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Most often asked Alzheimer's questions

By STEPHEN NOHLGREN
Published February 27, 2007


Q: What is Alzheimer's?

Alzheimer's is a disease that destroys brain cells, hampers communication between neurons and seriously impairs a person's ability to function. Memory, language and thought are particularly affected. Symptoms include asking the same question over and over and getting lost in familiar places. The chances of Alzheimer's increases steadily after age 65, but it is not the mild memory decline associated with normal aging. It is a disease.

Q: Why is it called Alzheimer's?

The disease was first identified 100 years ago by German psychiatrist Alois Alzheimer. Scientists did not recognize the disease's widespread prevalence until about 30 years ago.

Q:What causes Alzheimer's?

So far, scientists only understand part of the puzzle. Brains of people with Alzheimer's contain inflammation, sticky clumps of protein called plaque, as well as dead neurons, the brain cells that create memory and thought. Tangled fibers of protein also appear inside the neurons. It is not clear how these conditions interact, though many researchers think that a floating protein fragment called beta-amyloid is probably the central culprit. Beta-amyloid fragments eventually clump together to form the tell-tale Alzheimer's plaque. It is unclear whether the plaque itself destroys neurons or whether it is a byproduct of some other destructive process.

How is Alzheimer's different from dementia?

Dementia is the general term for various cognitive impairments. Alzheimer's accounts for about 90 percent of all dementia. When it comes to symptoms and care-giving needs, it is often hard to distinguish one dementia from another.

How is Alzheimer's diagnosed?

Only a brain autopsy can diagnose Alzheimer's conclusively. But brain scans, physical exams and proper cognitive tests can diagnose it with 90 percent accuracy. It is important to get a diagnosis from a neurologist, psychiatrist or other specialist and to get a complete physical workup. Dementia symptoms sometimes stem from depression, vitamin deficiencies, thyroid problems and other treatable disorders.

Is there any way to know if I will get Alzheimer's?

Right now, most people will get Alzheimer's if they live long enough. The risk begins to escalate sharply at about age 80: About 40 percent of people 85 or older have at least some Alzheimer's. How long you stave off symptoms depends partly on your genes. The disease is more likely to attack people whose siblings or parents had it, though that's not a guarantee.

Early-onset Alzheimer's, which shows up before age 60, usually has a strong genetic connection and runs in families.

How is Alzheimer's treated?

Four FDA-approved drugs are in common use. Aricept, Exelon and Razadyne (formerly called Reminyl) help the brain maintain a chemical important for communication between cells. Namenda does the same thing, but through a different means. Some physicians prescribe Namenda in combination with one of the other three drugs. None of these drugs interrupts the disease itself. They usually produce only short-term benefits.

When will there be a cure?

With luck, new drugs that actually interrupt the disease could hit the market within five years. They may stop Alzheimer's destruction of brain cells, but will not revive dead brain cells. People who now have dementia will not return to their healthy memory levels, but the medicine may keep them from deteriorating further or at least slow down that deterioration.

Do people die from Alzheimer's?

The median survival rate after diagnosis for men is 4.4 years, compared with 5.7 years for women. Often, people with Alzheimer's die from stroke, pneumonia, heart disease and other ailments before Alzheimer's runs its full course. But a brain severely damaged by Alzheimer's can shut down the body.

What about supplements?

None have been proven to help. Despite early reports that vitamin E had protective powers, recent research has rejected that notion. The National Institute on Aging is underwriting clinical trials on gingko biloba and a Chinese herb called hyperzia serrata.

Where can I get more information and help?

Look for resources on Page 20.

Q: Can I prevent Alzheimer's by doing puzzles, exercising, taking supplements and eating right?

Evidence is mounting that a healthy lifestyle can delay the onset of Alzheimer's by years. Exercise seems to be particularly potent. Low-fat diets probably help. Evidence is less solid about puzzles. They may help, but perhaps no more so than gardening, socializing, knitting, reading and other activities that stimulate the brain. Foods rich in omega-3 fatty acids and antioxidants seem to strengthen the brain.

 

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