What research has taught us about Alzheimer’s and Dementia Diseases
A.F. Jorm, Ph.D. National Health & Medical Research Council Social Psychiatry ResearchUnit Australian National University
Five years ago I was in the situation that many of you are in today living with a dementingrelative, but having all too little knowledge of the condition he was suffering from. Since then,my dementing relative has died and I have become a professional researcher on the topic of dementia. I wish that 5 years ago I knew as much about dementia as I do now. My aim todayis to provide answers to some of the questions you may have as care-givers. I will pose thesequestions one by one and try to give an answer in the light of current research knowledge.
What is Alzheimer's Disease?
Alzheimer's Disease is a disorder affecting the brain which causes severe deterioration inmemory and self-care skills and which can cause distressing changes in personality. In theearly stages of the disorder the changes may be subtle. Often the first changes are in thearea of memory, with particular difficulty in remembering new things. In some cases,personality changes are the first problem noticed. Sufferers may be suspicious, irritable,changeable in mood, stubborn, impatient or easily upset. In the early stage, care-givers willnot be aware that brain changes are occurring to produce these effects and the dementingperson may be seen as deliberately willful or difficult. As the disorder progresses, all aspectsof intelligence are affected and the former personality is lost. Eventually, the sufferer may bebedridden, incontinent, and unable to communicate in any meaningful way. Death usuallyoccurs sometime after through some other medical condition such as an infection, but theunderlying cause of death is Alzheimer'sDisease.Alzheimer's Disease has been known about since early this century, but until a few years agoit was seldom heard about. The reason for this change in awareness is curious. WhenAlzheimer's Disease was first described by the German physician Alois Alzheimer in 1907, itwas in a 51 year old woman. Other early cases were also described in people under the ageof 65. It therefore came to be believed that Alzheimer's Disease occurred only in peopleunder the age of 65 and, because Alzheimer's Disease is rare in middle-aged people, it wasbelieved to be a quite rare neurological disorder. At this time, Alzheimer's Disease wasdistinguished from the common "senile dementia" which affected elderly people. Manyphysicians believed (and some still do!) that senile dementia is caused by blocked arteries,with the brain's blood supply becoming slowly strangled.This distinction between Alzheimer's Disease (occurring under age 65) and senile dementia(occurring over age 65) persisted until fairly recent times. It was only in the late 1960s andearly 1970s that researchers studying the brains of people dying from senile dementia foundthat most of them had the brain changes of Alzheimer's Disease. It then became common tosay that these people suffered from "senile dementia of the Alzheimer type". More recently,the term "Alzheimer Disease" has been extended to cover elderly cases as well as themiddle-aged ones. Research on the subject has thus led to a revolution in thinking, whereAlzheimer's Disease has been transformed from a rare neurological disorder affecting the