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MEMORY LOSS:
Alzheimer's Disease affects approximately 70% of all patients with memory disorder, and is the fourth leading cause of death among elders in the U.S. Alzheimer's disease is the most common form of "dementia", a degenerative disease of the brain characterized by progressive loss of memory. It affects approximately 70% of all patients with memory disorder, and is the fourth leading cause of death among elders in the U.S. The average life expectancy of patients with Alzheimer's disease is 8 to 10 years, although it can range between 3 to 20 years. Alzheimer's disease typically affects the elderly, and is uncommon in persons younger than 50 years. Most cases of Alzheimer's disease are sporadic, although 10% of patients may have a family history of the disease. A smaller percentage has inheritable mutations in their genes (known as the amyloid precursor protein gene, presenilin I gene, and presenilin 2 gene), and patients can be tested for these mutations. Not all cases of dementia (progressive memory loss) are due to Alzheimer's disease. Other causes of dementia include the so-called "Lewy Body disease" (which is usually also accompanied by some form of movement disorder) and "vascular dementia" (due to disease of blood vessels supplying nutrition to the brain). Some dementing conditions are potentially reversible (such as those induced by drugs, vitamin deficiencies, and depression). Forgetfulness and temporary lapses in memory may also be related to normal aging process, which are not generally associated with impairment of other mental functions (such as reasoning, judgment and comprehension). In some elderly people, the degree of forgetfulness may be greater than expected in healthy aging, but it is usually not severe enough to interfere with daily functioning. Certain forms of memory (like remote memory, world knowledge, vocabulary, remembering gist of information) remain stable with aging. Memory functions that may decline with aging include new learning (which occurs at a slower pace), ability to process new information in-depth, recalling details of new information and events, and non-verbal memory (such as misplacing things). These symptoms become more severe and progressive in patients with Alzheimer's disease. Because Alzheimer's disease is characterized by a progressive but slow progression of symptoms, it usually takes a few years before the patient is diagnosed with the disease. Some patients may not be aware of their behavioral changes, so that information comes more from friends and relatives who are able to notice the slow decline in their mental ability. Patients with AlzheimerÕs disease respond vaguely to questions on mental status information because of their limited ability to retain details of the information that is related to them. They have a tendency to insert bits of information that were not originally presented to them , and make up stories to compensate for their lack of ability to remember complex new material. Approximately 15% of patients with AlzheimerÕs disease may be slow in walking, have lack of facial expression and low voice volume, which are symptoms usually associated with Parkinson's disease. The presence of focal arm or leg paralysis, loss of sensation and unstable gait (or unsteady walking) may indicate that the mental dysfunction is due to multiple strokes rather than due to Alzheimer's disease. Patients with Alzheimer's disease lose their ability to remember, become oriented in time and place, express themselves, understand and learn new information, draw or construct visual images, become focused, perform daily tasks, solve problems, and pay attention to details. Serial mental screening tests (such as the Mini-Mental State Examination) can allow for comparison between the baseline (initial) and follow-up studies, but these may not be sensitive enough to detect subtle decline in mental function. Carefully developed neuropsychological tests can be performed on patients who are suspected of having Alzheimer's disease. It is also important to rule out depression as a cause for the change in mental status (so-called pseudo-dementia). Symptoms of depression (loss of interest, slow responses, lack of energy and decreased attention and memory) can occur in patients with Alzheimer's disease. Agitation and psychosis (hallucinations and delusions) occur in approximately 30% to 50% of patients with Alzheimer's disease and should not be confused with a primary psychiatric illness. Personality changes are noted, but most patients maintain their basic personality make-up until the late stages of the disease. Special studies (such as CT scans and MRI or magnetic resonance imaging of the brain) are performed to rule out the presence of stroke, tumor or other lesions in the brain that might be causing the memory disorder. Blood studies are done and the status of liver, kidney and thyroid are evaluated to rule out metabolic or endocrine disorder . The treatment is likely to be most effective in the early stages of Alzheimer's disease. Donepazil (an inhibitor of the enzyme acetylcholinesterase) can improve alertness and behavior in approximately 5% of patients. Large doses of Vitamin E (2000 IU/day) and herbs such as ginkgo biloba may also be slightly beneficial. Recent studies suggest that a non-steroidal anti-inflammatory drug, ibuprofen (Advil) and estrogen in women may also reduce the incidence or slow the progression of Alzheimer's disease, but more studies and needed to confirm this. [Cullum CM and Rosenberg RN. Memory Loss: When Is It Alzheimer Disease? Journal of American Medical Association (1988), vol 279, pp. 1689-1690]. |
NANAY Inc. is supported by Florida Older Americans Act, Alliance for Aging for Miami-Dade and Monroe Counties, Florida Department of Transportation, Miami-Dade Alliance for Human Services, Dept of Health and Human Services, Miami-Dade County Office of Community and Economic Development, North Miami CDBG, Association of Asian Pacific Community Health Organizations (AAPCHO), National Asian Women's Health Organization (NAWHO), AETNA Foundation and United Way (Miami-Dade Reg. # 161126)
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When is it Alzheimer's Disease?