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Alzheimer's disease: What you need to know?
By fc/nih
Jan 15, 2007 - 9:58:18 AM
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Twenty-nine variations in a gene known as SORL1 have been
identified, which may affect production of a protein that determines the level of
amyliod beta fragments- key components for plagues found in the brains of
Alzheimer's patients, according to a study published in
the Nature Genetics online on Jan. 14 2007.
Richard Mayeux and colleagues from Columbia University,
Boston University and the University of Toronto with assistance from other 14
institutions, analyzed blood samples from 6,000 individuals for seven genes that
were initially believed to have an impact on Alzheimer's.
They found that variations of the gene SORL1 are associated
with Alzheimer’s, but not other six genes.
Further, they found that faulty genes reduce production of the SORL1
protein, resulting in high production of amyloid beta fragments, which form
plaques in the brains of Alzheimer’s patients.
For more information, read an earlier report titled
Alzheimer's
gene found.
But here we cited the basics on Alzheimer’s disease from the
National Institute of Health for those who want to know more about the disease.
This citation does not indicate that foodconsumer.org
has any association with the government’s agency, nor implies that we endorse
the opinions reflected in the Questions and Answers.
Questions and Answers about Alzheimer's disease
1. What is Alzheimer's disease?
Alzheimer's disease is the most common cause of dementia
among older people. It is marked by progressive and, at present, irreversible
declines in certain cognitive functions. These impairments may include declines
in memory, time and space orientation, abstract thinking, the ability to learn
and carry out mathematical calculations, language and communication skills, and
the performance of routine tasks.
Other symptoms of Alzheimer's disease include personality
changes and impairment of judgment.
2. What is dementia?
Dementia is a group of symptoms characterized by a decline
in intellectual functioning severe enough to interfere with a person's normal
daily activities and social relationships. Alzheimer's disease is the most
common cause of dementia in older persons.
The second most common cause of dementia is multi-infarct
dementia, which is caused by a series of strokes. Dementia can also develop
from other diseases affecting the nervous system, including Parkinson's disease
and AIDS.
3. What is senile dementia?
Senile dementia is an outdated term once used to refer to
any form of dementia that occurred in older people.
4. How many people suffer from Alzheimer's disease?
It is estimated that up to 4 million people currently suffer
from Alzheimer's disease in the
United
States. The proportion of people with the
disease doubles every 5 years beyond the age of 65.
5. What is the age of most people with Alzheimer's disease?
In most people with Alzheimer's disease, symptoms first
appear after age 60. About 3 percent of men and women ages 65 to 74 have the
disease, but nearly half of those age 85 and older may have the disease. The
average age at diagnosis is about 80. It is not uncommon for individuals to
have mild symptoms for some time before a diagnosis is made.
6. Do we know what causes Alzheimer's disease?
Scientists do not yet fully understand what causes
Alzheimer's disease, but it is clear that Alzheimer's disease develops as a
result of a complex series of pathological events that takes place over time
inside the brain.
How Alzheimer's Affects Neurons in the BrainAge is the most
important known risk factor for Alzheimer's disease.
7. If a member of my family has Alzheimer's disease, am I at
increased risk for developing it?
Two types of Alzheimer's disease exist: familial Alzheimer's
disease or FAD, which is an early-onset form of the disease that appears to be
inherited, and sporadic Alzheimer's disease, where no obvious inheritance
pattern is seen. Approximately 5 percent of Alzheimer's disease is familial and
approximately 95 percent is sporadic.
In familial Alzheimer's disease or FAD, several members of
the same generation in a family are often affected. Sporadic Alzheimer's
disease develops as a result of variety of factors which scientists are still
attempting to determine.
Age is the most important known risk factor for sporadic
Alzheimer's disease. Having a family member with Alzheimer's disease does
increase the risk two to three-fold in sporadic Alzheimer's disease, but by no
means guarantees that you will develop the disease.
8. What other factors, beside genetics, contribute to
developing Alzheimer's disease?
Although the cause of Alzheimer's disease is not yet
established, researchers suggest that factors such as the buildup of damage
from molecules known as oxygen free radicals -- which are a normal part of
metabolism -- may be involved when neurons stop functioning.
Slides of neurofibrillary tangles and amyloid plaques in
brain tissue.This "oxidative stress" may contribute to the
development of Alzheimer's disease. Chronic inflammation in the brain also may
be a contributing factor, as may head injury with loss of consciousness that
occurred years before.
9. Do men or women have a higher risk of developing
Alzheimer's disease?
More women than men have Alzheimer's disease, although their
higher lifetime risk may only reflect the effects of age. Women have longer
life spans than men.
10. How does a head injury affect the development of
Alzheimer's disease?
Some studies have shown that there is about a two-fold
increased risk for Alzheimer's disease among people who have suffered previous
head injuries with loss of consciousness from which they recovered, but other
studies show no association.
11. Does educational level affect the development of
Alzheimer's disease?
Research suggests that the more years of formal education a
person has, the less likely he or she is to develop Alzheimer's disease later
in life.
The Nun StudySome studies suggest that keeping an active
mind by engaging in activities such as crossword puzzles may help to maintain
function.
12. What is the relationship between aluminum and the
development of Alzheimer's disease?
One of the most publicized and controversial hypotheses in
the area of Alzheimer's disease research concerns aluminum, which became a
suspect in Alzheimer's disease when researchers found traces of this metal in
the brains of people with Alzheimer's disease. Many studies since then have
failed to provide consistent or conclusive evidence of a role for aluminum in
Alzheimer's disease.
13. What are the stages in the development of Alzheimer's
disease?
Alzheimer's is a progressive disease; the symptoms grow
worse over time. Yet, it is also a variable disease. Symptoms progress at
different rates and in different patterns. The appearance and progression of
symptoms will vary from one person to the next.
Some of the common symptoms are:
* anxiety,
paranoia, suspiciousness, agitation
* changes in
personality and judgment
* confusion and
memory loss
* difficulty with
activities of daily living, such as feeding and bathing
* difficulty
recognizing family and friends
* disorientation
* getting lost in
familiar surroundings
* hallucinations
and delusions
* loss of appetite
* weight loss
* loss of bladder
and bowel control
* loss of speech
* problems with
routine tasks
* repetitive
speaking or action
* sleep
disturbances
* total dependence
on caregiver
* wandering,
pacing.
14. How is Alzheimer's disease diagnosed?
Alzheimer's disease can only be conclusively diagnosed by
examining the brain after death in an autopsy to determine the presence of
characteristic plaques and tangles in certain brain areas. However, doctors can
make a clinical diagnosis of "possible" or "probable"
Alzheimer's disease in a living person.
Several tools are used to arrive at this diagnosis. These
include a complete medical history and tests that measure memory, problem
solving, attention, counting, and language abilities. Medical tests such as
analysis of blood and urine are used to determine if the dementia has another
cause.
Diagnosing Alzheimer's DiseaseBrain scans can be used to see
whether the person has abnormalities such as strokes that could account for the
dementia.
15. How accurate are tests for Alzheimer's disease?
Cognitive Test for Alzheimer'sDoctors in specialized
Alzheimer's disease treatment centers can now diagnose Alzheimer's disease with
up to 90 percent accuracy in a living person.
16. What other conditions have symptoms like Alzheimer's
disease?
Tumors, strokes, severe depression, thyroid problems,
medication side effects, nutritional disorders, and certain diseases can all
have effects that mimic those of Alzheimer's disease. Early diagnosis increases
the chances of treating these conditions successfully.
17. Is misplacing your keys a normal part of aging or could
it be a symptom of Alzheimer's disease?
Problems with memory may be due to a variety of factors. It
is normal for people of all ages occasionally to forget names, appointments, or
the location of objects like their keys. Such memory problems may result from
stress, distractions, grief, fatigue, poor vision or hearing, use of alcohol,
an illness, or trying to remember too many details at once.
Clinical depression also may cause poor concentration, sleep
disturbance, or other symptoms that lead to forgetfulness in people who do not
have Alzheimer's disease. A decline in short-term memory that sometimes
accompanies aging is called age-associated memory loss and does not lead to
Alzheimer's disease.
People with early-stage Alzheimer's disease often experience
forgetfulness. They may have constant trouble remembering recent events,
activities, or the names of familiar people or things. Memory loss that is
associated with Alzheimer's disease interferes with activities of daily living.
18. What is mild cognitive impairment?
Mild cognitive impairment, or MCI, is a change in memory
that is different from both Alzheimer's disease and normal age-related memory
change. People with MCI have greater than normal age-associated memory
problems, but do not have other cognitive losses typical of Alzheimer's such as
confusion, attention problems, or difficulty with language.
Researchers funded by the National Institute on Aging are
conducting the Memory Impairment Study to learn whether early diagnosis and
treatment of mild cognitive impairment might prevent or slow further memory
loss, including the development of Alzheimer's disease.
19. How important is a diagnosis of Alzheimer's disease?
The earlier an accurate diagnosis of Alzheimer's disease is
made, the greater the gain in managing symptoms and allowing the person to take
part in future life course decisions.
20. How long do people with Alzheimer's disease live after
developing the disease?
Persons with Alzheimer's disease often live for years with
the disease, eventually dying from pneumonia or other diseases. The duration of
Alzheimer's disease from time of diagnosis can be 20 years or more. The average
length of time from onset of symptoms is thought to be in the range of 4 to 8
years.
21. How is Alzheimer's disease treated?
No treatment is yet available that can stop Alzheimer's
disease. However, for some people in the early and middle stages of the
disease, the drugs Cognex®, Aricept®, Exelon®, or Razadyne® may help prevent
some symptoms from becoming worse for a limited time. Memantine, also known by
its brand name Namenda®, is approved for use in moderate to severe forms of the
disease.
Photo of Alzheimer's disease research lab.Also, some
medicines may help control behavioral symptoms of Alzheimer's disease such as
sleeplessness, agitation, wandering, anxiety, and depression. Treating these
symptoms often makes people with Alzheimer's more comfortable and makes their
care easier.
22. Is there currently a vaccine for Alzheimer's disease?
Currently, there is no vaccine available to treat
Alzheimer's disease. The vaccine approach is being investigated for its
potential to stimulate the immune system to recognize and attack the amyloid
plaques associated with Alzheimer's.
Amyloid plaques are one of the hallmarks of Alzheimer's
disease and are thought to contribute to the loss of some cognitive functions,
such as memory. While one recent clinical trial of a vaccine was halted when
some patients in the study were reported to have signs of inflammation in the
central nervous system, the search for a vaccine continues to be an active area
of study.
23. Can estrogen be used to treat Alzheimer's disease?
Research is under way to see if estrogen reduces the risk of
Alzheimer's disease or slows the disease. One study showed that estrogen does
not slow the progression of already diagnosed disease, but more research is
needed to find out if it may play another role. For example, scientists now are
trying to find out whether estrogen can prevent Alzheimer's disease in women
with a family history of the disease.
Estrogen and progesterone combination therapy is not
recommended for prevention of cognitive decline or dementia. In one large
national study of women 65 and older, Prempro, a specific form of combination
hormone therapy, was found to double the risk of dementia in women on
combination therapy when compared to those not taking the medication.
24. What options are there for people who want to help test
new treatments for Alzheimer's disease?
People with Alzheimer's disease and those with mild
cognitive impairment who want to help scientists test possible treatments may
be able to take part in clinical trials. Clinical trials are research studies
on people to find out whether a new drug or treatment is both safe and
effective.
New therapies are tested on people only after laboratory and
animal studies show promising results. The Food and Drug Administration, or
FDA, sets strict rules to make sure that people who agree to be in the studies
are treated as safely as possible.
The U.S. National Institutes of Health, through its National
Library of Medicine and other Institutes, maintains a database of clinical
trials at ClinicalTrials.gov. Click here to see a list of the current clinical trials on
Alzheimer's disease. A separate window will open. Click the "x"
in the upper right hand corner of the "Clnical Trials" window to
return here.
25. What other resources exist that can provide information
about Alzheimer's disease?
The National Institute on Aging's Alzheimer's Disease
Education and
Referral
Center, or the
ADEAR
Center,
is a reliable source of information about Alzheimer's disease. Contact ADEAR at
1 (800) 438-4380 or visit the web site at www.alzheimers.org
Topic last updated: 14 January 2005
http://nihseniorhealth.gov/alzheimersdisease/faq/faq7c.html