An Introduction to Alzheimer's Disease
Ask a healthy senior what they fear most about getting older, and you'll likely here "Alzheimer's" or "dementia." First, you lose your mind. Then you lose your body. Alzheimer's is a terminal disease with no cure.
Alzheimer's and the Dementia Family
The word dementia is not a disease itself but rather a "descriptive term for a collection of symptoms that can be caused by a number of disorders affecting the brain," says the Stanford School of Medicine.
Alzheimer's disease is the most common form of dementia. Other diseases in the dementia family include Parkinson's, vascular dementia, mixed dementia, dementia with Lewy bodies, frontotemporal dementia, Creutzfeldt-Jakob disease, and normal pressure hydrocephalus.
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The main results of dementia-related diseases are damaged brain cells or damaged connections between brain cells, which lead to memory loss and one or more the following conditions, according to the Alzheimer's Association:
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- Decline in coherent speech, or the ability to understand written and spoken language.
- Decline in the ability to recognize objects
- Decline in motor skills, sensory function and comprehensive of the required task
- Decline in ability "to think abstractly, make sound judgments, and carry out complex tasks."
People with Alzheimer's eventually exhibit all of these conditions.
A Brief History of Alzheimer's
In 1901, a 51-year-old woman, Auguste D., became a patient of German physician Alois Alzheimer (1864-1915). At the Hospital for the Mentally Ill and Epileptics in Frankfurt, Alzheimer studied dementia and nervous disorders.
Doctors had known about dementia for centuries but attributed it simply to old age.
But Auguste D's case was different because she was relatively young. Her symptoms included "reduced comprehension and memory, aphasia, disorientation, unpredictable behavior, paranoia, auditory hallucinations and pronounced psychosocial impairment," says an article in the medical journal, The Lancet.
The following is taken from Alzheimer's case history file for Auguste D:
"During physical examination she cooperates and is not anxious. She suddenly says Just now a child called, is he there? She hears him calling…she knows Mrs. Twin. When she was brought from the isolation room to the bed she became agitated, screamed, was non-cooperative; showed great fear and repeated I will not be cut. I do not cut myself."
After Auguste D died in 1906, Alzheimer examined her brain and case history. Her brain appeared shrunken and contained weird clumps of protein called plaques and tangled fibers inside the nerve cells—two main features of Alzheimer's.
He reported his findings of a new form of dementia to a German psychiatrist's conference, later publishing his lecture titled: "A characteristic serious disease of the cerebral cortex."
Unfortunately, the medical community did not recognize Alzheimer's as a disease until the 1970s. Fortunately, since then focus on the disease, its causes, effects and the brain's overall functioning has exploded.
How Alzheimer's Works
We don't know how Alzheimer's begins, but it likely initiates in the brain about a decade before the signs become noticeable. During this pre-stage, toxic changes are occurring throughout the brain.
A normal adult brain has 100 billion neurons. Each neuron has long branching extensions that form specialized connections to other neurons. These connection points are called synapses (the brain has 100 trillion of them).
Synapses allow information to flow via chemical pulses from one neuron to another. Think of it as one big highway of communication for memories, thoughts, emotions, sensations and movements.
Deposits of protein beta-amyloid accumulate outside nerve cells (neurons) forming hard plaque. At the same time, abnormal versions of the protein tau accumulate inside the neurons causing a neuron's transport microtubule to collapse.
Over time, these neurons begin to function less efficiently, eventually losing the ability to communicate with one another. As neurons die, brain tissue begins to shrink. And as the disease spreads to the outer layer of the brain (cerebral cortex), one's judgment worsens.
This is the beginning of the end for those with Alzheimer's.
Alzheimer's: By the Numbers
- Alzheimer's is the most common type of dementia
- An estimated 5.4 million Americans have Alzheimer's
- Every 69 seconds someone in America develops Alzheimer's
- One in Eight older Americans has the disease
- Alzheimer's is the sixth leading cause of death across all ages in the U.S.
- Between 2000 and 2008, deaths from Alzheimer's increased 66% while deaths from heart disease, stroke, breast cancer, and prostate cancer all declined.
- About 4% are under 65, 6% are 65 to 74, 45% are 75 to 84 and 45% are 85 and older
- Almost two-thirds of those with Alzheimer's are women. However, women are not more susceptible to the disease. They simply live longer than men.
- Proportionately, older African-Americans and Hispanics are more likely to have Alzheimer's than whites.
It seems every year a new study is published uncovering something new, a step forward on tackling this insidious disease that affects so many. One recent study suggests that women taking estrogen for menopause may be protected from Alzheimer's. Or this Case Western Reserve study showing the positive effects of a drug on rats with Alzheimer's.
We're getting there but it may be too late for some.
To learn more, read "Causes of Alzheimer's" to see what doctors believe increases your risk.
If your loved one needs Alzheimer's care, read, "Finding the Best Memory Care Facility."
Updated: Oct 31, 2011