home

==  //**Alzheimer's Disease**// Alzheimer’s disease is the most frequently occurring form of dementia. Dementia is a brain dysfunction that affects intelligence and occurs in older people.

** Detection- ** Alzheimer’s disease is detected by extensive tangles of plaque in the brain during a brain biopsy; this means that they cannot tell for sure that a person has this disease until they are dead. Researchers are finding commonalities in the brains of people with Alzheimer’s by using positron emission tomography (PET) scans. Currently, physicians observe the behavior of the person and perform a physical examination. Some physicians also use a screening test called the Mini-Mental State Examination (MMSE); this determines short and long term memory and the patient’s writing and speaking skills. Some physicians do paper and pencil testing such as drawing a clock with a time of five o’clock on it. In 2000, researchers developed a blood test that could pick up early stages of Alzheimer’s. This is done by looking for a specific protein that is low in concentration in people with this disease’s blood. In brain imaging, physicians can predict dementia twelve to twenty-four months before the symptoms appear; this is done through MRI and PET scans. A carrier cannot be detected at this time.

**Disease Inherited-** It is currently not known how familial Alzheimer’s is inherited. The leading thought of it being inherited is through gene mutation. Researchers think they found a correlation of Alzheimer’s with the mutation of the apoE gene on chromosome 19; this has a tendency, depending on the allele inherited, to form Alzheimer’s in old age. Researchers think that there are other genes that affect a person’s likelihood of getting this disease as well as environmental factors such as lifestyle and health of the person. Early-onset Alzheimer’s disease, which means the symptoms occur before the person is sixty, is the only known type that forms through hereditary. It occurs through mutated genes on chromosomes 1, 14, and 21. These mutations occur in an autosomal dominant inheritance pattern. **Effects on the person-** According to the Global Deterioration Scale there are seven stages of Alzheimer’s disease. Stage 1 : No cognitive decline -Experiences no problems Stage 2 : Very mild cognitive decline -Forgets names and locations of objects -May have trouble finding words Stage 3 : Mild cognitive decline - Has difficulty traveling to new locations -Has difficulty handling problems at work Stage 4 : Moderate cognitive decline -Has difficulty with complex tasks (finances, shopping, planning dinner for guests) -Decreased knowledge of personal history and current events Stage 5 : Moderately severe cognitive decline -Needs help to choose clothing -Needs prompting to bathe Stage 6 : Severe cognitive decline -Needs help putting on clothes -Requires assistance especially with bathing -Has decreased ability to use the toilet -May forget names of spouses or loved ones -Has a change in emotions, personality, and sleep patterns Stage 7 : Very severe cognitive decline -Vocabulary becomes limited, eventually lost -Loses ability to walk and sit -reduced consciousness -unable to feed and toilet self The health of a person with Alzheimer’s disease will continue to deteriorate until it causes death. The rate of deterioration is usually between two to twenty years but varies per person depending on different factors such as lifestyle and previous health of the person.

**Effects on the family-** Most people with Alzheimer’s disease live at home but have the help of medical aides. The aides are important because studies have shown that 10% of family caregivers have become injured or sick out of direct consequence of caring for the person with Alzheimer’s. About 45% of the family caregivers are depressed. If the person with Alzheimer’s stays at the home, the home has to be modified so that it is safe for that person to live there. Some go to nursing homes and some go to state provided adult day centers so that family members can continue to work. The Alzheimer’s Association and the US Justice Department created a “Safe Run” program because people with Alzheimer’s sometimes wander off and cannot find their way back. The patient is given a special ID bracelet and is registered in a national database. This program is very successful; thousands of people have been returned home.  **Treatment and current research-** Currently there is no cure to Alzheimer’s disease. Researchers are still looking for a c ure and are coming close. There are a lot of clinical studies/trials going on. The US Food and Drug Administration (FDA) has approved two types of medicines to treat cognitive symptoms of Alzheimer’s disease—cholinesterase inhibitors and memantine. These drugs delay the symptoms for an average of six to twelve months. Cholinesterase prevents the breakdown of a chemical messenger involved in memory and learning. Memantine regulates the activity of a different chemical messenger involved in memory and learning. Vitamin E is also prescribed to help delay the loss of the ability to carry out daily activities. Some physicians tell patients to do crossword puzzles and play specific games made for people with Alzheimer’s disease to exercise their brains. Some patients use adaptive devices such as an alarm wristwatch that remind them to take their medication.

Jeanne is a sixty-six year old woman who has lived with Alzheimer’s for twelve years. This interview is from http://alz.org/living_with_alzheimers_8673.asp. Jeanne has written a book about her experiences with Alzheimer’s disease and has a local TV series in her home state of Hawaii. She says that staying busy keeps her “downhill progress” go a little bit slower because she doesn’t think about it. Jeanne states, “… many persons ages 29 to 70 can have early-stage dementia and still contribute to society. We are not totally with care partners nor are we less than intelligent beings. We just move a bit slower than the rest of the population. Don't even think of counting us out.” She travels the world to give lectures on Alzheimer’s but notes that she has to read most of her lectures and cannot travel alone. She cannot do some things any longer but tries her hardest to focus on the things she still can do. She points out, “On a good day, I am capable of writing a reasonably coherent letter. And yet on other days, I cannot even find a single word to begin the letter. Just because I have a hard time expressing myself does not mean I don't still have the same feelings and emotions – some may be even stronger.” Jeanne is a person that can inspire us all to focus on the things we know how to do and not get caught up in what we cannot do. 
 * [[image:alz5.jpg width="358" height="341" align="left" caption="top left- healthy brain, top right- Alzheimer's disease infected brain, bottom- comparison" link="http://alz.org/alzheimers_disease_4719.asp"]]   Personal perspective- **

**Statistics-** A study done in 1996, of thousands of families with a relative that had Alzheimer’s, found the risk of developing Alzheimer’s. -11% if neither parent has Alzheimer’s -36% if one parent has Alzheimer’s -54% if both parents have Alzheimer’s -40-50% if an identical twin has Alzheimer’s -In U.S. 68% of people affected with Alzheimer’s are women -In U.S. 85% of people affected with Alzheimer’s are white -The chance of getting Alzheimer’s increases with age -In U.S. about 10% of all people older than 65 have Alzheimer’s -In U.S. 30-50% of people older than 85 have Alzheimer’s Gwyther, Lisa P. __Understanding Stages and Symptoms of Alzheimer's Disease__. 19 Nov. 2008. Alzheimer's Disease Education and Referral Center of the National Inst. on Aging. 27 Dec. 2008 .
 * Bibliographies**

Kandel, Joseph, and Christine Adamec. "Alzheimer's disease and senior health." //The Encyclopedia of Senior Health and Well-Being//. New York: Facts on File, Inc., 2003. //Health Reference Center//. Facts On File, Inc. http://www.fofweb.com/activelink2.asp?ItemID=WE48&SID=5&iPin= ESHW0017&SingleRecord=True (accessed December 11, 2008).

Lillrank, Sonja M. "Alzheimer's disease." //Alzheimer's Disease and Other Dementias//, Psychological Disorders. New York: Chelsea House Publishing, 2007. //Health Reference Center//. Facts On File, Inc. http://www.fofweb.com/activelink2.asp?ItemID=WE48&SID=5&iPin= PDADOD0004&SingleRecord=True (accessed December 27, 2008).

"Alzheimer's disease." //The Facts On File Encyclopedia of Health and Medicine//. New York: Facts On File, Inc., 2006. //Health Reference Center//. Facts On File, Inc. http://www.fofweb.com/activelink2.asp?ItemID=WE48&SID=5&iPin= EHM0310&SingleRecord=True (accessed December 27, 2008).