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As one ages, several nagging questions come to mind. Will my
financial resources last my lifetime? Will my health be good
until I die? Will I be able to stay in my own home? All of these
questions will be impacted by the onset of Alzheimer's disease.
Dr. Alois Alzheimer documented the first known case of
Alzheimer's from 1901 to 1906 at the University of Frankfurt,
Germany. Termed "the long good-bye," it is probably the most
dreaded affliction of old age. Four million Americans have
Alzheimer's disease, and 100,000 of them die every year.
Alzheimer's strikes 7 to 10 percent of people more than 65
years old. It is estimated that more than half of all nursing
home patients have Alzheimer's disease, yet 67 to 85 percent of
Alzheimer's patients are cared for in private homes by members of
their families. A person with the disease can live three to 20
years after diagnosis.
Alzheimer's is a progressive, degenerative disease that
attacks the brain and impairs memory, thinking and behavior, but
motor skills remain functional. Severe forgetfulness is one of
the first symptoms of the disease. Forgetting the name of someone
you see infrequently is normal, but forgetting the name of a
loved one is a serious problem. Eventually, Alzheimer's leaves
individuals unable to care for themselves.
It is essential that anyone experiencing severe memory
problems or confusion be thoroughly examined by a physician
experienced in the diagnosis of Alzheimer's disease. However, a
complete and accurate diagnosis of Alzheimer's can only be made
by examining brain tissue after death.
It is possible there are different ways Alzheimer's
develops. Some may inherit Alzheimer's, and some may not. Three
key factors indicating the disease are an accumulation of starchy
protein, tangles of nerve fibers and death of selected nerve
cells.
Current research at major medical schools and research
universities shows a wide variety of possible causes.
Massachusetts Institute of Technology researchers isolated a
chemical disorder that impacts neurotransmitters in the brain.
Neurotransmitters transmit nerve impulses from one nerve to
another. A study reported this year shows a defect in
mitochondrial genes responsible for converting oxygen into energy
leads to the buildup of proteins currently blamed for causing
Alzheimer's disease. It also creates a loss of energy to brain
cells.
In 1996, a genetic test, which works only after the onset of
symptoms, confirmed an Alzheimer's diagnosis with about 98
percent accuracy in 65 percent of the cases where individuals had
at least one copy of the apoliprotein E gene apoE4. Individuals
with two apoE4 genes are at high risk for Alzheimer's.
French biochemists have modified a drug they believe will
reduce the decline in Alzheimer's patients without undesirable
side effects of earlier versions of the drug. Researchers are
studying the possibility that estrogen may help prevent or delay
Alzheimer's disease and even reverse some of its symptoms. If the
early findings are supported by new clinical trials, one
researcher said estrogen has the potential to prevent two-thirds
of Alzheimer's cases.
Two drugs, tacrine, known by the brand name Cognex, and
aricept ease symptoms in some patients. Drug makers found that
very high doses of tacrine delays deterioration in about 30
percent of people with mild Alzheimer's disease, and actually
leads to some improvement in another 40
percent. Other studies indicate vitamin E taken in very high
doses can delay Alzheimer's progression by seven months. At Johns
Hopkins University, people who regularly took ibuprofen for at
least two years were 30 percent to 60 percent less likely to
develop Alzheimer's than people who did not.
Some researchers believe that inherited Alzheimer's may be
caused by a defect in a gene on chromosome 19. Others believe
there may be defects in chromosome 14, while other researchers
have found alterations in chromosome 21. A gene found on
chromosome 14 may be responsible for the severe Alzheimer's cases
that are often fatal by age 50.
It is easy to understand why those with Alzheimer's disease
and those caring for persons with the disease have become so
frustrated. The research continues in many different directions,
with only small steps forward, no certain medications approved,
no certain cures found and no certain causes established.
If you are caring for a person with Alzheimer's disease,
remember, above all, take care of yourself so you are able to
take care of the patient. Surround yourself with support
systems--family, friends, respite care, adult day care, local
support groups and other resources available to you. Accept the
fact that the patient's lost skills are gone for good, and focus
on what the Alzheimer's patient can do. Any excitement can upset
the Alzheimer's patient and try to understand, accept and manage
your own emotions to reduce the possibility of extreme emotional
responses by the patient. Provide as much consistency and routine
for the patient as possible. When the patient is aggressive,
protect yourself and get help if necessary. Remove harmful
objects from their environment.
For more information, call 1-800-621-0379, a toll-free
24-hour information and referral line of the Alzheimer's
Association. This is a national voluntary health organization for
the prevention, cure and treatment of Alzheimer's disease and
other related illnesses, providing support and assistance to
patients and families. The Rocky Mountain Chapter of the
Alzheimer's Association toll free number is 1-800-864-4404, or in
Denver, 303-813-1669. The phone number for the national
headquarters of the Alzheimer's Association is 1-800-272-3900.
Their web site address is http://www.alz.org/.
There are also other web sites that may be of interest.
Washington University in St. Louis Alzheimer's Research Center
web site is
http://www.biostat.wustl.edu/ALZHEIMER/.
The ADEAR Center (Alzheimer's Disease Education and Referral
Center) web site has the latest news from the National Institute
of Aging. The web address is
http://www.cais.com/adear/.
For more information, contact your local
Colorado State University Extension office.
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