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Senior Citizen's Guide

Alzheimer's Disease 101

Alzheimer's disease is the most common form of dementia, a progressive brain disorder that diminishes an individual's thinking skills. Alzheimer's is a degenerative brain disease that usually begins gradually, causing a person to forget recent events or familiar tasks. It eventually causes memory loss, disorientation, confusion, personality and behavior changes, and impaired judgment. These losses are related to the breakdown of the connections between nerve cells in the brain and the eventual death of many of these cells. People with the disease struggle to find words, finish thoughts, or follow directions; they think less clearly and are easily confused. As the disease progresses, they may forget how to perform simple tasks, such as dressing themselves, brushing their teeth, or eating with proper utensils. They can become delusional and may hallucinate. Eventually, most people with Alzheimer's become bedridden and unable to care for themselves. They often develop other illnesses and infections and most commonly die of pneumonia.

Who is at risk for Alzheimer's?

The greatest known risk for developing Alzheimer's is increasing age. Ten percent of all people age 65 and older and fifty percent of all people age 85 and older have Alzheimer's. Family history, having a parent or sibling with Alzheimer's, also increases your chances of developing the disease. In rare cases, people in their 30s, 40s, and 50s can develop the disease. This is called early-onset Alzheimer's. This form of the disease has been linked to three different genes. Individuals who carry one of these genes will most likely develop Alzheimer's.

What causes Alzheimer's disease?

No one has yet determined exactly what causes Alzheimer's disease. Researchers are learning more about what happens to the brain as we grow older, what happens to brain cells in Alzheimer's patients, and about the genes associated with the disease. Most researchers agree that a variety of factors, rather than just one, may cause the disease.

How is Alzheimer's disease diagnosed?

A physician should be consulted about concerns with memory, thinking skills, and changes in behavior. Some dementia-like symptoms can be reversed if they are caused by treatable conditions, such as depression, drug interactions, thyroid problems, and certain vitamin deficiencies.

No one diagnostic test can determine if someone has Alzheimer's disease. The process involves several kinds of testing and may take more than one day. Diagnostic tools and criteria make it possible for physicians to make a diagnosis of Alzheimer's with 90 % accuracy.

The diagnostic process usually involves a primary care physician and possibly other specialists. Evaluations may include the following:

• A medical history, which collects information about current mental or physical conditions, prescription and nonprescription drug use, and family health history.

•A mental status evaluation to assess sense of time and place and ability to remember, understand, communicate, and perform simple math problems.

• A series of evaluations that test memory, reasoning, hand-eye coordination, and language skills.

• A physical examination, which includes evaluation of the person's nutritional status, blood pressure, and pulse.

• An examination that tests sensation, balance, and other functions of the nervous system.

• A brain imaging procedure to detect other causes of symptoms, such as stroke or tumor.

• Laboratory assessments, such as blood and urine tests, to provide additional information about problems other than Alzheimer's that may be causing dementia.

• A psychiatric evaluation, which assesses mood and other emotional factors that could cause dementia-like symptoms or may accompany Alzheimer's.

Can Alzheimer's be prevented?

New research has found preliminary evidence that diet, nutrition, cholesterol levels, body weight, exercise, blood pressure, as well as intellectual stimulation and social contact, may play a role in preventing or delaying the onset of Alzheimer's.

Are prescription drugs available to treat the disease?

Four federally approved drugs (donepezil, or Aricept®; galantamine, or Reminyl®; rivastigmine, or Exelon®; tacrine, or Cognex®) can prevent the breakdown of acetylcholine, a chemical messenger in the brain involved in memory and thinking. These drugs maintain levels of acetylcholine, even while cells that produce it continue to become damaged or die. About half of those who take these drugs experience some slowing of decline in cognitive ability for a certain length of time.

How many Americans have Alzheimer's?

Currently, 4 million Americans have the disease. By 2050, that number will rise to 14 million, unless the means of preventing the disease is found.

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