You are on page 1of 33

We all forget things once in a while.

Maybe you've forgotten to send a card for someone's birthday or to return an overdue library book. Forgetting stuff is a part of life and it often becomes more common as people age. But Alzheimer disease, which affects some older people, is different from everyday forgetting. It is a condition that permanently affects the brain, and over time, makes it harder to remember even basic stuff, like how to tie a shoe

Alzheimer Disease
fourth leading cause of death among the elderly in developed nations

Alzheimers disease is a brain disorder named for German physician Alois Alzheimer, who first described it in 1906. Scientists have learned a great deal about Alzheimers disease in the century since Dr. Alzheimer first drew attention to it. Today we know that Alzheimers:

Is

a progressive and fatal brain disease. Is the most common form of dementia Has no current cure

The Search For The Cause Of Alzheimer's Disease:

A.Biochemical Changes in Growth (Trophic) Factors B.Chemical Deficiencies C.Toxic Chemical Excesses
The Genetic Theory The Autoimmune Theory The Slow Virus Theory The Blood Vessel Theory

Chemical Theories

What Happens in the Brain?

You probably know that your brain works by sending signals. Chemical messengers, called neurotransmitters, allow brain cells to communicate with each other. But a person with AD has decreased amounts of neurotransmitters. People with AD also develop deposits of stuff (protein and fiber) that prevent the cells from working properly. When this happens, the cells can't send the right signals to other parts of the brain. Over time, brain cells affected by AD also begin to shrink and die.

Here is a view of how massive cell loss changes the whole brain in advanced Alzheimer's disease. This slide shows a crosswise "slice" through the middle of the brain between the ears. In the Alzheimer brain: The cortex shrivels up, damaging areas involved in thinking, planning and remembering. Shrinkage is especially severe in the hippocampus, an area of the cortex that plays a key role in formation of new memories. Ventricles (fluid-filled spaces within the brain) grow larger.

Alzheimers disease leads to nerve cell death and tissue loss throughout the brain. Over time, the brain shrinks dramatically, affecting nearly all its functions. These images show: A brain without the disease A brain with advanced Alzheimers How the two brains compare

Lots of research is being done to find out more about the causes of Alzheimer disease. There is no one reason why people get Alzheimer disease. Older people are more likely to get it, and the risk gets greater the older the person gets. For instance, the risk is higher for someone who is 85 than it is for someone who is 65. And women are more likely to get it than men. Researchers also think genes handed down from family members can make a person more likely to get Alzheimer disease. But that doesn't mean everyone related to someone who has Alzheimer disease will get the disease. Other factors, combined with genes, may make it more likely that someone will get the disease. Some of them are high blood pressure, high cholesterol, Down syndrome, or having a head injury.

Two-year-old boy suffers from Alzheimer's


It may be a disease that usually affects the elderly, but young mum Stephanie O'Hara is slowly learning to live with the fact that her toddler son Taylor has Alzheimer's.

Taylor O'Hara with parents Dave Smith and Stephanie O'Hara Photo The two-year-old suffers from the deadly genetic defect Niemann-Pick Type C, known as Children's Alzheimer's. The lively toddler will develop senile dementia before he reaches his teens, and the cruel symptoms that can occur at any time will see Taylor lose the skills he is currently developing from learning to speak to bouncing a ball. Stephanie described the disease as "like living with a timebomb".

What Are the Symptoms of AD?

AD begins slowly. At first, the only symptom may be mild forgetfulness. In the early stage of AD, people may have trouble remembering recent events, activities, or the names of familiar people or things. As the disease goes on Forgetfulness begins to interfere with daily activities. People in the middle stages of AD may forget how to do simple tasks like brushing their teeth or combing their hair. They can no longer think clearly. They can fail to recognize familiar people and places. They begin to have problems speaking, understanding, reading, or writing. Later on, people with AD may become anxious or aggressive, or wander away from home. Eventually, patients need total care.

In the early stages, the symptoms of AD may be subtle and resemble signs that people mistakenly attribute to "natural aging." Symptoms often include:

Repeating statements Misplacing items Having trouble finding names for familiar objects Getting lost on familiar routes Personality changes Losing interest in things previously enjoyed Difficulty performing tasks

In a more advanced stage, symptoms are more obvious:


Forgetting details about current events Forgetting events in your own life history, losing awareness of who you are Problems choosing proper clothing Hallucinations, arguments, striking out, and violent behavior Delusions, depression, agitation Difficulty performing basic tasks like preparing meals and driving

At end stages of AD, a person can no longer survive without assistance. Most people in this stage no longer:

Understand language Recognize family members Perform basic activities of daily living such as eating, dressing, and bathing

How is AD Diagnosed?

AD is an irreversible, progressive disorder in which brain cells (neurons) deteriorate, resulting in the loss of cognitive functions, primarily memory, judgment and reasoning, movement coordination, and pattern recognition. In advanced stages of the disease, all memory and mental functioning may be lost.

The condition predominantly affects the cerebral cortex and hippocampus, which lose mass and shrink (atrophy) as the disease advances.
Plaques and Tangles The two most significant physical findings in the cells of brains affected by AD are neuritic plaques and neurofibrillary tangles. Another significant factor in AD is the greatly reduced presence of acetylcholine in the cerebral cortex. Acetylcholine is necessary for cognitive function

At specialized centers, doctors can diagnose AD correctly up to 90 percent of the time. Doctors use several tools to diagnose probable AD, including: questions about the persons general health, past medical problems, and ability to carry out daily activities, tests of memory, problem solving, attention, counting, and language, medical testssuch as tests of blood, urine, or spinal fluid, and brain scans. Sometimes these test results help the doctor find other possible causes of the persons symptoms. For example, thyroid problems, drug reactions, depression, brain tumors, and blood vessel disease in the brain can cause AD-like symptoms. Some of these other conditions can be treated successfully.

The role of plaques and tangles

Two abnormal structures called plaques and tangles are prime suspects in damaging and killing nerve cells. Plaques build up between nerve cells. They contain deposits of a protein fragment called beta-amyloid (BAYtuh AM-uh-loyd). Tangles are twisted fibers of another protein called tau Tangles form inside dying cells. Though most people develop some plaques and tangles as they age, those with Alzheimers tend to develop far more. The plaques and tangles tend to form in a predictable pattern, beginning in areas important in learning and memory and then spreading to other regions

Tangles destroy a vital cell transport system made of proteins. This electron microscope picture shows a cell with some healthy areas and other areas where tangles are forming. In healthy areas: The transport system is organized in orderly parallel strands somewhat like railroad tracks. Food molecules, cell parts and other key materials travel along the tracks. A protein called tau (rhymes with wow) helps the tracks stay straight. In areas where tangles are forming: Tau collapses into twisted strands called tangles. The tracks can no longer stay straight. They fall apart and disintegrate. Nutrients and other essential supplies can no longer move through the cells, which eventually die.

Plaques form when protein pieces called beta-amyloid (BAY-tuh AM-uh-loyd) clump together. Beta-amyloid comes from a larger protein found in the fatty membrane surrounding nerve cells. Beta-amyloid is chemically "sticky" and gradually builds up into plaques. The most damaging form of beta-amyloid may be groups of a few pieces rather than the plaques themselves. The small clumps may block cell-tocell signaling at synapses. They may also activate immune system cells that trigger inflammation and devour disabled cells.

Scientists can also see the terrible effects of Alzheimer's disease when they look at brain tissue under the microscope: Alzheimer tissue has many fewer nerve cells and synapses than a healthy brain. Plaques, abnormal clusters of protein fragments, build up between nerve cells. Dead and dying nerve cells contain tangles, which are made up of twisted strands of another protein. Scientists are not absolutely sure what causes cell death and tissue loss in the Alzheimer brain, but plaques and tangles are prime suspects

Anatomy

The cerebral cortex is an extremely convoluted and complicated structure associated with the "higher" functions of the mindthought, reasoning, sensation, and motion. Each hemisphere of the cerebral cortex contains areas that control certain types of activity. These areas are referred to as the frontal lobe, parietal lobe, temporal lobe, and occipital lobe. The frontal lobe, located behind the forehead, is involved with controlling responses to input from the rest of the central nervous system (brain and spinal cord). It is responsible for voluntary movement, emotion, planning and execution of behavior, intellect, memory, speech, and writing.

The temporal lobe, located behind the ear, is involved in understanding sounds and spoken words, as well as emotion and memory. The occipital lobe, located at the back of the head, is involved in understanding visual images and the meaning of the written word. The hippocampus plays a crucial role in learning and in processing various forms of information as long-term memory. Damage to the hippocampus produces global amnesia. The parietal lobe, located above the ear, receives and interprets sensations of pain pressure, temperature, touch, size, shape, and body part awareness.

In advanced Alzheimers disease, most of the cortex is seriously damaged. The brain shrinks dramatically due to widespread cell death. Individuals lose their ability to communicate, to recognize family and loved ones and to care

In mild to moderate stages, brain regions important in memory and thinking and planning develop more plaques and tangles than were present in early stages. As a result, individuals develop problems with memory or thinking serious enough to interfere with work or social life. They may also get confused and have trouble handling money, expressing themselves and organizing their thoughts. Many people with Alzheimers are first diagnosed in these stages. Plaques and tangles also spread to areas involved in: Speaking and understanding speech Your sense of where your body is in relation to objects around you As Alzheimers progresses, individuals may experience

In the earliest stages, before symptoms can be detected with current tests, plaques and tangles begin to form in brain areas involved in: Learning and memory Thinking and planning

Plaques and tangles (shown in the blue-shaded areas) tend to spread through the cortex in a predictable pattern as Alzheimers disease progresses. The rate of progression varies greatly. People with Alzheimers live an average of eight years, but some people may survive up to 20 years. The course of the disease depends in part on age at diagnosis and whether a person has other health conditions. Earliest Alzheimer's changes may begin 20 years or more before diagnosis. Mild to moderate Alzheimer stages generally last from 2 - 10 years. Severe Alzheimers may last from 1 - 5 years

How is AD Treated?

AD is a slow disease, starting with mild memory problems and ending with severe brain damage. The course the disease takes and how fast changes occur vary from person to person. On average, AD patients live from 8 to 10 years after they are diagnosed, though some people may live with AD for as many as 20 years. No treatment can stop AD BUT

The components of a Mediterranean diet, which include fruit and vegetables, bread, wheat and other cereals, olive oil, fish, and red wine, may all individually or together reduce the risk and course of Alzheimer's disease. Vitamins E, B, and C, or folic acid have appeared to be related to a reduced risk of AD, but other studies indicate that they do not have any significant effect on the onset or course of the disease, while at the same time may have important secondary effects in conjunction with other therapies. Curcumin in curry has shown some effectiveness in preventing brain damage in mouse models Intellectual activities such as playing chess, completing crossword puzzles or regular social interaction, may also delay the onset or reduce the severity of Alzheimer's disease. Bilingualism is also related to a later onset of Alzheimer

Prevention:

Lifestyle Changes EXERCISE: Regular exercise will keep your body strong and able to fight off disease. DON'T SMOKE OR DRINK: Avoid alcohol, cigarette smoke, processed foods, and environmental toxins, especially metals like aluminum and mercury. AVOID ALUMINUM: Autopsies of people who have died of Alzheimer's disease have revealed higher than normal amounts of aluminum in the brain, especially in the parts of the brain concerned with memory.
EAT A HEALTHY DIET: Eat a well-balanced diet. Better nutritional status means better memory and mental function.
BE SURE TO GET ENOUGH FIBER: Include plenty of fiber in your diet. Oat and rice bran are good sources.

You might also like