Alzheimer’s disease (AD) is a devastating illness that gradually robs sufferers of their memory and other mental functions, leading to an inability to carry out activities of daily living, to a life of dependency, and eventually to death. Today, it is the sixth leading cause of death in the United States. There is no known cure and only a few approved treatments.
More than 4.5 million Americans currently are living with the disease and that number is expected to triple over the next 50 years as the baby boomer generation grows old. Currently, approximately one in eight people aged 65 and older have this brain-destroying illness, while nearly one in two people over 85 may be affected.
It is important to note, however, that AD is not a normal part of aging.
People under age 60 may get AD, but not as frequently as people past age 60. The number of young sufferers, however, is hard to estimate and may be underreported. For example, a 53-year old may start having problems at work, such as engaging in inappropriate behavior or missing deadlines—both are possible early signs of brain impairment—but such symptoms often go unrecognized until they progress into a full-blown dementia.
Alzheimer’s disease exhibits several warning signs. But if you or someone you know has some—or even most—of the following symptoms, don’t panic. Only a neurologist, a psychiatrist, or other specialist trained in evaluating memory disorders can diagnose Alzheimer’s disease and other dementias. According to the National Institutes of Health, the seven warning signs of Alzheimer’s disease are:
• asking the same question over and over again
• repeating the same story, word for word, again and again
• forgetting how to cook, how to make repairs, how to play cards, or how to do other activities that were previously done with ease
• losing the ability to pay bills or balance a checkbook
• getting lost in familiar surroundings or misplacing household objects
• neglecting to bathe, or wearing the same clothes over and over again, while insisting that they have taken a bath or that their clothes are still clean
• relying on a spouse or others to make decisions or answer questions they previously would have handled themselves
For many years, Alzheimer’s disease was considered an inevitable consequence of aging, but now we know that, similar to heart disease, AD has multiple risk factors that are modifiable. In fact Alzheimer’s disease may share some of the same risk factors as heart disease, including poor diet, lack of exercise, overweight, high cholesterol, and high blood pressure. Perhaps this is one reason why no clear line separates Alzheimer’s disease and vascular dementia, which comes about when blood vessels that feed the brain become narrow or clogged, either slowly or after a stroke.
Many scientists have now become interested in identifying factors that help protect people from AD’s devastating effects, and they have identified several factors closely related to better mental performance:
• more education
• professional success
• enhanced physical activity
• a lively and varied cognitive life
• robust social interaction with others
A 2003 study published in the New England Journal of Medicine, for example, found that people over 75 who danced, read, or played a musical instrument had lower rates of dementia.
No treatment has been proven to stop or reverse Alzheimer’s disease. However, in some patients in the early and middle stages of the disease, the drugs donepezil (Aricept®), rivastigmine (Exelon®), or galantamine (Razadyne®, formerly known as Reminyl®) may for a limited time help prevent some symptoms from becoming worse. And the drug memantine (Namenda®), though limited in its effects, has been approved to treat moderate-to-severe AD. Recently, the FDA also approved the use of donepezil to treat moderate-to-severe AD.
These treatment gains are of course modest, but every step forward is crucial. Statistics show that if a treatment can be found that delayed the onset of Alzheimer’s disease by just five years, the number of people with the disease would be cut in half. Even one that could delay the disease’s onset by a few months would have tremendous public health significance.
The increase in our understanding of the mental impairment and dementia of Alzheimer’s disease, as well as the availability of treatments for AD, brings new hope to the search for disease-preventing agents. The discovery of an effective treatment is essential because, without advances in therapy, the number of Alzheimer’s cases in the United States is predicted to rise to over 13 million by 2050. Alzheimer’s disease is poised to become an enormous public health problem.
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