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Alzheimer’s disease affects about 4.5 million older Americans, particularly those aged 65 or older. Because of the aging population, the number of people with this disease is expected to quadruple by the year 2050. According to the Alzheimer's Association, approximately one in 10 families has a relative with Alzheimer's disease.

W. Vincent Perrelli, M.D., a geriatrician at Mount Auburn Hospital in Cambridge, a teaching hospital of Harvard Medical School, says, “Alzheimer’s is a devastating, ultimately fatal disease that disables many older adults in our country; however, with early diagnosis of Alzheimer’s, we can sometimes slow the progress of the disease.”

Alzheimer’s develops when healthy brain tissue degenerates, resulting in a loss of intellectual and social abilities and a progressive decline in memory and mental capacity. Ultimately, the person with Alzheimer’s is unable to carry on the activities and tasks of daily living.

Dr. Perrelli points out that while Alzheimer’s may seem more prevalent today, there are two factors contributing to this perception. One is that our population is aging with more people living past 85 than ever before. The older people are, the more likely it is that they will develop Alzheimer’s. Consequently, the population most vulnerable to this disease is increasing and will continue to increase as the baby boomers age. In addition, in recent years, Alzheimer’s has been recognized as a disease entity and not as an inevitable consequence of aging.

Alzheimer's disease is named after Dr. Alois Alzheimer, a German neurologist. In 1906, when he examined the brain of a woman who had died after years of dementia, he found abnormal clumps and irregular knots of brain cells. Today, these clumps (now called plaques) and knots (now called tangles) are considered key characteristics of Alzheimer's disease. While Dr. Alzheimer actually first defined the disease in 1906, it took nearly 100 years for Alzheimer’s disease to become an official diagnosis.

Dr. Perrelli points out that the words, “dementia” and “senility,” are often used interchangeably with Alzheimer’s, although they refer to similar conditions. But however the disease is defined, it’s important to understand that it is not a normal part of aging. Alzheimer’s disease is an actual pathological process that is not necessarily inevitable in the elderly.

Forgetfulness is often sited as one of the earliest symptoms of Alzheimer’s; however, occasional memory lapses are normal. You should only be concerned when memory losses become much more frequent and when the person affected forgets the names of familiar objects or people.

Some symptoms of Alzheimer’s include the following: the loss of recent as opposed to remote memory; an inability to function independently, such as not being able to care for yourself or balance your checkbook; unreasonable behavior showing poor judgment, such as going outside in the bitter cold without a coat or running into traffic; executive function abnormalities, which means an inability to conceptualize or plan a normal course of activity. People with Alzheimer’s may also experience dramatic mood swings and changes in personality. Unfortunately, the person with Alzheimer’s does not usually recognize that these symptoms are taking place, although the person may sense that something is wrong. It usually takes family, friends, or caregivers to recognize that these symptoms, which are sometimes subtle at first, are developing and make sure the affected person receives medical attention.

Physicians diagnose Alzheimer’s disease by observation of symptoms and questioning of the patient and caregivers. There is currently no biological means, such as a blood test, to diagnose Alzheimer’s, but there are established behavioral characteristics of the disease that can usually be good guides for the physician making the diagnosis.

While Alzheimer’s cannot be cured, there are medications available that can slow the progress of the disease, often extending the time a person can function independently. These drugs are most effective if taken in the early stages of the disease, which emphasizes the importance of seeking medical attention at the first sign of symptoms. Dr. Perrelli observes that many families go through denial when their loved one starts exhibiting Alzheimer’s symptoms, and they only bring the family member in for evaluation when the symptoms are pronounced. Unfortunately, at that point the medications may not be as effective. He emphasizes that even if the signs are subtle, the person should be evaluated as soon as symptoms appear.

Once Alzheimer’s is diagnosed, the normal progression of the disease takes six to twelve years, although its duration varies widely in individuals. It’s difficult to determine the duration of the disease because so many times the diagnosis occurs a number of years after the disease first started developing. Unfortunately, the ultimate outcome of Alzheimer’s disease is death.

While no one knows what causes Alzheimer’s, there is a very small genetic predisposition to the disease. Your risk of developing Alzheimer's appears to be slightly higher if a first-degree relative — parent, sister or brother — has the disease. It is also suspected that there may be a vascular component to Alzheimer’s disease related to build-up of plaque in the vessels in the brain. There are some European studies which actually show that cholesterol-lowering drugs can improve the course of Alzheimer’s. Consequently, you should do what you would do to keep your heart healthy—exercise regularly, maintain a lean weight, don’t eat saturated fats, and don’t smoke. In addition to keeping your cardiovascular system in good shape, you may also be reducing your likelihood of developing Alzheimer’s disease

The majority of people with Alzheimer’s live at home — often receiving part- or full-time care from family members. Caring for someone with Alzheimer's is undeniably a challenge. It’s important to focus on the things a person can still do and enjoy. People with Alzheimer’s and their caregivers need a lot of support from their family members and friends. There are also many community resources that offer support to elderly adults with Alzheimer’s and their families.

There is much research currently being conducted in the area of Alzheimer’s disease—research aimed at curing, reversing and preventing this devastating disease. So there is hope for future generations as they age.

Dr. Perrelli says, “We hope that in the future we will have more effective tools for preventing and treating this life-altering disease; however, in the meantime, the most important step you can take is to recognize the early symptoms of Alzheimer’s in those around you and make sure the person with symptoms receives a medical evaluation. Early medical intervention may at least be able to slow down the person’s decline and allow them to remain independent longer.”

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