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What is Alzheimer’s

Transcript

In 1907, Alois Alzheimer peered through a microscope at the brain of a 55-year-old woman who had died after a rapid downhill course of pre-mature senility or dementia.1 What he saw was a mass of disordered and twisted protein fragments where normal brain cells and fibers should have been. Describing their appearance, he tagged these “neurofibrillary tangles.” Later, the disease associated with this condition became known as “Alzheimer’s disease.”2 Now, on the eve of the 100th anniversary of Alois Alzheimer’s discovery, how much closer are we to untangling this mess?

The answer is…closer – but not close enough. Alzheimer’s is a tough opponent, and we have a long way to go.

Still, there’s encouraging news for Alzheimer’s patients, which we’ll get to in a moment.

But first, let’s take a look at the history of the disease. Though it was discovered a century ago, the world’s focus on Alzheimer’s is only about 30 years old.3 It took nearly 70 years for the global scientific community to publicly connect the symptoms and findings to the disease and correctly assess the threat as the leading edge of disability for aging societies worldwide. Early in the process, it was recognized that this disease not only devastated the patient, but also family and loved ones; and that dealing with it would require enormous informational, emotional and logistical support.4 Out of this need emerged the Alzheimer’s Association in 1979.5

Thirty years ago, investigation into the disease was fledgling at best. In 1975, the National Institutes of Health awarded only 12 grants at $60,000 each for the study of brain aging.3 Today, the NIH annual research budget for Alzheimer’s disease is approximately $650 million.6 The private industry is “on to this issue” as well, considering the extraordinary numbers and staggering disability involved – two things that, if addressed, would translate into enormous societal good and remarkable earnings.7

The number of people affected and at risk has now come into clear focus. Approximately 6% of those over age 65, and up to 40% of those over age 80, suffer from the disease.3 By 2040, it is estimated that some 14 million people in the United States alone will be affected.8 Related spending is currently around $100 billion a year, and the disease is estimated to be the fourth or fifth most common cause of death in the United States.3

Numbers like these caused medical essayist Lewis Thomas early on to tag this condition “the disease of the century.”9 We know today that the areas most impacted are deep in the brain, not on the surface, affecting sites where activities are organized and integrated, including functions of memory, attention and association, such as putting a time and place to past events. We also know the disease preferentially attacks where we are neurologically most vulnerable -- at the synapse, the point where one nerve cell connects to the next. The chemicals that pass across the synapse, the messengers, if you will, especially acetylcholine, are diminished by the disease. Thus, some treatments for Alzheimer’s attempt to maintain and heighten the acetylcholine that is still present. We have learned that certain chemicals are deposited in the area of destruction, either as a cause of it or an effect from some other primary process, and the names of these chemicals are increasingly recognizable, including amyloid, apolipoprotein and Tau protein. And finally, we now know that genetic mutations on chromosomes 21, 14 and 1 are sometimes associated with familial cases of the disease.3

We now understand that the disease process results in profound behavioral and psychological changes in patients that are predictable and progressive.11 Thirty years ago, a great deal of this was explained away as “benign senescent forgetfulness.”3 But increasingly aggressive diagnostic assessment tools are pushing the time of diagnosis back closer to the point of origin; back closer to the chemical and biological processes that ensure future disability; back closer to an understanding of the events that will allow the development of effective new therapies. Today, experiments utilizing advanced MRIs detect early regional brain tissue loss. PET scans measure declines in regional glucose metabolism and diminished cerebral blood flow, which precede measurable declines in cognitive function. Stress test PET scans detect failure of high-energy demanding synapses as an early signal of future disease. And cerebrospinal fluid levels of chemicals tied to abnormal Tau protein and amyloid peptides help distinguish Alzheimer’s from Parkinson’s disease, alcoholic dementia, and depresssion.3

In addition to the direct focus on the primary disease, scientists now appreciate a variety of contributors to vascular dementia, which can complicate Alzheimer’s and worsen the societal burden in managing the challenges of aging. A focus on diagnosis and chronic management of hypertension, diabetes, cardiovascular disease, sleep apnea, and high circulating cholesterol, protein, and homocysteine could lessen the burden of dementia.8 We also now recognize on the front end of a diagnosis the vulnerability of first responders, and we’re conscious that the “first rule of caregiving is that care of the caregiver is the most effective treatment for the person with Alzheimer’s disease."4

How close are we to solving this riddle, to untangling the tangled web of Alzheimer’s? No one can say for sure, but we are certainly much closer than we were 30 years ago. We have moved from the gross findings and microscopic descriptions to the biologic, chemical, genetic and epidemiologic aspects of this disease. That is to say that scientists have begun to zero-in on the targets and are figuring out how to influence them. At scientific moments like this, it can be difficult to determine the next step. Will the cure help us understand brain function, or will understanding brain function help point us toward a cure? We just don’t know. But it’s clear we’re making progress, and where there’s progress, there is always reason to hope.

For Health Politics, I’m Mike Magee.

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References

1. University of Illinois at Chicago. “Dr. Alois Alzehimer.”
2. University of Okalahoma Health Sciences Center. “Neurofibrillary Tangles.”.
3. Rapoport S. 2006. Alzheimer’s Disease: Thirty Years of Progress. In Alzheimer’s: The Disease of the Century.  International Longevity Center-USA.
4. Wright L. 2006. Caregiving for Alzheimer’s Disease: Challenges and Opportunities. In Alzheimer’s: The Disease of the Century. International Longevity Center-USA.
5. Alzheimer’s Association. “About the Alzheimer’s Association.” Available at http://www.alz.org/AboutUs/overview.asp.
6. National Institutes of Health. “Grants for Alzheimer's Disease Drug Discovery.” Available at http://grants2.nih.gov/grants/guide/pa-files/pas-06-261.html.
7. 2005 Survey-Medicines in Development for Older Americans. “More than 900 Medicines are in Testing to Combat Diseases of Aging.” 2005. Available at http://www.phrma.org/files/New%20Meds%20for%20Older%20Americans.pdf.
8. Butler R. 2006. Introduction. In Alzheimer’s: The Disease of the Century. International Longevity Center- USA.
9. Campbell C. 2004. “The Human Face of Alzheimer’s.” The New Atlantis.
10. Mace N. and Rabins P. The 36 Hour Day.  New York: Warner Books, 2001.
11. Callahan CM et al. 2006. Effectiveness of Collaborative Care for Older Adults with Alzheimer’s Disease in Primary Care. JAMA. 295:18, 2148-2163.

SOURCE:

Dr. Mike Magee, HealthPolitics.org . Health Politics is supported by the Pfizer Medical Humanities Initiative

COPYRIGHT:

Copyright © 2007 HealthPolitics.org. All rights reserved.

Alzheimer’s Foundation of America vs Alzheimer’s Assocation

An interesting letter posted by the CEO of the The Alzheimer's Foundation of America (AFA).

The Alzheimer's Foundation of America (AFA) is proud of our efforts to protect the intent of our donors. It is for that reason that we, regretfully, are currently involved in a lawsuit against the Alzheimer's Association.

We want to update you on the current legal matters facing AFA.

In order to protect the intent of our donors, AFA recently filed a lawsuit against the Alzheimer's Association, and last week, we filed an amended complaint. Our case is straightforward - the Alzheimer's Association has time and again deposited checks into its own accounts from donors who intended to give money to the Alzheimer's Foundation of America. The Alzheimer's Association's chief operating officer has admitted as much under oath, saying that the Alzheimer's Association will deposit any check that has "Alzheimer's" as part of the organization's name.

Despite our requests that the association rectify this situation, the Alzheimer's Association still has not implemented safeguards that protect the intent of its donors and donors to other charitable organizations. Our own investigation has shown that the Alzheimer's Association continues to deposit funds directed to the Alzheimer's Foundation into its own accounts. This must stop.

In sharp contrast, the Alzheimer's Foundation has policies in place to protect the intent of our donors. If we receive a check that is not directed specifically to the Alzheimer's Foundation, we send that check back to the donor with a letter explaining that the donor has sent a donation that was actually written to a different organization. We firmly believe that this is the only honorable course of action for a respectable non-profit institution.

In response to our lawsuit, the Alzheimer's Association has sued our organization, contending that we have somehow infringed on its copyright. This lawsuit comes eight years after we registered our trademarks and have been providing programs and services nationwide to serve the dementia population. Since that time, the Alzheimer's Association has never contested our name or our trademarks. Its lawsuit is nothing but an attempt to divert attention from the real issues at hand, and we are sorry the association has responded in this fashion.

Our work at the Alzheimer's Foundation of America is quite different from the work of the Alzheimer's Association. While we respect its mission, it is not ours. And when donors are kind and generous enough to fund the work that we do, we need to fight to ensure that the money they intend for us in fact gets to us. Until and unless the Alzheimer's Association agrees to safeguards that protect both their donors and our own, we will continue to fight to protect your intent and your money.

Meanwhile, please know that the Alzheimer's Foundation's board of trustees and staff are committed to conducting our operations as usual. We will continue to provide the high level of service to our donors, clients and member organizations that has been AFA's hallmark since our inception, doing our utmost to meet the current and emerging needs of the dementia population across the country. Nothing will deter us from our mission.

Memory Tricks

By Patricia Curtis

Can't remember where you put your glasses? Blanked on your new colleague's name? "Forgetting these types of things is a sign of how busy we are," says Zaldy S. Tan, MD, director of the Memory Disorders Clinic at Beth Israel Deaconess Medical Center in Boston. "When we're not paying good attention, the memories we form aren't very robust, and we have a problem retrieving the information later."

The key, says Harry Lorayne, author of Ageless Memory: Simple Secrets for Keeping Your Brain Young, is to get your brain in shape. "We exercise our bodies, but what good is that great body if you don't have the mental capabilities to go with it?" Sure, you could write everything down, keep organized lists and leave electronic notes on your BlackBerry, cell phone or PDA. But when you don't have access to those aids, or if you want to strengthen your brain, try these expert-recommended strategies to help you remember.

PLUS: Top 10 Tips for a Healthy Brain

Brain Freeze: "What the heck is his name?"

1. Pay attention. When you're introduced to someone, really listen to the person's name. Then, to get a better grasp, picture the spelling. Ask, "Is that Kathy with a K or a C?" Make a remark about the name to help lock it in ("Oh, Carpenter -- that was my childhood best friend's last name"), and use the name a few times during the conversation and when you say goodbye.

2. Visualize the name. For hard-to-remember monikers (Bentavegna, Wobbekind), make the name meaningful. For Bentavegna, maybe you think of a bent weather vane. Picture it. Then look at the person, choose an outstanding feature (bushy eyebrows, green eyes) and tie the name to the face. If Mr. Bentavegna has a big nose, picture a bent weather vane instead of his nose. The sillier the image, the better.

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3. Create memorable associations. Picture Joe Everett standing atop Mount Everest. If you want to remember that Erin Curtis is the CEO of an architectural firm, imagine her curtsying in front of a large building, suggests Gini Graham Scott, PhD, author of 30 Days to a More Powerful Memory.

4. Cheat a little. Supplement these tips with some more concrete actions. When you get a business card, after the meeting, jot down a few notes on the back of the card ("red glasses, lives in Springfield, went to my alma mater") to help you out when you need a reminder.

Download our Life IQ trivia game for your iPhone.

Brain Freeze: "Where in the world did I leave my glasses?"

5. Give a play-by-play. Pay attention to what you're doing as you place your glasses on the end table. Remind yourself, "I'm putting my keys in my coat pocket," so you have a clear memory of doing it, says Scott.

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7. Make it a habit. Put a small basket on a side table. Train yourself to put your keys, glasses, cell phone or any other object you frequently use (or misplace) in the basket -- every time.

Brain Freeze: "What else was I supposed to do today?"

8. Start a ritual. To remind yourself of a chore (write a thank-you note, go to the dry cleaner), give yourself an unusual physical reminder. You expect to see your bills on your desk, so leaving them there won't necessarily remind you to pay them. But place a shoe or a piece of fruit on the stack of bills, and later, when you spot the out-of-place object, you'll remember to take care of them, says Carol Vorderman, author of Super Brain: 101 Easy Ways to a More Agile Mind.

9. Sing it. To remember a small group of items (a grocery list, phone number, list of names, to-do list), adapt it to a well-known song, says Vorderman. Try "peanut butter, milk and eggs" to the tune of "Twinkle, Twinkle, Little Star," "Happy Birthday" or even nursery rhymes.

PLUS: 6 Fish Recipes to Boost Your Brain

10. Try mnemonic devices. Many of us learned "ROY G BIV" to remember the colors of the rainbow, or "Every Good Boy Deserves Favors" to learn musical notes. Make up your own device to memorize names (Suzanne's kids are Adam, Patrick and Elizabeth, or "APE"), lists (milk, eggs, tomatoes, soda, or "METS") or computer commands (to shut down your PC, hit Control+Alt+Delete, or "CAD").

11. Use your body. When you have no pen or paper and are making a mental grocery or to-do list, remember it according to major body parts, says Scott. Start at your feet and work your way up. So if you have to buy glue, cat food, broccoli, chicken, grapes and toothpaste, you might picture your foot stuck in glue, a cat on your knee looking for food, a stalk of broccoli sticking out of your pants pocket, a chicken pecking at your belly button, a bunch of grapes hanging from your chest and a toothbrush in your mouth.

Enhance your IQ with our new Word Power game!

12. Go Roman. With the Roman room technique, you associate your grocery, to-do or party-invite list with the rooms of your house or the layout of your office, garden or route to work. Again, the zanier the association, the more likely you'll remember it, says Scott. Imagine apples hanging from the chandelier in your foyer, spilled cereal all over the living room couch, shampoo bubbles overflowing in the kitchen sink and cheese on your bedspread.

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Brain Freeze: "What's my password for this website?"

13. Shape your numbers. Assign a shape to each number: 0 looks like a ball or ring; 1 is a pen; 2 is a swan; 3 looks like handcuffs; 4 is a sailboat; 5, a pregnant woman; 6, a pipe; 7, a boomerang; 8, a snowman; and 9, a tennis racket. To remember your ATM PIN (4298, say), imagine yourself on a sailboat (4), when a swan (2) tries to attack you. You hit it with a tennis racket (9), and it turns into a snowman (8). Try forgetting that image!

14. Rhyme it. Think of words that rhyme with the numbers 1 through 9 (knee for 3, wine for 9, etc.). Then create a story using the rhyming words: A nun (1) in heaven (7) banged her knee (3), and it became sore (4).

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Brain Freeze: "The word is on the tip of my tongue."

15. Practice your ABCs. Say you just can't remember the name of that movie. Recite the alphabet (aloud or in your head). When you get to the letter R, it should trigger the name that's escaping you: Ratatouille. This trick works when taking tests too.

Brain Freeze: "I just can't memorize anything anymore!"

16. Read it, type it, say it, hear it. To memorize a speech, toast or test material, read your notes, then type them into the computer. Next, read them aloud and tape-record them. Listen to the recording several times. As you work on memorizing, remember to turn off the TV, unplug your iPod and shut down your computer; you'll retain more.

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17. Use color. Give your notes some color with bolded headings and bulleted sections (it's easier to remember a red bullet than running text).

18. Make a map. Imagine an intersection and mentally place a word, fact or number on each street corner.

LostnMissing Grab a Magazine Competition

Posted By: Cynthia Caron Lostnmissing

To: Members in HELP SUPPORT LOSTNMISSING, INC.

Very important message from LostNMissing, Inc Hello all, We know times are very tough, the economy is no fun:( Is it at all possible that those who support LostNMissing and our Cause to please join in the "Grab a Mag" contest? It costs $5.99 plus $2.00 shipping, however, the point is that you will receive a magazine that features 17 missing loved ones. You read it...and then simply leave it behind in your home state at a doctors office, dental office, bus station, anywhere where someone else will happen upon it! HELP spread the news and bring hope to the families of the featured missing loved ones in knowing their missing family members will have recognition all over the USA. We have absolutely nobody that has made a purchase for this contest, as yet:( We need one person from EVERY state in the USA to come forward and help us get the mag out to the public. Won't you please help? See details for the contest on prizes and our goals. You do not have to have a Paypal account to pay via Paypal, or you can mail a check.: http://www.lostnmissing.com/41.html Thank you, in advance, for considering.

Pam Rainey: Seniors should talk to their friends about health changes

When someone asks you how you are doing, what’s your answer? Living in our candy-coated world, I would assume your standard answer is “just fine,” or some variety of that response. Often that question seems like a greeting delivered by someone with a head turned downward and a walk aimed forward.

But are you really fine? If you are living in a senior adult body, you may not be just fine — you might be nearly fine, almost fine or halfway fine. You may be having a bad day or a bad season. Sure, you don’t want to bore innocent people with your troubles, but when is it time to tell your friends how you are really doing?

My good friend is a member of the sandwich generation — meaning she has younger children and an aging parent — and related a conversation she had with her mother, who recently was diagnosed with Alzheimer’s disease. Her mother has good days and bad days. She is still alert enough to know that her memory is declining, but she doesn’t want to level with her lifelong friends about why her social life is not up to par.

Since she can’t read restaurant menus, she just orders what everyone else does. That intimidates her because it can be difficult on the pocketbook and results in food that does not match her taste buds.

She’s also afraid to drive on certain days, so she declines special outings when she knows she is having a bad day or thinks a bad day might be coming.

Since she is missing so much social interaction with lifelong friends who care about her, her daughter advised her to level with friends that she has been diagnosed with dementia. If those who she thought loved her walk away, so be it.

As it turned out, when her mother told her friends what was going on, her fears were not reality. Actually, her circle of friends became tighter and surrounded her with love and support — after sharing tears, hugs and much reaffirmation and commitment to stand by her side.

There are other health issues seniors have that might cause them to have good days and bad days: emphysema, rheumatoid arthritis, fibromyalgia, heart disease and lack of energy.

So, should seniors become martyrs and try to do all they once did, or is it OK to level with those they love and let them know they may not be available at times?

You decide, but let’s explore.

Saying no can be especially difficult for someone who had boundless energy in their youth. It is often a matter of pride and a matter of thinking that those to whom you feel obligated will no longer love you if you cannot be there for them.

It can be especially difficult to say no to our children, who would like us to travel with them or keep our grandchildren for extended stays. When I was young, I never thought my parents were getting older. It took some eye-opening experiences and medical challenges to make me aware of their fragility.

If you spend much time on the computer, your e-mail inbox is full of forwarded items. Sometimes I just don’t have time to read all the cute e-mails my friends send. However, I do appreciate their thoughts.

The other day, I did open an e-mail, and I’m glad I did. It has long left my computer but not my mind. It was about a gentleman who visited his wife every day. His wife had been placed in the Alzheimer’s wing of a nursing home. Someone asked him why he visited her every day, quipping: “She doesn’t remember who you are.” To that he lovingly answered, “Oh, but I remember who she was.”

My point: Those who love us will love us as we grow a little older, a little more absent- minded, and a little less able to play tennis, golf or go on long trips with the gang. They will love us for who we were, and will especially love us for the connection that somehow, someway in this world of billions, united our paths in the right season of our lives.

PAM RAINEY is a 40-year Denton resident and a real estate agent who has helped many seniors make decisions about living arrangements. You can reach her with suggestions at RpmRny@cs.com or 940-367-1188.

http://www.dentonrc.com/sharedcontent/dws/drc/entertainment/stories/DRC_rainey_0502.9767ad2.html

Dog Stayed By Deceased Owner’s Side for 7 Days

The animal chosen for the concluding feature in this series of animal stories wasn't able to save the life of her owner. But she absolutely tried.Lady, a 6-year-old golden retriever, was a loyal companion to 81-year-old Parley Nichols of Hartville, Ohio. The two were always together, and Nichols never left his home without his dog. So when Nichols, who had dementia, wandered off and went missing, Lady stayed right by his side."Dad had been wandering around, and we kept looking for him for a solid week, sending out flyers, doing whatever we could," Terry Nichols, one of Parley's two sons, told PeoplePets.com. A neighbor alerted Nichols to a dog barking and apparently trying to get attention near a creek outside of town, so he and his family investigated. "We found Lady and my dad, who was already dead," Nichols said. "Lady was standing by his side protecting him. We are sure that she never left my dad for seven days, staying alive by drinking water from the creek. ..."I don't know how dogs perceive things but she knew she had to stay with dad no matter what. And she did."

Maine Moves To Protect Lost Seniors

The story of a 77-year-old man who went missing and was later found dead in a remote part of Maine has prompted the Legislature to pass a "Silver Alert" law, which is aimed at preventing similar tragedies in the future.

Gov. John Baldacci on Thursday holds a ceremonial bill signing in his office to mark the law's enactment. Among those scheduled to attend is Claire Young, widow of William Young, whose body was found in the woods 150 miles north of his Auburn home days after he left to search for a woman who had been reported missing. William Young suffered from dementia.

The new law, modeled after Amber Alerts for missing children, creates a statewide public notification system utilizing radio and TV when a senior citizen gets lost.

NYC Expands Alert System to Include Missing Seniors

NEW YORK, NY April 28, 2010 —The city is expanding its emergency public alert system, called Notify NYC, to include missing senior citizens. About 600 older adults go missing each year, often due to Alzheimer's disease or other forms of dementia. Deputy Mayor Linda Gibbs says the city will trigger a "Silver Alert" when public assistance is needed.

"We want all hands on deck, anybody who might have seen this individual, speak up now before any worse circumstance should occur," Gibbs says.

The program is an addition to the local "Amber Alert" program that's activated when a child goes missing. The city is also expanding those alerts, distributing them to yellow cab drivers so they may help in the search for missing kids.

New Yorkers can sign up for these these emergency alerts by zip code at the city's website, NYC.gov.