailed examination is done, the

accuracy of diagnosis is about 90 percent.  However, the only way

to confirm a diagnosis of Alzheimer's disease is to examine brain

tissue under a microscope.

                What causes Alzheimer's disease?

     Scientists are still looking for the cause of Alzheimer's

disease, and their research is pointing in several directions.

     For one form of the disease called Familial or Uncommon

Alzheimer's Disease, there is strong evidence that a defect

exists in a single gene on Chromosome 21.

     However, for most Alzheimer's disease patients the genetic

involvement is less clear.  Although there does seem to be a

genetic predisposition for the disease, other factors influence

whether or not an individual develops Alzheimer's disease.

     Scientists continue to explore the importance of such things

as a slow virus; environmental toxins, such as aluminum; and

   other physical conditions of an individual that may interact with

the genetic defect.

                  Is Alzheimer's disease fatal?

     Although Alzheimer's disease is associated with a shortened

lifespan, the slow, progressive nature of the disease often means

the patient will live for several years after diagnosis.

     Alzheimer's disease eventually leaves the patient physically

less resistant to infections, such as pneumonia, which may be

fatal.  In addition, Alzheimer's disease generally affects an

older population that is subject to other chronic illnesses, and

those illnesses, too, may often be the cause of death.

          Can Alzheimer's disease be treated or cured?

     At this time, there is no treatment or cure available to

stop or reverse the mental deterioration of Alzheimer's disease. 

However, new research findings give reason for hope.  Several

drugs used to relieve the symptoms of memory loss are in clinical

trials.

     Other medications are available now to assist in managing

some of the most troubling symptoms of Alzheimer's disease. 

Under a doctor's supervision, medication can be used to control

depression, behavioral disturbances and sleeplessness.

              Can Alzheimer's disease be prevented?

     Prevention is not possible at this time because the cause of

the disease is not known.  However, advances in science are

bringing us closer to answers that can lead to treatments and/or

strategies for prevention.  Meanwhile, focus on improved care and

support for the caregiver are helping to ease the burden of

Alzheimer's disease.

    Is there help for people affected by Alzheimer's disease?

     The Alzheimer's Association is the only national voluntary

organization dedicated to providing support and assistance to

Alzheimer patients and their families.  The Alzheimer's

Association is continuing research into the cause, treatment and

cure of Alzheimer's disease, as well as ways to improve the care

and management of current Alzheimer patients.

     The Alzheimer's Association has more than 1,200 support

groups and 190 Chapters nationwide.  For more information on

Alzheimer's disease and the Alzheimer's Association or to

volunteer in the fight against Alzheimer's disease, call the

Association's toll-free number for the location of the Chapter

nearest you.

                            Glossary

  Dementia -- This is not a disease in itself but a group of

symptoms that characterize certain diseases and conditions.  The

major symptoms involve a decline in intellectual functioning that

is severe enough to interfere with routine activities. 

Alzheimer's disease is the most common form of dementia.

  Senility -- This label often was used to describe an individual

65 years or older with dementia.  Senility used to be considered

a normal part of aging.  Today, physicians recognize that

dementia is not a normal part of aging but the result of a

disease such as Alzheimer's disease.

  Senile dementia/pre-senile dementia -- Senile dementia is a label

that used to apply to patients whose symptoms of dementia

appeared after age 65.  Pre-senile dementia is a label that used

to apply to dementia victims who were younger than age 65.  These

distinctions have largely been eliminated.  Today, most cases of

dementia in both groups of patients are diagnosed as Alzheimer's

disease.

  Chronic organic brain syndrome -- This label is sometimes given

to patients with a collection of symptoms such as memory loss,

disorientation, confusion, personality changes and inability to

carry out normal daily activities.  The preferred term for these

symptoms is dementia or dementing illness.

  Hardening of the arteries -- The correct medical term is

arteriosclerosis.  The dementia symptoms associated with

arteriosclerosis result only when multiple cerebral infarcts

(strokes) have occurred.  This condition is called multi-infarct

dementia.

     This brochure is one of a series made available by the

Alzheimer's Association with underwriting from American Contract

Bridge League, Louis N. Cassett Foundation, the Coca Cola

Foundation, Ittleson Foundation, Inc., and Million Dollar Round

Table Foundation.