And I Would Know You From...

And I Would Know You From...

Alzheimer's disease is relentlessly destroying the brains and lives of our nation's older adults, robbing them of memory, the ability to reason, and affecting their emotions and behavior. Alzheimer's disease is a degenerative disorder of the brain. The longer we live the greater the risk: one out of every two Americans aged 85 and older and one out of every 10 aged 65 and older are afflicted with the disease. It affects two groups of people: those with the disease and the loved ones who care for them. According to Doraswamy (1997), by the year 2050, an estimated 14 million Americans will be in its grip.

Alzheimer's disease (AD) is a progressive disease of the brain, which is characterized by a gradual loss of memory and other mental functions (Cutler, Sramek, 1996). Alzheimer's is the most common form of dementia -- a general term referring to loss of memory and the ability to think, reason, function, and behave appropriately. The word dementia is derived from two Latin words, which mean away and mind, respectively (Goldman, 1999). It's different from the mild forgetfulness normally observed in older people. Over the course of the disease, people with AD no longer recognize themselves or much about the world around them.

Alzheimer's is marked by abnormal clumps, called senile plaques, and irregular knots, called neurofibrillary tangles, of brain cells. The plaque is an accumulation of an abnormal protein, amyloid (McGuffey, 1997). One theory regarding the cause of Alzheimer's disease suggests that this plaque forms because the processes that normally operate to clear away this protein have become defective. Neurofibillary tangles are skeins of another abnormal protein, but the tangle is found inside the nerve cells (McGuffey, 1997). The reason why the tangles develop is not known, but the normal processing of protein by the cell seems to be disrupted. These tangles choke the nerve cells and prevent them for working properly. For reasons not well understood, these plaques and tangles take over healthy brain tissue, which devastates the areas of the brain associated with intellectual function.

There are a number of behaviors that may signal that a person might be in the beginning stages of Alzheimer's disease. Here is a list of warning signs: (1) difficulty with familiar tasks, (2) slipping job performance, (3) language difficulties, (4) confusion of place and time, (5) lack of judgment, (6) problems in abstract thinking, (7) misplacing objects, (8) mood fluctuations, (9) changes in personality, and (10) lack of initiative (Cutler, Sramek, 1996).

The first signs of Alzheimer's disease include difficulty in remembering recent events and performing familiar everyday tasks. As the disease progresses, the affected person

may experience confusion, personality and behavior changes, impaired judgment, and difficulty finding words, finishing thoughts, or following directions. In the early and middle stages of AD, people with the illness may be painfully aware of their intellectual failings and what is yet to come. These changes occur at widely varying speeds in different people, and not all changes occur in everyone, but the outcome is always the same. Eventually, people with Alzheimer's disease completely lose the ability to care for themselves and must be confined to bed with constant care. In the latest stages of disease the brain can no longer regulate body functions, and victims die of malnutrition, dehydration, infection, heart failure, or other complications (Lucero, 1996). Alzheimer's disease progresses slowly, taking between three to eighteen years to advance from the earliest symptoms to death; the average duration of the disease is eight years. Unfortunately, science has not yet found a cure.

Dr. Alois Alzheimer, who discovered Alzheimer's disease, was a gifted German scientist who was born in the mid-nineteenth century (Medina, 1999). Though he will be forever linked to the disease that bears his name, Dr. Alzheimer actually did his landmark work in other areas of research. The sole reason his name became a household word for Alzheimer's disease was because of a brief talk he gave in 1906 to a small group of researchers.

Research indicates that there may be certain factors that seem to be more common in people with Alzheimer's disease than in the general population. There is major research into the origin of Alzheimer's disease, and explanations include genetic and environmental causes. There are two types of Alzheimer's disease - familial AD, which is found in families and follows certain inheritance patterns, and sporadic AD, where no obvious pattern of inheritance exists (McGuffey, 1997). Family history is a consistent risk factor. People who have a relative with Alzheimer's disease are more likely to develop the disease themselves.

Over four million people in the United States are living with Alzheimer's disease. Experts predict that as baby boomers age, Alzheimer's may affect as many as 14 million people nationwide. Alzheimer's is widespread, affecting 10% or more of those over age 65 and nearly half of those over age 85 (Doraswamy, 1997). Slightly more women then men have Alzheimer's disease. Its increasing prevalence has led epidemiologists to call Alzheimer's "the disease of the century".

The risk of Alzheimer's disease increases with age. While Alzheimer's usually affects those over age 65, a rare and aggressive form of Alzheimer's can happen in some people in their 40s and 50s. Family history or traumatic head injuries suffered earlier in life may increase the likelihood of developing Alzheimer's disease.

Since normal aging may also cause a decline in the ability to remember names, places, and objects, as can strokes and heart disease, it is important to be examined by a doctor for a proper diagnosis. Even though Alzheimer's disease is responsible for more dementia than all other causes combined, more than 60 other diseases are capable of causing Alzheimer's-like dementias, that is why AD can be so hard to detect. There is no well-accepted specific test to identify AD during a patient's lifetime. Therefore, doctors can diagnose Alzheimer's disease only after they have ruled out all other possible causes of dementia. No one test can determine whether Alzheimer's actually exists, which is also the reason why a physician must administer an exhausting battery of tests before making an Alzheimer's diagnosis. A detailed patient and family history will be taken; a physical exam will be conducted; mental status test will be administered; neurological exam will be completed; laboratory tests will