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, the ability to carry out the simplest tasks of daily living. In most people with AD, symptoms first appear after age 60.
Alzheimer’s disease is a brain disorder named for German physician Alois Alzheimer, who first described it in 1906. Scientists have learned a great deal about Alzheimer’s disease in the century since Dr. Alzheimer first drew attention to it. Today we know that Alzheimer’s:
Is a progressive and fatal brain disease. As many as 5.3 million Americans are living with Alzheimer’s disease. Alzheimer's destroys brain cells, causing problems with memory, thinking and behavior severe enough to affect work, lifelong hobbies or social life. Alzheimer’s gets worse over time, and it is fatal. Today it is the sixth-leading cause of death in the United States. For more information, see Warning Signs and Stages of Alzheimer’s Disease.
Is the most common form of dementia, a general term for the loss of memory and other intellectual abilities serious enough to interfere with daily life. Vascular dementia, another common type of dementia, is caused by reduced blood flow to parts of the brain. In mixed dementia, Alzheimer’s and vascular dementia occur together. For more information about other causes of dementia, please see Related Dementias. Has no current cure. But treatments for symptoms, combined with the right services and support, can make life better for the millions of Americans living with Alzheimer’s. There is an accelerating worldwide effort under way to find better ways to treat the disease, delay its onset, or prevent it from developing. Learn more about recent progress in Alzheimer science and research funded by the Alzheimer’s Association in the Research section.
Alzheimer's and the brain
Just like the rest of our bodies, our brains change as we age. Most of us notice some slowed thinking and occasional problems remembering certain things. However, serious memory loss, confusion and other major changes in the way our minds work are not a normal part of aging. They may be a sign that brain cells are failing. The brain has 100 billion nerve cells (neurons). Each nerve cell communicates with many others to form networks. Nerve cell networks have special jobs. Some are involved in thinking, learning and remembering. Others help us see, hear and smell. Still others tell our muscles when to move. To do their work, brain cells operate like tiny factories. They take in supplies, generate energy, construct equipment and get rid of waste. Cells also process and store information. Keeping everything running requires coordination as well as large amounts of fuel and oxygen. In Alzheimer’s disease, parts of the cell’s factory stop running well. Scientists are not sure exactly where the trouble starts. But just like a real factory, backups and breakdowns in one system cause problems in other areas. As damage spreads, cells lose their ability to do their jobs well. Eventually, they die.
Early stage and younger onset
Early-stage is the early part of Alzheimer’s disease when problems with memory, thinking and concentration may begin to appear in a doctor’s interview or medical tests. Individuals in the early-stage typically need minimal assistance with simple daily routines. At the time of a diagnosis, an individual is not necessarily in the early stage of the disease; he or she may have progressed beyond the early stage. The term younger-onset refers to Alzheimer's that occurs in a person under age 65. Younger-onset individuals may be
employed or have children still living at home. Issues facing families include ensuring financial security, obtaining benefits and helping children cope with the disease. People who have younger-onset dementia may be in any stage of dementia – early, middle or late. Experts estimate that some 500,000 people in their 30s, 40s and 50s have Alzheimer's disease or a related dementia. Back to top
At a scientific meeting in November 1906, German physician Alois Alzheimer presented the case of “Frau Auguste D.,” a 51-year-old woman brought to see him in 1901 by her family. Auguste had developed problems with memory, unfounded suspicions that her husband was unfaithful, and difficulty speaking and understanding what was said to her. Her symptoms rapidly grew worse, and within a few years she was bedridden. She died in Spring 1906, of overwhelming infections from bedsores and pneumonia. Dr. Alzheimer had never before seen anyone like Auguste D., and he gained the family’s permission to perform an autopsy. In Auguste’s brain, he saw dramatic shrinkage, especially of the cortex, the outer layer involved in memory, thinking, judgment and speech. Under the microscope, he also saw widespread fatty deposits in small blood vessels, dead and dying brain cells, and abnormal deposits in and around cells. The condition entered the medical literature in 1907, when Alzheimer published his observations about Auguste D. In 1910, Emil Kraepelin, a psychiatrist noted for his work in naming and classifying brain disorders, proposed that the disease be named after Alzheimer.
• Alzheimer's and dementia triple healthcare costs for Americans age 65 and older. Alois Alzheimer The role of plaques and tangles Two abnormal structures called plaques and tangles are prime suspects in damaging and killing nerve cells. Plaques and tangles were among the abnormalities that Dr. Tangles form inside dying cells. Tangles are twisted fibers of another protein called tau (rhymes with “wow”). although he called them different names. . The plaques and tangles tend to form in a predictable pattern. those with Alzheimer’s tend to develop far more. • Dr. Most experts believe they somehow block communication among nerve cells and disrupt activities that cells need to survive. o Plaques build up between nerve cells. someone develops Alzheimer’s.3 million people in the United States are living with Alzheimer’s. As many as 5. beginning in areas important in learning and memory and then spreading to other regions.Auguste D. Though most people develop some plaques and tangles as they age. • Every 70 seconds. They contain deposits of a protein fragment called beta-amyloid (BAY-tuh AM-uh-loyd). Alois Alzheimer saw in the brain of Auguste D. o Scientists are not absolutely sure what role plaques and tangles play in Alzheimer’s disease..
“With the country facing unprecedented economic challenges and a rapidly aging baby boomer population.” said Harry Johns. Medicaid and businesses amount to more than $148 billion each year. total healthcare costs are calculated as per person payments measured from all sources. “It is widely understood that addressing health care is key to the country regaining its financial footing.• Alzheimer's is the sixth-leading cause of death. released today. In the new report. New report says Alzheimer’s disease and dementia triple healthcare costs for Americans age 65 and older Total healthcare costs are more than three times higher for people with Alzheimer’s and other dementias than for other people age 65 and older. “And . • The direct and indirect costs of Alzheimer's and other dementias to Medicare.” continued Johns. according to the Alzheimer’s Association’s 2009 Alzheimer’s Disease Facts and Figures. New report 2009 Alzheimer's Disease Facts and Figures Statistics that convey the growing prevalence of Alzheimer's and its impact. Medicare payments alone are almost three times higher for people with Alzheimer’s and dementia than for others age 65 and over. Alzheimer’s Association CEO. now is the time to address the burgeoning Alzheimer crisis that triples healthcare costs for Americans age 65 and over. Medicaid payments alone are more than nine times higher.
605 Private insurance 1. 2004 Beneficiaries with no Beneficiaries with Average Per Alzheimer's or Other Alzheimer's or Other Person Payments Dementias Dementias Total payments* $10.007 Medicare payments 5. such as diabetes or coronary heart disease. nursing home and other health and long-term care services.” Average Per Person Payments by Source for Health and Long-term Care Services. With and Without Alzheimer’s Disease and Other Dementias. A strategy to immediately confront Alzheimer’s has the potential to save millions of lives and billions of dollars by reducing the burden on Medicare and Medicaid.847 payments Other sources 211 519 payments HMO payments 704 410 Out-of-pocket 1. Most people with Alzheimer’s also have one or more additional serious medical conditions.there is no way this can be done without improving Medicare and Medicaid which Alzheimer’s directly impacts. Source: Alzheimer’s Association 2009 Alzheimer’s Disease Facts and Figures People with Alzheimer’s are high consumers of hospital. which translates into high costs for Medicare. As families struggle to survive in a deepening recession and as states grapple with budget shortfalls.145 Medicaid payments 718 6. Medicaid and millions of families. For Persons.272 15. Alzheimer’s disease threatens to overwhelm them both.464 payments Uncompensated 201 261 care * Payments by source do not exactly equal total payments due to the effect of population weighting. Their Alzheimer’s greatly complicates the medical management for these other conditions and drives up costs significantly. Aged 65 Years and Older.466 1.603 $33.916 2. .
there will be nearly a million new cases per year. the report also reveals that Alzheimer’s creates high out-of-pocket health and long-term care expenses for families. Medicaid or other sources of insurance are 28 percent higher for Medicare beneficiaries with Alzheimer’s than those without. provided 8.5 billion hours of unpaid care valued at $94 billion. the ripple effects of the disease can be felt throughout the entire family.3 million Americans living with the disease and every 70 seconds someone in America develops Alzheimer’s disease.655 compared to $12. there are 5. and by 2050. nearly 10 million Alzheimer caregivers in the U. surpassing diabetes. In addition to the unpaid care families contribute. Out-of-pocket costs that are not covered by Medicare.640 for beneficiaries with coronary heart disease but no Alzheimer’s or dementia. According to Facts and Figures.979 for beneficiaries with diabetes but no Alzheimer’s or dementia. there will be nearly a half million new cases of Alzheimer’s each year.780 compared to $14. Alzheimer’s is the sixth leading cause of death in the country.S. and their average per person Medicare costs were $20.According to the Facts and Figures report. in 2006: • Medicare beneficiaries with diabetes plus Alzheimer’s or another dementia had 64 percent more hospital stays than those with diabetes and no Alzheimer’s. it is the fifth leading cause of death among . Individuals with Alzheimer’s and other dementia living in nursing homes or assisted living facilities incurred the highest out-of-pocket costs – an average of $16.689 a year. By 2010. By mid-century someone will develop Alzheimer’s every 33 seconds. in 2008. • Medicare beneficiaries with coronary heart disease and Alzheimer’s disease or another dementia had 42 percent more hospital stays than those with coronary heart disease and no Alzheimer’s or dementia. and their average per person Medicare costs were $20. Growing prevalence of Alzheimer’s disease and dementia According to the report. With family members providing care at home for about 70 percent of people with Alzheimer’s disease.
1 percent). The new Facts and Figures report highlights the BRFSS survey findings from the states of Washington and North Carolina. The BRFSS survey allows residents to say for themselves what their challenges are. An existing survey process is the easiest way to obtain this important information. From 2000 to 2006. deaths from Alzheimer’s disease rose 47. Implications for states Demographic trends indicate that the number of affected individuals and families will grow significantly in the years to come. Beginning this year. they must first have reliable information about the characteristics and needs of their residents who are coping with Alzheimer’s or other dementia.” Johns said. For example in Washington.5 percent). there are no treatments that can prevent.1 percent. some states have added questions about caregiving for people with Alzheimer’s and other dementias in their BRFSS surveys.individuals 65 and older. too little time and too much at stake for anything less. There are too many lives. 48 percent of the caregivers for individuals with memory loss or cognitive impairment revealed that stress was the greatest difficulty they faced. not only having a profound effect on families and health systems but on state budgets as well. and another set of questions on cognitive impairment is being . The Behavioral Risk Factors Surveillance System (BRFSS) is an annual state public health survey done in conjunction with the Centers for Disease Control and Prevention (CDC). delay or reverse Alzheimer disease and research funding has been stagnant for the past six years.3 percent) and stroke (-18. “Currently. breast cancer (-. In order for states to plan for this rapidly growing population. With the first baby boomers turning age 65 in just two short years – and entering the arena of increasing risk for developing Alzheimer’s – an aggressive plan is needed now to address the threat of this disease.6 percent). an approved set of family caregiving questions is available for all states to add to their BRFSS survey. while deaths from other major diseases dropped – heart disease (-11. prostate cancer (-14. Since 2003.
developed for 2010. Reality: In the past people believed memory loss was a normal part of aging. Individuals with MCI have a higher risk for developing Alzheimer’s disease.D.” Myth 1: Memory loss is a natural part of aging. M. Mild Cognitive Impairment (MCI) – An emerging issue Experts believe that early detection of Alzheimer’s disease and early intervention with improved therapies provides the greatest opportunity to delay or stop additional damage to the brain. often regarding even Alzheimer’s as natural agerelated decline. the new report highlights the emerging role of a condition known as mild cognitive impairment (MCI). Experts now recognize severe memory loss as a symptom of serious illness. individuals with MCI will help to speed progress in finding ways to prevent or cure Alzheimer’s by providing scientists with the opportunity to test new Alzheimer treatments and learn faster whether or not the treatments work. ideally even before symptoms appear. but more research is needed to determine why some people with MCI go on to develop Alzheimer’s and why some do not..” said Ronald Petersen.D. language or other essential cognitive functions that are severe enough to be noticeable to the individual and others. By participating in scientific studies and clinical trials. offering great hope that drugs that may slow or even reverse disease progression could be on the horizon – saving millions of dollars in public health programs. There is consensus within the scientific research community that intervention with any disease-modifying treatment should occur as early as possible. A person with MCI has problems with memory. To that end. diverse variety of treatment possibilities for Alzheimer’s that scientists are exploring. “A national strategy and a sustained commitment to Alzheimer research is what is needed to today to make Alzheimer survivors tomorrow. . but not severe to interfere with daily life. “There is a rich. Ph. the Alzheimer’s Association’s Medical Scientific Advisory Council Chair.
40s and even 50s. Since then. This suspicion led to concern about exposure to aluminum through everyday sources such as pots and pans.3 million people living with Alzheimer’s disease in the United States. It destroys brain cells and causes memory changes. Myth 2: Alzheimer’s disease is not fatal. think.000 people under age 65 with younger-onset Alzheimer’s disease. talk. Reality: During the 1960s and 1970s. walk and find his or her way home. studies have failed to confirm any role for aluminum in causing Alzheimer’s. It slowly and painfully takes away a person's identity. erratic behaviors and loss of body functions. Myth 4: Drinking out of aluminum cans or cooking in aluminum pots and pans can lead to Alzheimer’s disease. antacids and antiperspirants. ability to connect with others. This is called younger-onset Alzheimer's.Whether memory naturally declines to some extent remains an open question. beverage cans. This includes 5. and few believe that everyday sources of aluminum pose any threat. it is estimated that there are as many as 5. Myth 3: Only older people can get Alzheimer's Reality: Alzheimer's can strike people in their 30s. In 2009. Food and Drug Administration (FDA) for use in all foods and beverages . Myth 5: Aspartame causes memory loss. but determining whether there is any scientific basis for this belief is a research challenge still being addressed. aluminum emerged as a possible suspect in Alzheimer’s. Reality: Alzheimer's disease has no survivors. was approved by the U. eat. Reality: This artificial sweetener.1 million people age 65 and over and 200. Experts today focus on other areas of research. marketed under such brand names as Nutrasweet and Equal. Many people feel that their memory becomes less sharp as they grow older.S.
S. Read the May 2006 FDA statement about aspartame. 3. Myth 6: Flu shots increase risk of Alzheimer’s disease Reality: A theory linking flu shots to a greatly increased risk of Alzheimer’s disease has been proposed by a U. According to the FDA. 2001. • A Nov. The concern that there could be a link arose because "silver" fillings are made of an amalgam (mixture) that typically contains . and influenza seemed to have a lower risk of developing Alzheimer’s disease than those not receiving these vaccinations. Myth 7: Silver dental fillings increase risk of Alzheimer's disease Reality: According to the best available scientific evidence. 27. doctor whose license was suspended by the South Carolina Board of Medical Examiners. • A report in the Nov. there is no relationship between silver dental fillings and Alzheimer's. The abstract of that report is posted on PubMed. Canadian Medical Journal report suggests older adults who were vaccinated against diphtheria or tetanus. Several mainstream studies link flu shots and other vaccinations to a reduced risk of Alzheimer's disease and overall better health. JAMA found that annual flu shots for older adults were associated with a reduced risk of death from all causes. the agency had not been presented with any scientific evidence that would lead to change its conclusions on the safety of aspartame for most people. Since approval. concerns about aspartame's health effects have been raised. polio. 2004.in 1996. The agency says its conclusions are based on more than 100 laboratory and clinical studies. as of May 2006. The full text of this report is posted on the journal’s Web site.
endorse the continued use of amalgam as safe. strong. Many scientists consider the studies below compelling evidence that dental amalgam is not a major risk factor for Alzheimer's. FDA-approved drugs temporarily slow worsening of symptoms for about 6 to 12 months. • March 1991. Analysis by University statisticians revealed no significant association between silver fillings and Alzheimer's. 35 percent silver and 15 percent tin. inexpensive material for dental restorations. Mercury is a heavy metal that.about 50 percent mercury. Public health agencies. National Institutes of Health (NIH) in 1991 funded a study at the University of Kentucky to investigate the relationship between amalgam fillings and Alzheimer's. in certain forms.S. Public Health Service and the World Health Organization. • • Myth 8: There are treatments available to stop the progression of Alzheimer's disease Reality: At this time. Dementia . on average. The abstract for this study is posted on the New England Journal of Medicine Web site. 2003. is know to be toxic to the brain and other organs. the U. October 30. including the FDA. a New England Journal of Medicine article concluded that current evidence shows no connection between mercury-containing dental fillings and Alzheimer's or other neurological diseases. for about half of the individuals who take them. the Dental Devices Panel of the FDA concluded there was no current evidence that amalgam poses any danger. delay or stop the progression of Alzheimer's disease. The abstract for this study is posted on the Journal of the American Dental Association Web site. there is no treatment to cure.
thyroid problems. It is caused by changes in the brain. These dementia-like symptoms can be reversed if they are caused by treatable conditions. excess use of alcohol or certain vitamin deficiencies. Alzheimer’s disease is the most common form of dementia. . reasoning and behavior. please see Related Dementias. 10 warning signs of Alzheimer's: Memory loss. accounting for 50 to 70 percent of cases. People with dementia often find it hard to plan or complete everyday tasks. Doctors have identified other conditions that can cause dementialike symptoms. Other types of dementia include vascular dementia. It may be a sign of Alzheimer's disease. a fatal brain disease that gets worse over time and causes changes in thinking. place a telephone call or play a game. drug interaction. Forgetting recently learned information is one of the most common early signs of dementia. What's normal? Forgetting names or appointments occasionally. A person begins to forget more often and is unable to recall the information later. such as depression. 40s and 50s. Difficulty performing familiar tasks. For more information about other causes of dementia. dementia with Lewy bodies and frontotemporal dementia. it can also strike those in their 30s. Individuals may lose track of the steps to prepare a meal. mixed dementia.Dementia is a general term for loss of memory and other mental abilities severe enough to interfere with daily life. Although the disease is more common in people 65 and older. Memory loss that disrupts everyday life is not a normal part of aging.
like giving away large sums to telemarketers. They may show poor judgment about money. forget where they are and how they got there. Problems with language. and instead ask for "that thing for my mouth. People with Alzheimer's disease can become lost in their own neighborhoods. and not know how to get back home." What's normal? Sometimes having trouble finding the right word. People with Alzheimer's disease often forget simple words or substitute unusual words. What's normal? Forgetting the day of the week or where you were going. Poor or decreased judgment. What's normal? Making a questionable or debatable decision . They may be unable to find their toothbrush. for example. wearing several layers on a warm day or little clothing in the cold. making their speech or writing hard to understand.What's normal? Occasionally forgetting why you came into a room or what you planned to say. Those with Alzheimer's may dress inappropriately. Disorientation to time and place.
. Changes in mood or behavior. What's normal? Finding it challenging to balance a checkbook. Problems with abstract thinking. Someone with Alzheimer's disease may show rapid mood swings – from calm to tears to anger – for no apparent reason. A person with Alzheimer's disease may put things in unusual places: an iron in the freezer or a wristwatch in the sugar bowl. Someone with Alzheimer's disease may have unusual difficulty performing complex mental tasks. What's normal? Occasionally feeling sad or moody.from time to time. Misplacing things. like forgetting what numbers are and how they should be used. What's normal? Misplacing keys or a wallet temporarily.
What's normal? Sometimes feeling weary of work or social obligations. What's normal? People’s personalities do change somewhat with age. The personalities of people with dementia can change dramatically. suspicious. They may become extremely confused. sleeping more than usual or not wanting to do usual activities. Loss of initiative. fearful or dependent on a family member. sitting in front of the TV for hours. The difference between Alzheimer's and normal age-related memory changes Someone with Alzheimer's disease symptoms Someone with normal age-related memory changes Forgets entire experiences Rarely remembers later Is gradually unable to follow written/spoken directions Is gradually unable to use notes as reminders Forgets part of an experience Often remembers later Is usually able to follow written/spoken directions Is usually able to use notes as reminders . A person with Alzheimer's disease may become very passive.Changes in personality.
You may also increase your chances of participating in clinical drug trials that help advance research. you can: Get the maximum benefit from available treatments – You can explore treatments that may provide some relief of symptoms and help you maintain a level of independence longer. You can also participate in building the right care team and social support network. Learn more about treatments. When you see your doctor Your doctor will evaluate your overall health and identify any conditions that could affect how well your mind is working. financial and legal matters. Learn more about clinical studies. Your doctor may refer you to a specialist such as a: • • • • Neurologist – specializes in diseases of the brain and nervous system Psychiatrist – specializes in disorders that affect mood or the way the mind works Psychologist – has special training in testing memory and other mental functions Geriatrician – specializes in the care of older adults and Alzheimer's disease • What is the AEDA • The Alzheimer's Association has formed the Alzheimer's Early Detection Alliance (AEDA) to help educate everyone about the . Have more time to plan for the future – A diagnosis of Alzheimer's allows you to take part in decisions about care.Is gradually unable to care for self Is usually able to care for self With early detection. Learn more about planning ahead. Help for you and your loved ones – Care and support services are available. Learn how the Alzheimer's Association helps families. making it easier for you and your family to live the best life possible with Alzheimer’s or dementia. transportation. living options.
warning signs of Alzheimer's, the importance of early detection, and the resources available to help them. The Alzheimer's Association is inviting companies and organizations to be part of the AEDA and help us spread the word as widely as possible.
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Introduction Risk factors
Risk factors you may be able to influence
While scientists know Alzheimer’s disease involves progressive brain cell failure, they have not yet identified any single reason why cells fail. However, they have identified certain risk factors that increase the likelihood of developing Alzheimer’s.
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Age The greatest known risk factor for Alzheimer’s is increasing age. Most individuals with the disease are 65 or older. The likelihood of developing Alzheimer’s doubles about every five years after age 65. After age 85, the risk reaches nearly 50 percent. Family history Another risk factor is family history. Research has shown that those who have a parent, brother or sister, or child with Alzheimer’s are more likely to develop Alzheimer’s. The risk increases if more than one family member has the illness. When diseases tend to run in families, either heredity (genetics) or environmental factors or both may play a role. Genetics (heredity) Scientists know genes are involved in Alzheimer’s. There are two categories of genes that can play a role in determining whether a person develops a disease. Alzheimer genes have been found in both categories: 1) Risk genes increase the likelihood of developing a disease, but do not guarantee it will happen. Scientists have so far identified one Alzheimer risk gene called apolipoprotein Ee4 (APOE-e4). APOE-e4 is one of three common forms of the APOE gene; the others are APOE-e2 and APOE-e3. APOE provides the blueprint for one of the proteins that carries cholesterol in the bloodstream. Everyone inherits a copy of some form of APOE from each parent. Those who inherit one copy of APOE-e4 have an increased risk of developing Alzheimer’s. Those who inherit two copies have an even higher risk, but not a certainty. Scientists do not yet know how APOE-e4 raises risk. In addition to raising risk, APOE-e4 may tend to make symptoms appear at a younger age than usual. Experts believe there may be as many as a dozen other Alzheimer risk genes in addition to APOE-e4. 2) Deterministic genes directly cause a disease, guaranteeing that anyone who inherits them will develop the disorder. Scientists have found rare genes that directly
cause Alzheimer’s in only a few hundred extended families worldwide. When Alzheimer’s disease is caused by deterministic genes, it is called “familial Alzheimer’s disease,” and many family members in multiple generations are affected. True familial Alzheimer’s accounts for less than 5 percent of cases. Genetic tests are available for both APOE-e4 and the rare genes that directly cause Alzheimer’s. However, health professionals do not currently recommend routine genetic testing for Alzheimer’s disease. Testing for APOE-e4 is sometimes included as a part of research studies. Back to top
Risk factors you may be able to influence
Age, family history and heredity are all risk factors we can’t change. Now, research is beginning to reveal clues about other risk factors we may be able to influence. Head injury: There appears to be a strong link between serious head injury and future risk of Alzheimer’s. Protect your head by buckling your seat belt, wearing your helmet when participating in sports, and “fall-proofing” your home. Heart-head connection: Some of the strongest evidence links brain health to heart health. Your brain is nourished by one of your body’s richest networks of blood vessels. Every heartbeat pumps about 20 to 25 percent of your blood to your head, where brain cells use at least 20 percent of the food and oxygen your blood carries. The risk of developing Alzheimer’s or vascular dementia appears to be increased by many conditions that damage the heart or blood vessels. These include high blood pressure, heart disease, stroke, diabetes and high cholesterol. Work with your doctor to monitor your heart health and treat any problems that arise. General healthy aging: Other lines of evidence suggest that strategies for overall healthy aging may help keep the brain
For more information about keeping your brain healthy as you age. stay socially connected. and exercise both your body and mind. Alzheimer’s Association clients report they . please see our Brain Health section. Steps to Diagnosis þÿ Search By State Visit our action site Become an advocate Enroll in MedicAlert + Safe Return Ask a librarian Finding the right doctor • Understanding the problem • Reviewing medical history • Mental status tests Physical exam and diagnostic tests • Neurological exam • • • Brain imaging Finding the right doctor The first step in following up on symptoms is finding a doctor you feel comfortable with.healthy and may even offer some protection against developing Alzheimer’s or related diseases. Try to keep your weight within recommended guidelines. avoid tobacco and excess alcohol.
There is no single type of doctor who specializes in diagnosing and treating memory loss or Alzheimer’s disease. problem solving. Your local Alzheimer’s Association can help you find the right doctor. Doctors can almost always determine that a person has dementia. Many people contact their regular primary care physician or internist about their concerns. the primary care doctor may refer a patient to one of the following specialists: • • A neurologist. Primary care doctors often oversee the diagnostic process and provide treatment themselves. Be prepared for the doctor to ask: • What kind of symptoms have you noticed? • When did they begin? • How often do they happen? • Have they gotten worse? . who specializes in diseases of the brain and nervous system • A psychiatrist. concentration. language and other mental functions Back to top Understanding the problem There is no single test that proves a person has Alzheimer’s. who specializes in disorders that affect mood or the way the mind works A psychologist with advanced training in testing memory.are most likely to be satisfied seeing someone who is well informed about Alzheimer’s disease. In some cases. Experts estimate a skilled physician can diagnose Alzheimer’s with more than 90 percent accuracy. but it may sometimes be difficult to pin down the exact cause. The medical workup is designed to evaluate overall health and identify any conditions that could affect how well the mind works.
Although dementia screening tests don't claim to offer a definitive diagnosis. There is an established diagnostic criteria that physicians adhere to when evaluating someone for Alzheimer's disease. especially whether they may have had Alzheimer’s disease or a related disorder. time and where he or she is Can remember a short list of words. Back to top Mental status tests Mental status testing gives the doctor a general idea of whether a person: • • Is aware of having symptoms or feels nothing is wrong • Knows the date. The doctor will also obtain a history of medical conditions affecting other family members.Dementia screening tests An increasing number of test developers. It is helpful to bring a list of all the medications the person is taking. any test that plants the idea of a serious illness has the potential to cause great psychological distress to the test taker. health care facilities and others are marketing dementia screening tests directly to consumers. especially whether they may have had Alzheimer's disease or related disorders. The doctor will obtain a history of key medical conditions affecting other family members. The whole process of assessment and diagnosis should be carried out within the context of an ongoing relationship with responsible health care professionals. follow instructions and . Back to top Reviewing medical history The doctor will interview the person being examined or family members to gather information about current and past illnesses. The Alzheimer's Association believes that home screening tests can not and should not be used as a substitute for a thorough examination by a skilled doctor.
flower.” which involves two tasks: (1) remembering and a few minutes later repeating the names of three common objects. season. loss of interest in . A score of 20 . and less than 12 indicates severe dementia.24 suggests mild dementia. city. the MMSE score of a person with Alzheimer’s declines about 2 . In addition to assessing mental status.do simple calculations Mini-mental state exam (MMSE) The mini-mental state examination (MMSE) is one of the tests most commonly used to assess mental function.4 points each year. floor) • Repeat a common phrase or saying after the examiner • Copy a picture of two interlocking shapes • Follow a three-part instruction. fold it in half. and place it on the floor • • The maximum MMSE score is 30 points. In the MMSE. and (2) drawing a face of a clock showing all 12 numbers in the right places and a time specified by the examiner. 13 . Examples of questions include: Remember and repeat a few minutes later the names of three common objects (for instance. About the mini-cog Another popular mental status test is the “mini-cog. the doctor will evaluate a person’s sense of well-being to detect depression or other mood disorders that can cause memory problems. penny) • State the year. day of the week and date Count backward from 100 by 7s or spell “world” backwards • Name two familiar objects present in the office as the examiner points to them • Identify the location of the examiner’s office (state.20 suggests moderate dementia. street address. a health professional asks a patient a series of questions designed to test a range of everyday mental skills. horse. such as: take a piece of paper in your right hand. On average.
Such disorders include: • Anemia. • Collect samples of blood and urine. Back to top Physical exam and diagnostic tests The physician will Ask about diet. lung or blood vessels Back to top Neurological exam The neurological examination is an important part of the physical. • Check blood pressure. and other symptoms that can overlap with dementia. • Listen to the heart and lungs. malnutrition or certain vitamin deficiencies • Excess use of alcohol • Medication side effects • Certain infections • Diabetes • Kidney or liver disease • Thyroid abnormalities • Problems with the heart. or other symptoms similar to dementia.life. temperature and pulse. confused thinking. including over-the-counter drugs and supplements. • Review all medications. nutrition and use of alcohol. Its goal is to assess the function of the brain and nervous system to identify symptoms of brain disorders other than Alzheimer’s. During the neurological exam. It is helpful to bring a list or the containers of all medicines currently being taken. the physician may test: Reflexes Coordination and balance • • . • Information from these tests can help identify other disorders that may cause memory loss. trouble focusing attention.
Functional imaging reveals how well cells in various brain regions are working by showing how actively the cells use sugar or oxygen. a standard medical workup for Alzheimer’s disease often includes structural imaging with MRI or. However. Promising areas for brain imaging research Researchers are studying whether the use of MRI and other imaging methods may be expanded to play a more direct role in diagnosing Alzheimer’s. Structural techniques include magnetic resonance imaging (MRI) and computed tomography (CT). Research has also shown that shrinkage in specific brain regions may be an early sign of Alzheimer’s. These images are used primarily to detect tumors. evidence of small or large strokes. damage from severe head trauma or a buildup of fluid. scientists have not yet agreed upon standardized values that would establish the significance of a specific amount of shrinkage for any individual person at a single point in time. Many studies have shown that the brains of people with Alzheimer’s shrink significantly as the disease progresses. • • Structural imaging provides information about the shape.• Muscle tone and strength • Eye movement • Speech • Sensation Back to top Brain imaging New imaging technologies have revolutionized our understanding of the structure and function of the living brain. Currently. CT. Research with PET and other functional imaging methods also suggests that those with Alzheimer’s typically have reduced brain . position or volume of brain tissue. Functional techniques include positron emission tomography (PET) and functional MRI (fMRI). less frequently.
For example. as with the shrinkage detected by structural imaging. A diagnosis of Alzheimer’s disease reflects a doctor’s best judgment about the cause of a person’s symptoms. The diagnosing doctor can then schedule the next appointment or provide a referral. the doctor will review results and share conclusions. there is not yet enough information to translate these general patterns of reduced activity into diagnostic information about individuals. called Pittsburgh compound B. PET is used primarily in research studies in hopes of gaining further knowledge about its potential for wider use in diagnosing Alzheimer’s and monitoring progression and response to treatment. While there is currently no cure. Once testing is complete. Medicare will cover a PET scan for Alzheimer’s only to help distinguish the disease from frontotemporal dementia. However. At this time. Today. care and support can make life better. Another promising area of functional imaging research focuses on developing tracer compounds that will attach to key abnormal brain deposits implicated in Alzheimer’s. preliminary data suggests that one such tracer. You may want to ask the doctor to explain: Why the diagnosis is Alzheimer’s Where you or your loved one may be in the course of the disease • What to expect in the future • • Find out if the doctor will manage care going forward and. who will be the primary doctor. if not. may attach to beta-amyloid and “light up” in a PET scan. a rare related disorder that may cause dramatic loss of function in the front and side regions of the brain. treatments are available that may help relieve some symptoms.cell activity in certain regions. Research has shown that taking full advantage of available treatment. A diagnosis of Alzheimer’s disease is life-changing for both diagnosed individuals and those close to them. .
800. the guide gives you a confidential. You can plan for the right care by using the Alzheimer’s Association CareFinder™. Planning ahead Planning for the future plays an important part in making life better for those living with Alzheimer’s. referrals and care consultation. Treatments þÿ Search By State . After you enter information about your situation.272. See Living with Alzheimer's for tips to cope with the changes you may be experiencing • Your local Alzheimer’s Association offers programs and services tailored to your needs. Knowing what to expect can help foster ease of mind for all concerned. Join our online community and share your experiences with others who know what you are going through. The CareFinder guide will also help you learn how to recognize good care.3900 provides information.Finding support We are here to help you live with Alzheimer’s disease. customized report with care recommendations and questions to ask providers. • • • Our 24/7 Helpline at 1. Advance planning enables individuals with Alzheimer’s to make their wishes about medical care and living arrangements known. plan for care. communicate with care providers and find local support. This Web guide helps individuals and families make informed decisions when selecting a care provider for home-based or residential care.
Visit our action site Become an advocate Enroll in MedicAlert + Safe Return Ask a librarian Currently. Researchers are looking for new treatments to alter the course of the disease and improve the quality of life for people with dementia. But drug and nondrug treatments may help with both cognitive and behavioral symptoms. there is no cure for Alzheimer's. In this section: Standard Treatments • Vitamin E Treatments for Sleep Changes • Alternative Treatments • • • Standard Treatments • • • Introduction Treatments for cognitive symptoms Treatments for behavioral symptoms .
planning. Some experts believe a small percentage of people may benefit more dramatically. a chemical messenger important for learning and memory. delay worsening of symptoms for 6 to 12 months for about half the people who take them.• • Talking with the doctor More information Introduction Health professionals often divide the symptoms of Alzheimer's disease into "cognitive" and "behavioral and psychiatric" categories. approved to treat mild to moderate • • . These drugs affect the activity of two different chemicals involved in carrying messages between the brain's nerve cells. judgment. language. • • Cognitive symptoms affect memory. ability to pay attention and other thought processes. These drugs: • Support communication among nerve cells by keeping acetylcholine levels high. 1. Cholinesterase (KOH-luh-NES-ter-ays) inhibitors prevent the breakdown of acetylcholine (a-SEA-til-KOH-lean). Back to top Treatments for cognitive symptoms The U. Three cholinesterase inhibitors are commonly prescribed: Donepezil (Aricept). approved to treat all stages of Alzheimer's disease.S. • On average. Rivastigmine (Exelon). Behavioral and psychiatric symptoms affect the way we feel and act. Food and Drug Administration (FDA) has approved two types of medications to treat cognitive symptoms of Alzheimer's disease.
Many experts consider its degree of benefit is similar to the cholinesterase inhibitors. Memantine (Namenda) works by regulating the activity of glutamate. Treatments-at-a-glance Generic donepezil Brand Aricept Approved For All stages Side Effects Nausea. Galantamine (Razadyne). confusion and dizziness. loss of appetite and increased frequency of bowel movements. constipation. vomiting. Mild to moderate Nausea. 2. Memantine: • • Was approved in 2003 for treatment of moderate to severe Alzheimer's disease. a different messenger chemical involved in learning and memory. • Is currently the only drug of its type approved to treat Alzheimer's. Temporarily delays worsening of symptoms for some people. loss of appetite and increased frequency of bowel movements. vomiting. rivastigmine Exelon . galantamine Razadyne Mild to moderate memantine Namenda Moderate to severe Headache.• Alzheimer's. Nausea. approved to treat mild to moderate Alzheimer's.
and vomiting. For more information about behaviors in Alzheimer's disease. Non-drug approaches . There are two approaches to managing behavioral symptoms: using medications specifically to control the symptoms or nondrug strategies. In different stages of Alzheimer's. nausea. people may experience: Physical or verbal outbursts • General emotional distress Restlessness. the chief underlying cause is progressive destruction of brain cells. Alzheimer's disease affects the way they feel and act in addition to its impact on memory and other thought processes. Back to top Treatments for behavioral and psychiatric symptoms For many individuals. As with cognitive symptoms. Non-drug approaches should always be tried first. loss of appetite and increased frequency of bowel movements. tacrine Cognex Mild to moderate Possible liver damage. shredding paper or tissues and yelling Hallucinations (seeing.vomiting. hearing or feeling things that are not really there) • Delusions (firmly held belief in things that are not real) • • • Many diagnosed individuals and their families find these symptoms the most challenging and distressing effects of the disease. please see the Behaviors section. pacing.
Events or changes in a person's surroundings may contribute to a sense of uneasiness. Even though the chief cause of behavioral symptoms is the effect of Alzheimer's disease on the brain. especially if symptoms appear suddenly. Physical discomfort. Treatable conditions may include: Drug side effects. As the disease gets worse. • • Factors in the environment may also trigger behaviors. Discomfort from a full bladder. an exam may reveal treatable conditions that are contributing to the behavior. Many people with Alzheimer's take prescription medications for other health problems. those with Alzheimer's have more and more difficulty communicating about their experience.Steps to developing successful non-drug treatments include: • • • Recognizing that the person is not just "acting mean or ornery. These can contribute to confusion and frustration and foster a sense of isolation. Situations affecting behavior may include: Moving to a new residence or nursing home Changes in the environment or caregiver arrangements • Misperceived threats • • . constipation. Pain from infections of the urinary tract. security and ease of mind Everyone who develops behavioral symptoms should receive a thorough medical exam. or feeling too hot or too cold may also be expressed through behavior. Drug side effects or interactions between drugs can sometimes affect behavior. or increase fear or confusion. ear or sinuses may lead to restlessness or agitation. • Uncorrected problems with hearing or vision. symptoms of common illnesses may sometimes go undetected." but is having further symptoms of the disease Understanding the cause and how the symptom may relate to the experience of the person with Alzheimer's Changing the person's environment to resolve challenges and obstacles to comfort. As a result.
say. Try to remain flexible. For example. respond to the feeling behind what is being expressed. tasks and solutions. fatigue. Individuals taking medications for behavioral symptoms must be closely monitored. "Your mother is a wonderful person. constipation. don't point out that the parent is dead. Maintain a comfortable room temperature. patient and supportive. introducing medications may be appropriate when individuals have severe symptoms or have the potential to harm themselves or others. • Simplify the environment. full bladder. it is best to start with a low dose of a single drug. glare.• Admission to a hospital • Being asked to bathe or change clothes Fear and fatigue resulting from trying to make sense out of an increasingly confusing world • Potential solutions • • Monitor personal comfort. if a person expresses a wish to go visit a parent who died years ago. Avoid being confrontational or arguing about facts. People with dementia are susceptible to serious side . some antidepressants may also help people sleep better. Avoid noise. instead. In general. Effective treatment of one core symptom may sometimes help relieve other symptoms. but they must be used carefully and are most effective when combined with non-drug approaches. thirst. and too much background distraction. infections and skin irritation. • Provide a security object or privacy. Medications should target specific symptoms so their effects can be monitored. • Equip doors and gates with safety locks. • Remove guns. • Create a calm environment." • Redirect the person's attention. including television. Instead. Check for pain. Medications for behavioral symptoms If non-drug approaches fail after they have been applied consistently. Medications can be effective in some situations. • Allow adequate rest between stimulating events. For example. insecure space. I would like to see her too. hunger.
include the following: Antidepressant medications for low mood and irritability: • • citalopram (Celexa) fluoxetine (Prozac) . putting the person at greater risk. When considering use of medications. Sometimes medications can cause an increase in the symptom being treated. unless the person is in severe distress or there is a marked risk of harm. Despite some efficacy. The decision to use an antipsychotic drug needs to be considered with extreme caution.effects.” The analysis states that while risperidone and olanzapine are useful in reducing aggression and risperidone reduces psychosis. A recent analysis shows that atypical antipsychotics are associated with an increased risk of stroke and death in older adults with dementia. Risk and potential benefits of a drug should be carefully analyzed for any individual. some medical providers will increase rather than decrease the dose. Food and Drug Administration (FDA) to treat behavioral and psychiatric dementia symptoms. Some of the examples discussed here represent “off label” use.S. both drugs are associated with severe side effects. these drugs should not be used routinely with dementia patients. The warning states: “Elderly patients with dementiarelated psychosis treated with atypical antipsychotic drugs are at an increased risk of death compared to placebo. Risks and potential benefits of a drug should be carefully analyzed for any individual. it is important to understand that no drugs are specifically approved by the U. The FDA has asked manufacturers to include a “black box” warning about the risks and a reminder that they are not approved to treat dementia symptoms. Without careful evaluation. a medical practice in which a physician may prescribe a drug for a different purpose than the ones for which it is approved. listed in alphabetical order. including stroke and an increased risk of death from antipsychotic medications. Examples of medications commonly used to treat behavioral and psychiatric symptoms of Alzheimer's disease.
some physicians may prescribe a seizure medication/mood stabilizer. delusions. restlessness. aggression. such as: • carbamazepine (Tegretol) . Although antipsychotics are the most frequently used medications for agitation.• • • paroxeine (Paxil) sertraline (Zoloft) trazodone (Desyrel) Anxiolytics for anxiety. verbally disruptive behavior and resistance: • • lorazepam (Ativan) oxazepam (Serax) Antipsychotic medications for hallucinations. hostility and uncooperativeness: aripiprazole (Abilify) • clozapine (Clozaril) • haloperidol (Haldol) • olanzapine (Zyprexa) • quetiapine (Seroquel) • risperidone (Risperdal) • ziprasidone (Geodon) • Research evidence as well as governmental warnings and guidance regarding the use of antipsychotics indicate that individuals with dementia should only use these medications when: 1) their behavioral symptoms are due to mania or psychosis 2) the symptoms present a danger to the resident or others 3) the resident is experiencing inconsolable or persistent distress. Adverse side effects require careful monitoring. The minimum dosage should be used for the minimum amount of time possible. agitation. a significant decline in function or substantial difficulty receiving needed care Antipsychotic medications should not be used to sedate or restrain persons with dementia.
For another person. the same drug may be less effective but have no side effects. One large federally funded study showed that vitamin E slightly delayed loss of ability to carry out daily activities and placement in residential care. Scientists think vitamin E may help because it is an antioxidant.• divalproex (Depakote) Back to top Talking with the doctor Talk to your doctor about what treatment may be right for you or the person in your care..can vary from one person to the next. For one individual. but the answers to these questions will help you understand the options and make informed decisions. A medication's effectiveness. Ask the doctor the following questions when you discuss any treatments. a substance that may protect nerve cells from certain kinds of . and the side effects it may cause. What kind of assessment will you use to determine if the drug is effective? • How much time will pass before you will be able to assess the drug's effectiveness? • How will you monitor for possible side effects? • What effects should we watch for at home? • When should we call you? Is one treatment option more likely than another to interfere with medications for other conditions? • What are the concerns with stopping one drug treatment and beginning another? • • • Vitamin E At what stage of the disease would you consider it appropriate to stop using the drug? Doctors sometimes prescribe vitamin E to treat Alzheimer’s disease. They will not address all treatment needs. one drug may be more effective but have greater side effects.
Brain wave studies show decreases in both dreaming and non-dreaming sleep stages. Treatments for Sleep Changes • • Introduction Treatments Introduction Many people with Alzheimer’s experience changes in their sleep patterns. or yell or call out. Daytime napping and other shifts in the sleep-wake cycle.chemical wear and tear. Those who cannot sleep may wander. Individuals may feel very drowsy during the day and then be unable to sleep at night. disrupting the sleep of their caregivers. As with changes in memory and behavior. including those prescribed to keep blood from clotting. and vitamin E can negatively interact with other medications. be unable to lie still. Many older adults without dementia also notice changes in their sleep. Many people with Alzheimer’s wake up more often and stay awake longer during the night. Scientists do not completely understand why this happens. but some studies have also found them in early stages. There is evidence that sleep changes are more common in later stages of the disease. Sleep changes in Alzheimer’s may include: Difficulty sleeping. No one should use vitamin E to treat Alzheimer’s disease except under the supervision of a physician. The doses used in the federal study were relatively high. sleep changes somehow result from the impact of Alzheimer’s on the brain. an experience often called . They may become restless or agitated in the late afternoon or early evening. but these disturbances occur more frequently and tend to be more severe in Alzheimer’s.
Non-drug treatments for sleep changes Non-drug treatments aim to improve sleep routine and the sleeping environment and reduce daytime napping. In extreme cases. a disorder in which unpleasant “crawling” or “tingling” sensations in the legs cause an overwhelming urge to move them Sleep apnea. Examples of conditions that can make sleep problems worse include: Depression • Restless legs syndrome. To create an inviting sleeping environment and promote rest for a person with Alzheimer’s: • Maintain regular times for meals and for going to bed and . Studies have found that sleep medications generally do not improve overall sleep quality for older adults. individuals spend about 40 percent of their time in bed at night awake and a significant part of their daytime sleeping.” Experts estimate that in late stages of Alzheimer’s. resulting in poor sleep quality • • For sleep changes due primarily to Alzheimer’s disease. there are non-drug and drug approaches to treatment. Use of sleep medications is associated with a greater chance of falls and other risks that may outweigh the benefits of treatment.“sundowning. people may have a complete reversal of the usual daytime wakefulness-nighttime sleep pattern. Back to top Treatment of sleep changes A person experiencing sleep disturbances should have a thorough medical exam to identify any treatable illnesses that may be contributing to the problem. Most experts and the National Institutes of Health (NIH) strongly encourage use of non-drug measures rather than medication. an abnormal breathing pattern in which people briefly stop breathing many times a night.
but no later than four hours before bedtime • Avoid alcohol.” The risks of sleep-inducing medications for older people who are cognitively impaired are considerable. zaleplon and chloral hydrate “Atypical” antipsychotics such as risperidone. avoid giving the medicine before bed • Make sure the bedroom temperature is comfortable • Provide nightlights and security objects If the person awakens. oxazepam and temazepam • “Sleeping pills” such as zolpidem. an attempt should be made to discontinue them after a regular sleep pattern has been established. If sleep medications are used. rivastigmine or galantamine). such as lorazepam. For those individuals who do require medication. discourage staying in bed while awake. donepezil. and a decline in the ability to care for oneself. such as nortriptyline and trazodone • Benzodiazepines. onlanzapine • • . They include increased risk for falls and fractures. The type of medication prescribed by a doctor is often influenced by behaviors that may accompany the sleep changes. Examples of medications used to treat sleep changes include: Tricyclic antidepressants. non-drug approaches fail to work or the sleep changes are accompanied by disruptive nighttime behaviors. use the bed only for sleep • Discourage watching television during periods of wakefulness Medications for sleep changes In some cases. experts recommend that treatment “begin low and go slow. caffeine and nicotine • Treat any pain If the person is taking a cholinesterase inhibitor (tacrine.• • • getting up • Seek morning sunlight exposure Encourage regular daily exercise. confusion.
are based largely on testimonials. however. The rigorous scientific research .and quetiapine Alternative Treatments • Older “classical” antipsychotics such as haloperidol þÿ Search By State Visit our action site Become an advocate Enroll in MedicAlert + Safe Return Ask a librarian Introduction • Concerns • Coenzyme Q10 • Coral calcium • Ginkgo biloba • Huperzine A Omega-3 fatty acids Phosphatidylserine • • • • More information Introduction A growing number of herbal remedies. vitamins and other dietary supplements are promoted as memory enhancers or treatments for Alzheimer’s disease and related diseases. tradition and a rather small body of scientific research. Claims about the safety and effectiveness of these products.
S. The agency does provide voluntary reporting channels for manufacturers. and will issue warnings about product when there is cause for concern. Back to top Coenzyme Q10 Coenzyme Q10. Food and Drug Administration (FDA) for the approval of a prescription drug is not required by law for the marketing of dietary supplements. It is a manufacturer’s responsibility to develop and enforce its own guidelines for ensuring that its products are safe and contain the ingredients listed on the label in the specified amounts. or ubiquinone. • Dietary supplements can have serious interactions with prescribed medications. No supplement should be taken without first consulting a physician. is an antioxidant that occurs naturally in the body and is needed for normal cell reactions. The FDA has no authority over supplement production. • Bad reactions are not routinely monitored. • Purity is unknown. and consumers. The maker of a dietary supplement is not required to provide the FDA with the evidence on which it bases its claims for safety and effectiveness. Back to top Concerns about alternative therapies Although many of these remedies may be valid candidates for treatments. This compound has not been studied for its effectiveness in treating . health care professionals. Manufacturers are not required to report to the FDA any problems that consumers experience after taking their products.required by the U. there are legitimate concerns about using these drugs as an alternative or in addition to physician-prescribed therapy: • Effectiveness and safety are unknown.
In June 2003. See also the FDA/FTC press release on the coral calcium complaint. The agencies state that they are aware of no competent and reliable scientific evidence supporting the exaggerated health claims and that such unsupported claims are unlawful. Most experts recommend that individuals who need to take a calcium supplement for bone health take a purified preparation marketed by a reputable manufacturer. Coral calcium differs from ordinary calcium supplements only in that it contains traces of some additional minerals incorporated into the shells by the metabolic processes of the animals that formed them. A synthetic version of this compound. called idebenone. was tested for Alzheimer’s disease but did not show favorable results.Alzheimer’s. Back to top Coral calcium “Coral” calcium supplements have been heavily marketed as a cure for Alzheimer’s disease. It offers no extraordinary health benefits. cancer and other serious illnesses. the Federal Trade Commission (FTC) and the Food and Drug Administration (FDA) filed a formal complaint against the promoters and distributors of coral calcium. Little is known about what dosage of coenzyme Q10 is considered safe. Ginkgo biloba is thought to have both antioxidant and anti- . and there could be harmful effects if too much is taken. Coral calcium is a form of calcium carbonate claimed to be derived from the shells of formerly living organisms that once made up coral reefs. Back to top Ginkgo biloba Ginkgo biloba is a plant extract containing several compounds that may have positive effects on cells within the brain and the body.
It has properties similar to those of cholinesterase inhibitors. 2008) showed that gingko was no better than placebo in delaying changes in memory. Back to top Huperzine A Huperzine A (pronounced HOOP-ur-zeen) is a moss extract that has been used in traditional Chinese medicine for centuries. However. 277 developed dementia. . one class of FDA-approved Alzheimer medications. Ginkgo has been used for centuries in traditional Chinese medicine and currently is being used in Europe to alleviate cognitive symptoms associated with a number of neurological conditions.000 individuals age 75 or older who either had no dementia or mild cognitive impairment. Among those receiving gingko. to protect cell membranes and to regulate neurotransmitter function. Participants were randomly assigned to receive twice daily doses of either a placebo or 120 milligrams of gingko biloba extract. it is promoted as a treatment for Alzheimer's disease. 246 developed dementia. thinking and personality and had no impact on the development of dementia and Alzheimer’s. Researchers found no statistical difference in dementia or Alzheimer’s rates between the groups. Mortality rates were also similar. The research team intends to conduct a follow-up analysis of brain function and structure in a subset of study participants using magnetic resonance imaging and positron emission tomography scans. As a result. The Gingko Evaluation and Memory (GEM) Study enrolled 3. Among those receiving placebo. an effect may have been observed if the study was longer because it takes many years to progress from the initial brain changes of Alzheimer’s to the clinical symptoms of dementia. They were followed up every six months for six years. According to the researchers. results of a large.inflammatory properties. multicenter Phase III study published in the Journal of the American Medical Association (November 19.
clinical trial of huperzine A as a treatment for mild to moderate Alzheimer’s disease. If used in combination with FDAapproved Alzheimer drugs.” and then list the amount of DHA or EPA in the product. A Jan. the National Institute on Aging (NIA) launched the first large U. Research has also linked high intake of omega-3s to a possible reduction in risk of dementia or cognitive decline. But the reviewers found enough laboratory and epidemiological studies to conclude this . The labels may state. In Spring 2004.Evidence from small studies shows that the effectiveness of huperzine A may be comparable to that of the approved drugs. Back to top Omega-3 fatty acids Omega-3s are a type of polyunsaturated fatty acid (PUFA). they are unregulated and manufactured with no uniform standards. 2006. Research has linked certain types of omega-3s to a reduced risk of heart disease and stroke. literature review by the Cochrane Collaboration found that published research does not currently include any clinical trials large enough to recommend omega-3 supplements to prevent cognitive decline or dementia.S. The FDA recommends taking no more than a combined total of 3 grams of DHA or EPA a day. “Supportive but not conclusive research shows that consumption of EPA and DHA omega-3 fatty acids may reduce the risk of coronary heart disease. 25. with no more than 2 grams from supplements.S. Because currently available formulations of huperzine A are dietary supplements. The chief omega-3 in the brain is DHA. which is found in the fatty membranes that surround nerve cells. especially at the microscopic junctions where cells connect to one another. an individual could increase the risks of serious side effects. Food and Drug Administration (FDA) permits supplements and foods to display labels with “a qualified health claim” for two omega-3s called docosahexaneoic acid (DHA) and eicosapentaenoic acid (EPA). The U.
nonprofit organization that makes objective assessments of available evidence on a variety of issues in treatment and health care. Rich branching creates a dense “neuron forest. Working with laboratory cell cultures. A report in the April 2006 Nature described the first direct evidence for how omega-3s might have a helpful effect on nerve cells (neurons). antiinflammatory effects. the researchers found that omega-3s stimulate growth of the branches that connect one cell to another.” which provides the basis of the brain’s capacity to process. nerve cells degenerate for reasons that are not yet understood. and support and protection of nerve cell membranes. Theories about why omega-3s might influence dementia risk include their benefit for the heart and blood vessels.should be a priority area for further research. store and retrieve information. According to the review. See also the 2004 FDA press release announcing extension of the qualified health claim for omega-3s and coronary heart disease from supplements to foods. Back to top Phosphatidylserine Phosphatidylserine (pronounced FOS-fuh-TIE-dil-sair-een) is a kind of lipid. that is the primary component the membranes that surround nerve cells. In Alzheimer’s disease and similar disorders. or fat. The Cochrane Collaboration is an independent. The first clinical trials with phosphatidylserine were conducted . results of at least two larger clinical trials are expected in 2008. There is also preliminary evidence that omega-3s may also be of some benefit in depression and bipolar disorder (manic depression). The theory behind treatment with phosphatidylserine is its use may shore up the cell membrane and possibly protect cells from degenerating.
The brain stem sits beneath your cerebrum in front of your cerebellum. yet weighs only about three pounds. The authors concluded that the results were encouraging but that there would need to be large carefully controlled trials to determine if this could be a viable treatment. It also controls movement. three parts Your brain is your most powerful organ. and feeling. thinking. digestion. It controls coordination and balance. most trials were with small samples of participants. A report was published in 2000 about a clinical trial with 18 participants with ageassociated memory impairment who were treated with phosphatidylserine.with a form derived from the brain cells of cows. Three pounds. . heart rate and blood pressure. It connects the brain to the spinal cord and controls automatic functions such as breathing. 1. There have been some animal studies since then to see whether phosphatidylserine derived from soy may be a potential treatment. 3. The cerebellum sits at the back of your head. This line of investigation came to an end in the 1990s over concerns about mad cow disease. Some of these trials had promising results. The cerebrum fills up most of your skull. under the cerebrum. It has three main parts: 1. 2. It is involved in remembering. problem solving. However. It has a texture similar to firm jelly.
solve problems and make plans. • • Form and store memories. your brain may use up to 50 percent of the fuel and oxygen. Control voluntary movemen . Supply lines Your brain is nourished by one of your body's richest networks of blood vessels. The cortex: "Thinking wrinkles" Your brain’s wrinkled surface is a spe outer layer of the cerebrum called the Scientists have “mapped” the cortex b identifying areas strongly linked to ce functions.2. where billions of cells use about 20 percent of the oxygen and fuel your blood carries. Specific regions of the cortex: • Interpret sensations from you body. sounds and smell the outside world. When you are thinking hard. • Generate thoughts. The whole vessel network includes veins and capillaries in addition to arteries. With each heartbeat. arteries carry about 20 to 25 percent of your blood to your brain. and sights. 3.
thoughts. The neuron forest The real work of your brain goes on in individual cells. th language area is chiefly o the left. Scientists call this dense. Neurons are the chief type of cell destroyed by Alzheimer's disease. Experts are not how the "left brain" and "ri brain" may differ in functio except: • The left half contr movement on the body's side. ." Signals traveling through the neuron forest form the basis of memories. • The right half con the body's left side. or neurons. branching network a "neuron forest. An adult brain contains about 100 billion nerve cells. Left brain/right brain Your brain is divided into r left halves. with branches that connect at more than 100 trillion points. Brain Tour Brain Basics 1234567 Alzheimer's Disease and the Brain 8 9 10 11 12 13 14 15 16 Act 17 Link Cre 5. and feelings. • In most people.4.
All rights reserved.272. www. Scientists have identified dozens of neurotransmitters.alz.org. contact brandhelp@alz. If you are a member of the general public. carrying signals to other cells. The neurotransmitters travel across the synapse.© 2009 Alzheimer's Association.3900 If you are a member of the media and want to request permission to reproduce images. 6. Nerve cells connect to one another at synapses. Cell signaling Signals that form memories and thoughts move through an individual nerve cell as a tiny electrical charge.org | 800.org. it may trigger release of tiny bursts of chemicals called neurotransmitters. Alzheimer's disease disrupts both the way electrical charges travel within cells and the activity of neurotransmitters. Signal coding . contact media@alz. . When a charge reaches a synapse.
our experiences create patterns in signal type and strength. have new experiences and acquire new skills. at the cellular level. the brain shrinks dramatically. The positron emission tomography (PET) scan on the left shows typical patterns of brain activity associated with: • • • • Reading words Hearing words Thinking about words Saying words Activity is highest in red areas and then decreases through the other colors of the rainbow from yellow to blue-violet. our brains code our thoughts.100 billion nerve cells… 100 trillion synapses… dozens of neurotransmitters… This “strength in numbers” provides your brain’s raw material. Specific activity patterns change throughout life as we meet new people. affecting nearly all its functions. . Alzheimer’s changes the whole brain Alzheimer’s disease leads to nerve cell death and tissue loss throughout the brain. skills and sense of who we are. 8. The patterns also change when Alzheimer’s disease or a related disorder disrupts nerve cells and their connections to one another. memories. Over time. Over time. These patterns of activity explain how.
This slide shows a crosswise "slice" through the middle of the brain between the ears. More brain changes Here is another view of how massive cell loss changes the whole brain in advanced Alzheimer's disease. Under the microscope . an area of the cortex that plays a key role in formation of new memories. • Shrinkage is especially severe in the hippocampus.These images show: • A brain without the disease • A brain with advanced Alzheimer’s • How the two brains compare . planning and remembering. • Ventricles (fluid-filled spaces within the brain) grow larger. damaging areas involved in thinking. 10. In the Alzheimer brain: • The cortex shrivels up.
Scientists are not absolutely sure what causes cell death and tissue loss in the Alzheimer brain. but plaques and tangles are prime suspects. Beta-amyloid is chemically "sticky" and gradually builds up into plaques. build up between nerve cells. 11.Scientists can also see the terrible effects of Alzheimer's disease when they look at brain tissue under the microscope: • Alzheimer tissue has many fewer nerve cells and synapses than a healthy brain. More about plaques Plaques form when protein pieces called beta-amyloid (BAY-tuh AM-uh-loyd) clump together. • Dead and dying nerve cells contain tangles. Beta-amyloid comes from a larger protein found in the fatty membrane surrounding nerve cells. • Plaques. The most damaging form of beta-amyloid may be groups of a few pieces rather than the plaques themselves. which are made up of twisted strands of another protein. The small clumps may block cell-to-cell signaling at synapses. They may also activate immune system . abnormal clusters of protein fragments.
More about tangles Tangles destroy a vital cell transport system made of proteins. • 13. 12. cell parts and other key materials travel along the “tracks.” • A protein called tau (rhymes with wow) helps the tracks stay straight.cells that trigger inflammation and devour disabled cells. Food molecules. This electron microscope picture shows a cell with some healthy areas and other areas where tangles are forming. which eventually die. They fall apart and disintegrate. • In areas where tangles are forming: Tau collapses into twisted strands called tangles. • The tracks can no longer stay straight. In healthy areas: The transport system is organized in orderly parallel strands somewhat like railroad tracks. • Nutrients and other essential supplies can no longer move through the cells. Progression through the brain .
• Severe Alzheimer’s – may last from 1 . • Earliest Alzheimer's – changes may begin 20 years or more before diagnosis. but some people may survive up to 20 years. The course of the disease depends in part on age at diagnosis and whether a person has other health conditions. 14. People with Alzheimer’s live an average of eight years. • Mild to moderate Alzheimer stages – generally last from 2 .Plaques and tangles (shown in the blue-shaded areas) tend to spread through the cortex in a predictable pattern as Alzheimer’s disease progresses. Earliest Alzheimer stages . The rate of progression varies greatly.10 years.5 years.
expressing themselves and organizing their thoughts. Mild to moderate Alzheimer's In mild to moderate stages. They may also get confused and have trouble handling money. plaques and tangles begin to form in brain areas involved in: • • Learning and memory Thinking and planning 15. Many people with Alzheimer’s are first diagnosed in these stages. before symptoms can be detected with current tests.In the earliest stages. individuals develop problems with memory or thinking serious enough to interfere with work or social life. As a result. brain regions important in memory and thinking and planning develop more plaques and tangles than were present in early stages. Plaques and tangles also spread to areas involved in: • Speaking and understanding speech • Your sense of where your body is in relation to objects around you .
individuals may experience changes in personality and behavior and have trouble recognizing friends and family members. Individuals lose their ability to communicate.As Alzheimer’s progresses. 16. The brain shrinks dramatically due to widespread cell death. to recognize family and loved ones and to care for themselves. Clinical Studies þÿ Search By State Visit our action site Become an advocate . most of the cortex is seriously damaged. Severe Alzheimer's disease In advanced Alzheimer’s disease.
prevention and diagnosis. Improved treatments can never become a reality without testing in human volunteers. More than 100 clinical studies are now recruiting participants with and without Alzheimer’s disease. new treatments must undergo clinical studies (testing in human volunteers. but anyone can consider helping to advance knowledge about an illness affecting them or someone close to them. Following successful laboratory work or animal studies. scientists have made enormous strides in understanding how Alzheimer’s disease affects the brain. Scientists work constantly to find better ways to treat diseases. Many of these recent insights point toward promising new strategies for treatment. also called clinical trials). No one ever chooses to become ill. Back to top Reasons to consider participating You can make a difference! Clinical studies are the engine that powers medical progress. There is reason for optimism about experimental . related diseases or memory loss to help test these exciting new approaches.Enroll in MedicAlert + Safe Return Ask a librarian • Introduction Consider participating How clinical trials work How to find a study • • • • More information Introduction Over the last 15 years.
No investigational treatment advances to clinical testing unless there is strong evidence indicating it will be as good or better than currently available therapies Every study matters. The system gradually builds evidence for a drug’s effectiveness and determines that a drug has an acceptable “safety profile” (that is. Scientists believe this advantage may be due to the general high quality of care provided during clinical studies.treatments. These studies provide further information about safety and focus on determining the best dose of a drug. regardless of whether the experimental treatment works. Every clinical study contributes valuable knowledge.S. the first stage of human testing. Phase II trials enroll up to a few hundred volunteers with the condition the drug is designed to treat. Food and Drug Administration (FDA) has established a rigorous sequence of testing for experimental drugs. the risks associated with its use are reasonable. These studies are primarily concerned with assessing risks and side effects associated with a drug. Phase I trials. but Phase II trials are generally . Experimental drugs must perform well enough in each phase to be allowed to progress to the next one. Back to top How clinical trials work Studies proceed in “phases” The U. given its potential benefit). All participants receive regular care related to the study and opportunities to talk to study staff. • • • Preclinical studies in laboratories establish a scientific basis for believing a drug is reasonably safe and may be effective. Scientists also watch for signs of effectiveness. Participants receive a high standard of care. typically enroll fewer than 100 volunteers. whether or not the treatment works as hoped. Research shows that people involved in studies tend to do somewhat better than people in a similar stage of their disease who are not enrolled.
Doctors can also convince themselves a treatment is working because they care about their patients and want to help them get better.” This means that some study participants are randomly chosen by a computer to receive the experimental treatment and some receive a “placebo” (an inactive. just because they believe a treatment is helping them. • Phase IV trials. There are two main strategies to reduce the likelihood that hopes and beliefs will affect the outcome of clinical studies: 1) Trials are “placebo-controlled. And some studies can be designed so all participants get the treatment for part of the study.” This means that both participants and study staff are “blind” (unaware) about who is getting the drug and who is getting the placebo. look-alike treatment). They provide the chief evidence for safety and effectiveness that the FDA will consider in deciding whether to approve a drug.too small to provide clear evidence about benefit. are often required by FDA after a drug is approved. • Phase III trials enroll several hundred to thousands of volunteers. Some studies are designed so the group of participants getting the treatment is larger than the group receiving the placebo. Back to top Designed for accuracy Scientists have learned that people can sometimes feel better. often at multiple study sites nationwide. also called post-marketing studies. The trial sponsor must monitor the health of individuals taking the drug to gain further insight into its long-term safety and effectiveness and the best way to use it. Back to top Safety behind the scenes . 2) Trials are “double-blinded. and even have improved results on medical tests.
People who decide to join the study must sign the informed consent form. It is often more challenging to assess the impact of drugs for chronic. Participants are also free to leave a study at any time. Examples of these criteria include: Limiting participants to a certain age range Requiring participants to be in a certain stage of the disease • Not allowing health conditions other than the one being • • . Individuals who are invited to participate in a study are not required to do so.Although participants and study staff don’t know who’s getting the drug and who’s getting the placebo. researchers define “inclusion and exclusion criteria” for each clinical study. To eliminate certain factors that make it harder to assess a treatment. Committee members regularly analyze data behind the scenes and step in if they notice any worrisome patterns of serious side effects in drug recipients. Informed consent is the process of learning key facts about a study before deciding whether to volunteer. Some drugs. serious diseases. independent Data Safety and Monitoring Committee with access to this information. Back to top Matching participants to studies Enrolling the right participants helps researchers maximize the likelihood of accurately measuring the effect of an experimental treatment. have an obvious effect that is easy to detect. Back to top Informed consent Participating in research is a big step. The FDA requires potential participants to be given complete information about the study in writing. most trials have a separate. like antibiotics for an infection. Study staff also meet personally with each potential participant to explain risks and possible benefits and answer any questions. including Alzheimer’s and related diseases.
please see our Clinical Trials Index. As the largest private.272. In addition. These advances occurred on all fronts. 2007: The Year in Alzheimer Science • • • Introduction Promoting research and supporting individuals with Alzheimer's • Focus on prevention Research advances span the spectrum • Caring for the caregiver Association expands research funding • • More information Introduction The year 2007 entered the history books as a period of tremendous advances in Alzheimer research. the Association brought together . Your local Alzheimer’s Association may be aware of additional opportunities. imaging studies to identify Alzheimer's in the living brain and blood tests that may one day be used to diagnose Alzheimer's. the Alzheimer's Association played a key and highly visible role in nurturing research.3900. encompassing areas as diverse as genetic risk factors for Alzheimer's. This role included not only providing more than $21 million in funding for research grants. You may also call our 24/7 Helpline at 1. nonprofit funding organization for Alzheimer research. but also launching the Clinical Studies Initiative to explore ways to improve recruitment and retention of clinical study participants.800.• studied • Not permitting use of certain other medications Requiring participation of a caregiver or “study partner” Back to top How to find a study near you If you would like to consider participating in research.
data collection was being completed and analysis of data undertaken. Tulsa. the Association began physician outreach efforts to foster positive attitudes toward clinical studies and generate increased referrals to studies. such as the introduction of the Champions Campaign and publication of the inaugural issue of Alzheimer's Disease Facts and Figures. Atlanta. At the end of 2007. The first stage of the initiative was the implementation of a ninemonth pilot program conducted at five Alzheimer's Association chapters (Providence.I.. The program included physician market research. Ind. their knowledge of the local research environment and reasons for previous reluctance to refer individuals to clinical studies... the Alzheimer's Association in April 2007 launched the Clinical Studies Initiative. Calif. .). R. Based on market research data. market research assessed physicians' attitudes toward studies. These research efforts paint only part of the picture of the Association's accomplishments in 2007.. Because physicians' opinions about clinical studies can greatly influence individuals' decisions about participation. feed into the Association's broader research efforts by increasing awareness of both the impact of the disease and the urgent need for escalated national funding to combat it. physician outreach and efforts to increase consumer awareness. Ga. Back to top Promoting research and supporting individuals with Alzheimer's who help make it possible Clinical studies are the basis for advancement of knowledge in all areas of medicine. Many of the Association's other accomplishments. To better understand the issues at play when clinical study participation is being considered. and Mountain View. Indianapolis. but these studies are sometimes hampered by difficulty in recruiting individuals to participate. Okla.researchers from around the world at the International Conference on Prevention of Dementia and convened two Research Roundtable meetings to spur collaborations in the field.
000 scientists. the Association hosted the first of four town hall meetings across the country to give people living with the early stages of the disease the opportunity to discuss issues they face and share helpful resources.C.. Alzheimer's Association president and CEO. In November the FDA expanded its Patient Consultant and Patient Representative Programs to include individuals in the early stages of Alzheimer's disease and their caregivers." said Harry Johns. June 9–12. drug discovery. physicians and policymakers gathered in Washington. at the second Alzheimer's Association International Conference on Prevention of Dementia. "People who are living with this terrible disease have much to offer to the pharmaceutical industry. The 250-plus presentations addressed topics including emerging diagnostic strategies. Beginning July 28. 2007. 2007. Part of the Association's Early Stage Initiative. D. A "virtual" town hall meeting Web site was developed to ensure the widest possible access to the valuable perspectives shared.S. these town hall meetings gave the Association and wider public the opportunity to learn from those who are still able to advocate for themselves. Food and Drug Administration (FDA) to give those directly affected by Alzheimer's a more active role in the review and approval of new drugs. The Alzheimer's Association took its commitment to individuals with Alzheimer's even further in 2007 when it asked the U. and their voices must be heard. researchers and government regulators. risk factors and experimental therapies in clinical trials.While the scientific community recognizes the pivotal role that research participants play in advancing knowledge. the Alzheimer's Association's commitment extends beyond promoting that role to supporting the myriad needs of individuals with Alzheimer's. programs and services. Back to top Conference and brain health 'Road Map' focus on prevention More than 1. During the conference the Centers for Disease Control and Prevention (CDC) and the Alzheimer's Association released the first National Public Health .
told the gathering. legislators and the public health community would be mobilized to study. which was designed to block aggregation of beta-amyloid into plaques. recommends particular actions to be taken to support cognitive health and calls for additional research to better understand the risk factors for cognitive decline and to design interventions to prevent it. when it too was halted.Road Map to Maintaining Cognitive Health. updates on research under way were much anticipated highlights of the conference.P.052 individuals with Alzheimer's. The clinical trial had been carried out at 67 sites and involved 1. however.. Treatment horizon In the meantime. the makers of Flurizan. CDC Director Julie L. Our challenge is to offer a coordinated and unified national effort. The Road Map meets that challenge by laying out a shared vision that builds on the foundation of the work done to date and shapes the work of the future. provides strategies for assessing public perceptions about cognitive health.. The European trial.S. Myriad. "By embracing cognitive health as a priority issue.H.cdc. The makers of Alzhemed (Neurochem) announced that the U. clinical trial of the drug had been halted due to high data variations among trial sites that had invalidated the statistical model for evaluating the drug. Road Map The Road Map highlights the importance of maintaining and improving cognitive health to the overall health of the nation. was continued until November. These are therapies that either reduce the production of the protein beta-amyloid that forms the hallmark plaques of Alzheimer's or that increase the clearance of beta-amyloid from the brain. reported results of a 12-month . available at http://www." The Road Map. but in late August revealed that the FDA had deemed trial results inconclusive. Neurochem hoped to develop a new statistical model to lessen the impact of site variations. identify and implement effective interventions that preserve it.gov/. M. Gerberding. Many of the updates focused on anti-amyloid therapies. M.D.
SORL1 In the January 14. delivered as a vaccine. 2007 yielded advances that underscore the vast number of approaches taken by investigators to better understand Alzheimer's. 2007. made by Elan and Wyeth. Flurizan reduces beta-amyloid by changing the activity of an enzyme involved in its production. was stopped in 2002 when 6 percent of study participants experienced brain inflammation. Back to top Alzheimer research advances span the spectrum of approaches In addition to the research news presented at the International Conference on Prevention of Dementia. Bapineuzumab is a "passive vaccine" that delivers antibodies against beta-amyloid. A Phase II trial of AN-1792. people in the mildest stages of Alzheimer's who received the highest drug dose showed significant stabilization or improvement in cognition and function. After 24 months of treatment. The drug is expected to move into Phase III trials in 2008. made by Lilly. Researchers continued to collect data on participants and found that those who developed the highest levels of anti-amyloid antibodies appeared to have benefited from the vaccine. While AN-1792 was an "active vaccine" designed to stimulate production of beta-amyloid antibodies in participants.follow-on study to a Phase II trial. Phase III studies were begun. Conference attendees also heard an update on AAB-001 (Bapineuzumab). Development of the drug was informed by preceding trials of the companies' drug AN1792. researchers . online Nature Genetics. Results of Phase II studies showed that the gamma-secretase inhibitor decreased beta-amyloid levels in both blood and spinal fluid. the first anti-amyloid drug to reach clinical trials. A Phase III study was also planned for LY450139.
Their next step is to examine the areas around the SNPs to try to identify specific genetic variations that might lead to Alzheimer's. The study results were based on genetic information from more than 6.and gamma-secretase cut it apart. before death. The article describes the first postmortem study of an individual with dementia who.800 individuals. The gene. is one of several involved in a cellular sorting process that sends amyloid precursor protein (APP) down one of two paths: a path in which it is recycled or a path that moves it to cell structures called endosomes where the enzymes beta. Hispanics and Israeli Arabs with Alzheimer's had a different one.described results of a study implicating the gene SORL1 in lateonset Alzheimer's disease. Because Alzheimer's can now only be definitively diagnosed on autopsy. freeing the beta-amyloid peptide component of APP to leave the brain cell. Study results published in the March 2007 issue of Archives of Neurology demonstrated that significant strides are being made toward that goal. also known as SORLA (sortilin-related. had undergone positron emission tomography (PET) after injection of Pittsburgh compound B (PIB). while African-Americans. large studies. a radioactive dye. combine with additional beta-amyloid and potentially form the amyloid plaques of Alzheimer's. low-density lipoprotein receptor class A repeatcontaining protein). only SORL1 was associated with an increased risk of Alzheimer's. If the accuracy of PET-PIB is replicated in additional. When researchers investigated the genes involved in APP sorting. a postmortem comparison of amyloid distribution was necessary to confirm the accuracy of PET-PIB. PET-PIB An established technology for identifying Alzheimer's in the living brain will be an invaluable tool for early diagnosis of the disease and monitoring the effects of drugs designed to stop or slow its progression. The study showed that the distribution of amyloid at autopsy matched the overall distribution on PET-PIB. The association between SORL1 and Alzheimer's was statistically significant in six of nine cohorts. it could enable a definitive diagnosis of . Researchers used single-letter changes in gene sequence (called SNPs for single nucleotide polymorphisms) to track SORL1 genes and found that Caucasians with Alzheimer's had one SNP. 48 percent of whom had Alzheimer's.
Further research is needed to determine their accuracy in large. Among the 92 study volunteers. would be enormous. but caregivers' . the former included an article describing the physical toll of being an Alzheimer caregiver. Comparing 41 caregivers with 41 noncaregivers. whether it revolves around genetics. In its September 15 issue. a distinct body of research has developed around Alzheimer caregivers as well. the pattern accurately identified 91 percent of volunteers who would go on to develop Alzheimer's during the follow-up period. the protein pattern identified with 90 percent accuracy those who had clinically diagnosed Alzheimer's. They found that as few as 18 proteins were needed to identify an Alzheimer's-specific pattern. looking for patterns that differed between people with and without Alzheimer's. 2007. In 47 volunteers with mild cognitive impairment. such as a blood test. the scientific community takes a step closer to uncovering the causes of and potential treatments for Alzheimer's. They studied 120 proteins involved in cell-to-cell communication. blood tests or an array of other approaches. Researchers reported taking a step in that direction in an article appearing October 15. diverse patient populations.Alzheimer's in the living brain. Telomeres are the genetic material at the end of chromosomes that promote error-free cell division. Shortening of telomeres is a natural part of aging. in the online Nature Medicine. researchers found that Alzheimer caregivers had shorter telomeres than noncaregivers. But with every study. This is only one of several tests of this type in development. Back to top Caring for the caregiver While most basic science and clinical research in Alzheimer's focuses on individuals with the disease. Protein patterns The impact of an even simpler test for Alzheimer's. Among the journals publishing articles on caregivers in 2007 were the Journal of Immunology and American Journal of Geriatric Psychiatry. imaging.
senior director of programs for the Association. Dr. and 2007 was no exception. Added Jane Tilly.telomeres were shortened to an extent comparable to four to eight years of aging beyond the shortening found in the control group. Throughout its 27-year history. the journal describes the effect of extra counseling and support versus standard support in 406 caregivers. "Our highly collaborative.P. The effect began within four months of the start of the study and continued for more than a year. the Alzheimer's Association has led the way in supporting and educating individuals with Alzheimer's and caregivers alike. Half the caregivers had six sessions of individual and family counseling. During the conference the Association released its Dementia Care Practice Recommendations for Assisted Living Residences and Nursing Homes: Phase 3. Ph. the third in a series of recommendations.. These most recent recommendations focus on improving the end-of-life experience for people with Alzheimer's and other forms of dementia by offering concrete suggestions for addressing issues pertinent to this population. The recommendations were the results of collaborations among Association staff members. 2007. participated in support groups and received telephone counseling as needed.D. "Underlying the…recommendations is a person-centered approach to dementia care. From August 26 to 29. In its September issue. learn from renowned aging experts and participate in educational programs tailored to their unique needs. representatives of more than 30 national associations and other experts. providing care professionals with the opportunity to connect with peers from around the country. which involves tailoring care to the abilities and changing needs of each resident. but not formal counseling sessions. Geriatric Psychiatry published results of a study testing an intervention for Alzheimer caregivers. Those in the first group reported better physical health than did those in the second group. director of quality care advocacy for the Association. the Association held its 15th annual Dementia Care Conference. The other half received help when they asked for it." said Peter Reed.H. End-of-Life Care. They also had fewer immune system T cells and more inflammation-promoting proteins. consensus-based process ensures that ..
000 to $450.C. Cure Alzheimer's Fund and Lou Ruvo Brain Institute announced that they had joined forces to establish the Tomorrow's Leaders in Alzheimer's Disease Research Awards. treatment or prevention of Alzheimer's.D.000 to each of three outstanding new M. The Roundtable facilitates collaborations between researchers in academia and industry. including the Zenith Award. The grants program offers several types of awards. with industry membership expanding in 2007 . while the November 12– 14 meeting focused on the latest diagnostic tools for early-risk assessment. In July 2007 evidence of the Association's commitment to funding research grew when the Association. Since the grants program began in 1982. which in 2007 provided an additional $200. the Alzheimer's Association stepped up its efforts to provide financial support to investigators through its 2007 grants program. The annual award program provides $100. The first awards will be given in 2008. D.000. investigators who have made pivotal contributions to basic understanding. or Ph.000 per grant awarded. early detection.the recommendations represent the best dementia care practices and…are practical so nursing homes and assisted living residences can incorporate them into the daily care routines of their residents." Back to top Alzheimer's Association expands research funding In the face of decreased federal funding for Alzheimer research. it has provided more than $220 million for Alzheimer research. To speed research advances.D. This unique forum for the sharing of information continues to grow in popularity. an increase from $250. The May 30–31 meeting convened more than 90 members and invited guests to explore the academic-industry interface for Alzheimer's drug discovery. The Association awarded more than $21 million for 109 research projects from a competitive field of 639 applications from 42 states and 27 countries. the Association hosted two Research Roundtable meetings in Washington.
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