Latest Discoveries in Alzheimer’s Disease Therapy to Be Presented
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The world’s leading physicians and scientists in the fields of Alzheimer’s disease treatment and dementia research will participate in the 9th International Geneva/Springfield Symposium on the Advances in Alzheimer Therapy. The conference will be held April 19-22 at the International Conference Center in Geneva, Switzerland. They will highlight the latest discoveries in the treatment of dementia and results of the most recent clinical trials using drug, cellular and gene therapies.
More than 100 sessions will be presented by 125 speakers during the four-day symposium. Nearly 800 specialists are expected to attend the international gathering. Included in those presentations will be historical data reflecting the progress of the treatment of Alzheimer’s disease with cholinesterase inhibitors over the past 20 years; the results of three large clinical trials utilizing cholinesterase inhibitors in at-risk patients; and recommendations for usage of vaccination against beta-amyloid aggregation, the accumulation of toxins in the brain that destroys nerves which can lead to Alzheimer’s disease.
Dr. Paul Coleman, neuroscientist at the Center for Aging and Developmental Biology in Rochester, New York, will give the keynote address entitled The Impact of Science on Future Alzheimer Disease Diagnosis.The symposium was established by Dr. Ezio Giacobini, Ph.D., professor of rehabilitation and geriatrics at the University of Geneva Medical School in Switzerland and professor emeritus of the Southern Illinois University School of Medicine in Springfield, Ill., USA. Giacobini organized this year’s conference with Dr. Jean-Pierre Michel, professor and chair of rehabilitation and geriatrics at the University of Geneva Medical School in Switzerland.Featured speakers and their topics at the ninth annual symposium include -Dr. Kaj Blennow, Department of Clinical Neuroscience, Sahlgren’s University Hospital, Molndal, Sweden: Use of CFS Biomarkers in Early Diagnosis and Monitoring of Treatment;Karen Duff, Ph.D., Nathan Kline Institute, Orangeburg, New York: Impact of Kinase Modulation on Pathogenesis in Mouse Models of Neurodegenerative Diseases;Dr. Nick Fox, Dementia Research Group, Institute of Neurology, London, England: Immunotherapy of Alzheimer Disease: MR Imaging of Changes in Brain Morphology;Stephen L. Minger, Ph.D., Wolfson Center for Age-Related Disease, London, England: Stem Cell Therapy of Alzheimer Disease: Which Way to Go?;Dr. Roger Nitsch, Division of Psychiatric Research, University of Zurich, Zurich, Switzerland: The Immunotherapy of Alzheimer Disease;Dr. Agneta Nordberg, Ph.D., Division of Molecular Neuropharmacology, Karolinska Institute, Stockholm, Sweden: Amyloid Imaging in MCI Patients;
Dr. Lon Schneider, Department of Psychiatry, Neurology & Gerontology, Keck School of Medicine, University of California Los Angeles: Treatment of Behavioral Symptoms in Alzheimer Disease;Rudy Tanzi, Ph.D., Genetics & Aging Research, Massachusetts General Hospital, Charlestown: Identifying the Genetics Causes of Alzheimer Disease;Dr. Anders Wimo, Ph.D., Karolinska Institute, Stockholm, Sweden: Cholinesterase Inhibitors for Alzheimer Disease Therapy: Are They Worth the Price?;Dr. Bengt Winblad, Ph.D., Karolinska Institute, Stockholm, Sweden: Treatment Strategies in Severe Dementia.
The International Geneva/Springfield Symposium on the Advances in Alzheimer Therapy was first held in 1988 in Springfield, Illinois. The conference is held biennially.
Information about the conference, including a complete list of speakers, is posted online at: http://www.siumed.edu/cme/alzheimer/media.

The technique is likely to accelerate research on the cause of the diseases and could lead to the first diagnostic procedure for Alzheimer's in patients while they are alive. Click link to read more.
http://www.medicalnewstoday.com/medicalnews.php?newsid=38360

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Depressive symptoms in Alzheimer's disease

Authors: Holtzer R, Scarmeas N, Wegesin DJ, Albert M, Brandt J, Dubois B, Hadjigeorgiou GM, Stern Y
OBJECTIVES: To examine the natural course of depressive symptoms in patients with probable Alzheimer's disease (AD), specifically, the temporal relationship between depressive symptoms, function, and cognitive status.

DESIGN: Multicenter cohort study with follow-up of up to 14 years.

SETTING: Patients from the two Multicenter Study of Predictors of Disease Course in Alzheimer's Disease (Predictors Study) cohorts were recruited at five sites in the United States and Europe.

PARTICIPANTS: Patients diagnosed with probable AD (n=536) enrolled in a longitudinal study (Predictors Study).

MEASUREMENTS: Depressive symptoms were evaluated at 6-month intervals using the Columbia Scale for Psychopathology in Alzheimer's Disease. The Modified Mini-Mental State (3MS) and Blessed Dementia Rating Scale (BDRS) were used to assess cognitive status and functional activity, respectively.

RESULTS: The prevalence of depressive symptoms was stable over the first 3 years of follow-up, at approximately 40%. There was a significant drop to 28% and 24% in the fourth and fifth years of follow-up, respectively. Time-dependent Cox analysis revealed that functional activity (BDRS) but not cognitive status (3MS) was a significant predictor of the first episode of depressive symptoms during follow-up. Generalized estimating equation analyses showed that AD duration and functional activity but not cognitive status were significantly related to depressive symptoms over the entire follow-up period.

CONCLUSION: Depressive symptoms are common in AD, but their prevalence decreases over time. Examination of the temporal relationship between depressive symptoms and risk factors suggests that decline in function but not in cognition precedes the first episode of depressive symptoms in patients with probable AD.

Biomechanical activity devices to index wandering behavior in dementia. Read on

Perspective of dementia therapy. Read on

Depressive symptoms in Alzheimer's disease

Authors: Holtzer R, Scarmeas N, Wegesin DJ, Albert M, Brandt J, Dubois B, Hadjigeorgiou GM, Stern Y
OBJECTIVES: To examine the natural course of depressive symptoms in patients with probable Alzheimer's disease (AD), specifically, the temporal relationship between depressive symptoms, function, and cognitive status.

DESIGN: Multicenter cohort study with follow-up of up to 14 years.

SETTING: Patients from the two Multicenter Study of Predictors of Disease Course in Alzheimer's Disease (Predictors Study) cohorts were recruited at five sites in the United States and Europe.

PARTICIPANTS: Patients diagnosed with probable AD (n=536) enrolled in a longitudinal study (Predictors Study).

MEASUREMENTS: Depressive symptoms were evaluated at 6-month intervals using the Columbia Scale for Psychopathology in Alzheimer's Disease. The Modified Mini-Mental State (3MS) and Blessed Dementia Rating Scale (BDRS) were used to assess cognitive status and functional activity, respectively.

RESULTS: The prevalence of depressive symptoms was stable over the first 3 years of follow-up, at approximately 40%. There was a significant drop to 28% and 24% in the fourth and fifth years of follow-up, respectively. Time-dependent Cox analysis revealed that functional activity (BDRS) but not cognitive status (3MS) was a significant predictor of the first episode of depressive symptoms during follow-up. Generalized estimating equation analyses showed that AD duration and functional activity but not cognitive status were significantly related to depressive symptoms over the entire follow-up period.

CONCLUSION: Depressive symptoms are common in AD, but their prevalence decreases over time. Examination of the temporal relationship between depressive symptoms and risk factors suggests that decline in function but not in cognition precedes the first episode of depressive symptoms in patients with probable AD.

Biomechanical activity devices to index wandering behavior in dementia. Read on

Perspective of dementia therapy. Read on

Alzheimer's disease: Travel

The most important thing to do when traveling with someone with Alzheimer's disease is to plan ahead and try to anticipate the person's needs so you'll be ready for any changes or problems. As you plan, be sure to consider the stage of the person's illness and any behaviors that may be affected by traveling away from home. You may want to try taking a short trip to see how he or she reacts to traveling. Here are a few other tips to consider:
Plan some activities for the person with Alzheimer's disease. Simple things--such as a magazine, a deck of cards, a favorite music tape, etc.--can help keep the person calm when traveling.
Never leave a person with dementia alone in a car. When moving, be sure to keep the seat belt buckled and the doors locked.
Plan regular rest stops.
Bring an extra driver if your trip involves more than six hours of driving time.
If the person becomes agitated while traveling in a car, stop at the first available place. Don't try to calm the person while driving.
Consider planning your vacation at a place that is familiar to the person with Alzheimer's disease; for example, at a lake cabin that he or she has visited in the past.
If your loved one is easily agitated, it may be wise to avoid places that are very crowded. You also may want to avoid fast-paced sightseeing trips.
If your loved one has never been on a plane, it may be wise to consider driving, if possible.
Alert the airlines and hotel staff that you are traveling with a person who is memory impaired. Make sure the person is carrying or wearing some sort of identification.
Don't forget that your caregiving responsibilities continue, even though you are on vacation. It may help to bring someone along who can help you with these duties.

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Alzheimer's disease: Driving

A means of transportation is an essential ingredient in maintaining independence. It is especially important as people grow older. Transportation allows them to run errands, go to doctor's appointments, and socialize with family and friends. However, there will come a time when your loved one's driving skills will decline due to age, disability, or both. Once this occurs, it is important to assess whether or not it is still safe for your loved one to drive. Some warning signs of a possible decline in driving skills include:
A series of close calls, collisions, or driving violations, even if they are minor
Braking harder than normal for stoplights and stop signs, running over curbs, or running through stop signs
Difficulty seeing things on the road
Difficulty maintaining the car in the center of the lane
Trouble turning his or her head before changing lanes
Trouble adjusting to the oncoming glare of headlights
Increased frustration, anger, or anxiety when driving
Becoming confused in simple driving situations or lost in familiar areas
Failure to use turn signals or mirrors
Hitting the brakes instead of the accelerator or vice versa
Increased confrontation with other drivers
If you notice some of the above declines in driving skills in your loved one, this does not mean the car must be taken from him or her immediately. The first step a caregiver must take with the patient is to talk about the signs of possible decline that are of concern. During this talk, the caregiver can make suggestions such as encouraging his or her loved one to avoid driving at night, during rush hour, or when weather makes the roads slick. Another approach can be recommending a medical and/or eye exam to see if any of the above signs can be corrected.
Research suggests that even mild Alzheimer's disease is associated with an increased risk of accidents. It is important to check with your state's Department of Motor Vehicles to find out the procedure for evaluating the patient's driving ability. Many areas will perform a thorough "driver safety evaluation" to determine whether it is safe for the person to continue driving. If there is any impairment noted in visual or spatial abilities or judgment, the person with Alzheimer's disease should not be driving.
If the caregiver determines that a loved one should no longer be driving, alternate means of transportation should be sought. Often this means that the caregiver must provide transportation. However, it is not always possible or practical to provide transportation when needed.

With the rapid aging of the population, the National Institutes of Health (NIH) is intensifying the search for strategies to preserve brain health as people grow older. The effort moved an important step forward today with a report by an expert panel to the NIH, suggesting a number of promising avenues for maintaining or enhancing cognitive and emotional function. Click link to read more.
http://www.medicalnewstoday.com/medicalnews.php?newsid=38204

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Alzheimer's disease: Safety

Because activities of daily living--including eating, bathing, grooming, dressing, and using the toilet--can become more difficult for people with Alzheimer's disease, it's important to modify the environment to make it as easy as possible for the person with the disease to live and function.
A careful evaluation of the home, especially the physical layout and the services that will be available to the person for support, is essential. Some patients can continue to be independent in their living situation if they have complete support services. Things that should be evaluated include safe operation of the stove or oven, and bathroom/bathtub or shower use. Therapists and social service workers who are professionally trained to look for potential hazards can perform a full home safety evaluation.
Bathroom: The bathroom can be a dangerous place for a person with Alzheimer's disease. As the person's ability to function decreases, it may become necessary to install grab bars in the shower or fold-down shower seats. Also, be sure to use nonslip floor mats and slip-resistant appliqués or tiles in the shower or tub.
Furniture: Simplify furniture arrangements. Make it as easy as possible for the person with Alzheimer's disease to navigate a room and get from point A to point B. Move or remove objects, such as a loose throw rug, that could be a tripping hazard.
Lighting: Be sure there is sufficient lighting. As people get older, they require two to three times the amount of light they needed when they were younger. Add the confusion associated with Alzheimer's disease, and you can understand how important it is to have enough light. However, too much light, especially when it causes glare, can be distracting and irritating.

General tips
Have emergency numbers (police, fire, poison control, and a neighbor's phone number) readily available in case of emergency. Suggestion: Write these numbers on a sticker, and put it on the receiver.
Have at least one phone located where it is always accessible. The person with Alzheimer's could keep a cordless phone in his or her pocket--this is especially important if he or she falls and can't get up to use the phone.
Make sure smoke detectors work properly, and remember to change the batteries frequently. Use a carbon monoxide detector.
Avoid the use of space heaters and electric blankets; these are fire hazards. If they must be used, follow the manufacturer's safety instructions, and keep them on a sturdy surface away from rugs, curtains, furniture, or papers.
Consider installing a medical alert or personal alarm system for emergencies. Professional systems link directly to a representative 24 hours a day, seven days a week. A person who has an immediate medical problem simply pushes a button on a special device worn around the wrist or neck, and a signal for help is immediately sent.

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Alzheimer's disease: Sundown syndrome

Sundown syndrome--also called sundowning or sunsetting--is a behavior common in people with Alzheimer's disease. It describes the episodes of confusion, anxiety, agitation, or disorientation that often occur at dusk and into the evening hours. The episodes may last a few hours or throughout the night.
While the exact cause of sundown syndrome is not known, experts believe there are several contributing factors. These include physical and mental exhaustion (after a long day) and a shift in the internal body clock caused by the change from daylight to dark. Some people with Alzheimer's disease have trouble sleeping at night, which may contribute to their disorientation. Medication that can cause agitation or confusion also may be a contributing factor to this syndrome.
Sundown syndrome can be draining for the person with Alzheimer's disease and his or her caregivers. Here are some suggestions for helping a loved one with sundown syndrome:
Schedule your day so that the more difficult tasks are done early in the day, when the person is less likely to become agitated.
Watch the person's diet and eating habits. Restrict sweets and drinks with caffeine to the morning hours. Try serving the person a late afternoon snack or an early dinner. To help the person relax, try decaffeinated herbal tea or warm milk.
Keep the house or room well lit. Close the drapes before the sun goes down, so the person doesn't watch it become dark outside.
If the person falls asleep on the sofa or in a chair, let him or her stay there. Don't wake the person to go to bed.
Try distracting the person with activities he or she enjoys. Soothing music or a favorite video may help, as well.
Encourage the person to engage in some physical activity--such as walking, if able--during the day. This may help him or her to sleep better at night.

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Mind Fitness: To sharpen the brain, first hone the body

Exercise

For people with Alzheimer's disease, physical activity should be continued for as long as possible.
Exercise offers many benefits for people with Alzheimer's disease, including improved strength, endurance, and cardiovascular fitness. Exercise helps people with Alzheimer's disease preserve motor skills and improve balance, which in turn can help prevent serious injury from falls. Exercise also can increase energy, promote a normal day and night routine, and help to improve mood. Further, exercise increases circulation and can help improve mental clarity. Repetitive exercises--including walking, indoor bicycling, and activities such as folding laundry--may decrease anxiety in people with Alzheimer's disease because they don't have to make decisions about the activity or remember what to do next.
The type and intensity of exercise appropriate for someone with Alzheimer's disease depends on the person's degree of impairment. People in the early stages of the disease may enjoy exercises such as walking, bowling, dancing, golf, and swimming, although supervision may be necessary. Greater supervision may be required as the disease progresses, and activities that could lead to injury should be avoided. Most of all, select a hobby or activity you enjoy, and stick with it. Some suggestions include golfing, walking, swimming, water aerobics, yoga, and tai chi.
It is important to talk to your doctor before beginning any exercise program. There may be other factors--such as osteoporosis, a heart condition, or a balance problem (possibly due to medication)--that could limit or restrict activity.
Your doctor may make recommendations about:
The types of exercise best suited to you and those to avoid
The intensity of the workout (how hard you should be working)
The duration of your workout and any physical limitations
Referrals to other professionals, such as a physical therapist who can help you create your own personal exercise program.

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Alzheimer's disease: Maintaining good nutrition

For a person with Alzheimer's disease, the illness itself or associated depression can affect the desire and ability to eat. Good nutrition is important for people with Alzheimer's disease. In fact, poor nutrition can worsen some symptoms of dementia, such as listlessness and confusion.
If poor appetite is becoming a concern for your loved one, try following these nutrition guidelines.
General guidelines:
Talk to the doctor. Sometimes poor appetite is due to depression, which can be treated. Your loved one also may be suffering from a treatable disorder--such as heartburn, constipation, diarrhea, nausea, or sore mouth--that may be affecting his or her eating.
Don't force feed. Try to encourage the person to eat, and try to find out why he or she doesn't want to eat (not hungry, the food is cold or doesn't taste good, etc.).
Remember to treat the person as an adult, not a child. Don't punish the person for not eating.
Serve small, frequent meals and snacks.
Walking or participating in other light activities can help stimulate the appetite.
Consider finger foods that are easy to handle and eat.
Adaptive equipment, such as plate guards or silverware with specially designed handles, is available for individuals who have difficulty holding or using utensils.
Meal guidelines:
Serve beverages after a meal instead of before or during a meal so that the person does not feel full before starting to eat.
Plan meals to include favorite foods.
Use your imagination to increase the variety of food you're serving. Prepare meals that offer different textures, colors, and temperatures.
Snack guidelines:
Don't waste your energy preparing foods that provide little or no nutritional value (such as potato chips, candy bars, sodas, and other snack foods).
Choose high-protein and high-calorie snacks.
Dining guidelines:
Make food preparation an easy task: Choose foods that are easy to prepare and eat.
Make eating a pleasurable experience, not a chore: Liven up meals by using colorful place settings; play background music during meals.
Use colorful garnishes such as parsley and red or yellow peppers to make food look more appealing and appetizing.

Alzheimer's disease: Personal care

People with Alzheimer's disease have special needs that can pose unique challenges for their caregivers. Depending on their level of independence, people with Alzheimer's disease may need help with personal care activities, including eating, bathing, shaving, and using the toilet. To assist with these activities, caregivers need knowledge, skill, and patience.
Following are some tips for caring for your loved one's personal needs:
General tips
Establish a routine. Schedule grooming activities for the same time and same place each day; for example, brush the patient's teeth after meals, or schedule baths for the mornings or evenings. Choose the most relaxed time of the day for bathing and grooming.
Respect the person's privacy. Close doors and blinds. Cover the person with a towel or bathrobe.
Encourage the person to do as much as possible. This will help to promote a sense of independence and accomplishment.
Keep in mind the person's abilities. Give him or her enough time to complete each task; for example, brushing his or her hair or teeth.
Give the person encouragement and support for completing tasks. Acknowledge his or her efforts. "You did a nice job brushing your hair today."
Tell the person what you are doing. "I'm going to wash your hair now."
If the person can dress himself or herself, lay out clothes in the order they are to be put on. Clothing that is easy to put on, with few buttons, is best.
Bathing
A complete bath may not be needed every day. A sponge bath may be enough.
Always check the temperature of the water in the bath or shower.
If giving a bath in the tub, try using a bath chair with handrails. Also, place rubber mats in the tub to prevent slipping.
Make sure the bathroom is warm and well-lit.
Remove or secure throw rugs to prevent falls in the bathroom.
If the person is heavy or can offer little help, special equipment may be needed. Your doctor can give you advice on how to safely bathe your loved one.
Hair care and shaving
Try washing the person's hair in the sink, especially if the person prefers baths to showers.
If your loved one is able, a trip to the salon or barbershop may be a fun and positive experience.
Try using a dry shampoo if the person is bedbound or fearful of having his or her hair washed.
To reduce the risk of cuts, use an electric razor for shaving, especially if the person is taking blood-thinning medicines (such as Coumadin).
Dental care
Brush the person's teeth daily. If the person wears dentures, clean them every day. Check that the dentures fit properly, and examine the gums for sores or areas of redness.
If the person refuses to open his or her mouth, try brushing only the outside of the teeth. Ask your dentist for advice on providing good dental care.
If the person brushes his or her own teeth, help by putting the toothpaste on the brush.
Using the toilet
Install safety features in the bathroom, such as grab bars and raised toilet seats.
A bedside commode or urinal may be helpful if getting to the bathroom, especially at night, is a problem.
Schedule routine bathroom visits to prevent accidents.
Tell the doctor about any loss of bowel or bladder control. These problems may be symptoms of conditions that can be treated with medication.

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Dealing with behavioral changes

Caring for a loved one with Alzheimer's disease poses many challenges for the caregiver--particularly as the disease progresses and your loved one's ability to communicate declines.
The changes in the brain that are associated with Alzheimer's disease can lead to unusual and unpredictable thinking and behavior. For example, your loved one may become anxious around family members, neighbors, or friends whom he or she may not recognize or in situations that stray from the normal routine. The person with Alzheimer's disease also may become suspicious and suffer from delusions. He or she may begin to withdraw from social interaction, wander, become aggressive, and/or become angry and irritable.
In some cases, behavioral problems--especially physical aggressiveness and delusions--may require treatment with medications, such as antianxiety or antipsychotic drugs. However, these drugs can have negative side effects, including drowsiness and depression, and can further affect memory.
Following are some tips to help you manage the changes in thinking and behavior that often accompany Alzheimer's disease:
Maintain: Work to preserve your loved one's abilities, particularly those that affect dignity (such as eating and using the toilet), rather than try to teach new skills.
Keep it simple: Follow simple routines, and avoid situations that require the person with Alzheimer's disease to make decisions. Having to make choices can be very frustrating and cause anxiety for a person with Alzheimer's disease. Try to minimize any changes in the surroundings or to your loved one's daily routine. If you have to make changes in routines, do so gradually.
Reword statements: It may help to simplify or reword your statements or requests if the person with Alzheimer's disease doesn't seem to understand. Try to be patient and supportive, especially if your loved one is confused and/or anxious.
Reassure: Reassure your loved one every day, even if he or she does not respond. Use a quiet voice, and be protective and affectionate. If he or she has delusions, be reassuring rather than defensive.
Be calming: If your loved one becomes agitated or aggressive, try playing music or a video that he or she used to enjoy. Keep photos of family members and friends where the person can see them. Label photos with names, if necessary. Reminisce with him or her about the family or activities he or she once enjoyed (sports, hobbies, etc.).
Gently remind: Help your loved one maintain his or her orientation by naming events for the day; reminding him or her of the date, day, time, place, etc.; and repeating the names of the people with whom he or she has contact.
Communicate: Try to understand the words and gestures your loved one uses to communicate. Adapt to his or her way of communicating; don't force your loved one to try to understand your way of communicating.
Watch medications: Be sure your loved one gets the right medications and at the right time. Watch for reactions and possible side effects of medicines, such as depression or agitation. Consult with the doctor about giving any over-the-counter medicines, because they may react with prescription medications and cause serious side effects.
Provide a good diet: Because the effects of dementia can be worsened by poor nutrition, be sure to provide your loved one with a nutritious diet and plenty of healthful fluids, such as water or juice. Limit alcohol consumption, and try to ensure your loved one gets adequate sleep.
Encouragement: Encourage your loved one to exercise his or her mind by reading, doing puzzles, writing, etc., as well as to exercise his or her body as appropriate. However, avoid challenging your loved one to the point of frustration.
Identify triggers: Try to identify any actions, words, or situations that may trigger inappropriate or dangerous behavior. Document any episodes of such behavior so you can try to avoid the triggers in the future.
Adapt the environment: To minimize confusion and anxiety, adapt your loved one's environment to his or her capabilities. Make adjustments as his or her abilities decline. Try placing large labels (with words or pictures) on drawers and shelves to identify their contents. If your loved one tends to wander, you may need to lock the doors, especially at night. Consider participating in the Alzheimer's Association's Safe-Return Program. As part of this program, the person with Alzheimer's disease wears a bracelet with a toll-free number and code. The toll-free number may be called from anywhere in North America, and the code is used to identify the person and alert his or her family of the person's whereabouts.
Be honest: Recognize when the person's behavior is more than you can handle. Safety--your own and your loved one's--must be considered at all times.

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Early-onset Alzheimer's disease

People with early-onset Alzheimer's disease must understand that life is not over. While it's true that your life will change, particularly as the disease progresses, there are things you can do to maintain a meaningful and productive life. It is especially important to continue with activities and interests you can still enjoy, and take comfort in the support of friends and family.
Yourself

Alzheimer's disease affects each person differently. You will have good days and bad days. Try to maximize the good days and not dwell on the bad days.
Remember, you are not alone. Consider joining a support group. Call your local chapter of the Alzheimer's Association for information on support groups for people with early-onset Alzheimer's disease.
Don't keep your fears and feelings inside. Seek professional counseling, and/or share your feelings with your friends, family, or a clergy member.
Take care of yourself. Get regular checkups, and follow your doctor's recommendations about diet, exercise, and taking medications.
Family and friends
Talk openly with your spouse about issues that are important to you, such as finances, household and child-rearing responsibilities, and sexual intimacy. Look toward future caregiving needs, and try to make plans and decisions together, ahead of time. Encourage your spouse to join a caregivers' support group.
Talk openly with your children about the disease and your symptoms. Understand that your disease affects your children, as well. In addition to being concerned about you, your children may have understandable fears about developing Alzheimer's disease themselves. When appropriate, include your children in making decisions that affect the whole family. Encourage them to become involved in a support group. Consider recording your thoughts, feelings, wisdom, and memories, so you may pass them on to your children.
Don't tune out your friends. Share your experience of living with Alzheimer's disease. Stay as active as possible for as long as possible. Invite your friends to attend educational programs about Alzheimer's disease.
Career
As your disease progresses, you may find job-related tasks more difficult to perform. Plan when and what you will tell your employer about the disease, and at what point you should no longer work.
Make adjustments so that you may continue to work as long as possible. This will help to maintain your income and independence, and boost your self-esteem. Consider asking to be placed in a position that better matches your skills and capabilities, or to reduce your work hours.
Investigate all possible options, including early retirement, as well as ways to access all benefits available to you through your employer.
Financial and legal matters
Plan ahead for financial needs, knowing that eventually you will have to leave your job and will lose income. Meet with a financial counselor who can help you investigate insurance, investments, and other financial options.
Talk with your family and doctor about what medical treatments you want to receive in the event you become unable to communicate your wishes. You may wish to prepare an advance directive, a legal document that outlines your wishes for future medical treatment.
Organize all your financial and legal documents, as well as other important information (insurance policies, Social Security information, wills, etc.) in one place, and let your spouse and/or children know where to find them.

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Alzheimer's disease: getting help

Alzheimer's disease, like many other chronic illnesses, will affect you both physically and mentally. It is important to realize that you are not alone and that if you feel you need help coping, you should consider seeking counseling.
The decision to seek counseling is an important step. Too often, people don't get help because they feel guilt, shame, or embarrassment. By deciding to get help, you have made a choice to feel better and to improve your life. Taking action early will enable you to understand and deal with the many effects of a chronic illness. Learning to manage stress will help you to maintain a positive physical, emotional, and spiritual outlook on life. If depression is present, medications other than those treating the physical illness may be ordered to help lift your mood.
Although no cure for Alzheimer's disease is now available, planning and medical/social management can help ease the burden on both patients and family members. Physical exercise, good nutrition, activities, and social interaction are important. A calm, structured environment also may help the person with Alzheimer's disease to continue functioning as long as possible.
Your healthcare provider can refer you to a mental healthcare professional, who could be a family therapist, social worker, psychologist, psychiatrist, or other professional. First, you will receive an "assessment," a review of your mental health. The assessment is used to diagnose the problem and determine the best treatment. You will be asked to describe why you want counseling, any symptoms you have (emotional, mental, and physical), and your medical history. You may be given a question-and-answer survey.
Once you complete the assessment, a treatment plan can be chosen. At this time, you and your counselor can discuss:
The best type of counseling
The best setting for counseling (counselor's office, outpatient clinic, hospital, residential treatment center)
Who will be included in your treatment (you alone, family members, others with similar problems)
How often you should go to counseling
How long counseling may last
Any medications that may be needed

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Managing Alzheimer's disease

AD gets worse over time, and the course of the disease varies from person to person. Some people have the disease for only the last five years of their lives, while others may have it for as long as 20 years. The most common cause of death in people with Alzheimer's disease is infection.

n managing the disease, physical exercise and social activity are important, as are proper nutrition, health maintenance, and a calm and well-structured environment.

The economic and social burden of AD is very high; it is estimated that $80 billion to $100 billion is spent annually on the care of AD patients, and the cost per family is over $200,000 for each affected patient. Caregivers spend an average of 70 to 100 hours per week providing care and are more likely to require medical care themselves, including treatment for depression.

What to expect

When you get an illness like bronchitis or the flu, you know you will be feeling better and functioning normally within a week or so. Alzheimer's disease is different. It will never go away and can change your life and lifestyle in many ways.

Disability and fatigue may become a frequent part of your day. Physical and mental changes from Alzheimer's disease may occur and affect your mood and even your appearance. These changes may diminish your positive self-image. When you don't feel good about yourself, you may prefer isolation and withdraw from friends and social activities.

Alzheimer's disease also can influence your ability to function and get around at home. Confusion, as well as impaired judgment and disorientation, may require you to modify your work activities and environment. Decreased work ability and the increasing cost of care can lead to financial difficulties.
Specific tasks may take much longer to accomplish. You may need the help of your spouse, a relative, or a home healthcare provider. As your life changes, you may feel a loss of control and more anxious from the uncertainty of what lies ahead.
Stress can build and influence how you feel about life. Prolonged stress can lead to frustration, anger, hopelessness, and, at times, depression--all of which can worsen the symptoms of Alzheimer's disease. The person with the illness is not the only one affected. Family members are also influenced by the persistent health changes of a loved one.

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Based on laboratory research, scientists at Georgetown University Medical Center have a new theory as to why people with Alzheimer's disease have trouble performing even the simplest memory tasks, such as remembering a family member's name. Click link to read more.
http://www.medicalnewstoday.com/medicalnews.php?newsid=37655

Symptoms. Drug interactions.

There are treatments for some of the disruptive symptoms of Alzheimer's disease. These symptoms--which include depression, paranoia, wandering, hallucinations, agitation, and confusion--can interfere with normal daily activities, as well as with sleeping.
Antipsychotics: Medicines used to treat paranoia and confusion are called neuroleptics or antipsychotics. Examples of these medicines are haloperidol, risperdone (Risperdal), and olanzepine (Zyprexa). Side effects can include drowsiness, rigidity, and unusual movements.
Antidepressants: Drugs such as fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), and nortriptyline (Pamelor) are used to treat depression. Side effects of these medicines can include drowsiness, dry mouth, and constipation.
Antianxiety medications: These medications--which include alprazolam (Xanax), lorazepam (Ativan), and buspirone (BuSpar)--often produce drowsiness.

A person with Alzheimer's disease may be taking medicines to treat symptoms of the disease, as well as other health problems (high blood pressure, diabetes, high cholesterol, etc.). However, when a person takes many medications--a situation called polypharmacy--there is an increased risk of adverse reactions, including confusion, agitation, sleepiness or sleeplessness, mood swings, memory problems, stomach upset, and/or changes in appetite.
While it may become necessary for a person to take medicine to treat the severe symptoms of Alzheimer's disease--such as hallucinations or aggressive behavior--some of these medications can worsen other symptoms of the disease. For example:
Some sedatives or hypnotics, such as benzodiazepines and barbiturates, can cause confusion, increased memory impairment, and slowed reactions, which can lead to falls.
Certain antidepressant medicines, particularly the tricyclic antidepressant amitriptyline (Elavil), can cause sedation. These drugs also can react with the medicines used to treat Alzheimer's, including rivastigmine (Exelon), donepezil (Aricept), and galantamine (Razadyne).
Some antipsychotics (medicine used to treat hallucinations) can cause sedation, cognitive impairment, and drops in blood pressure. They also can react with the medicines used to treat Alzheimer's disease.
It is important to discuss the pros and cons of these medication options with a doctor before making a decision regarding medication.
In addition, it is important to consider the possible side effects of over-the-counter medicines, including cough and cold remedies, and sleep medicines. These drugs also may react with other medications taken by the person with Alzheimer's disease. It is best to consult a doctor before using over-the-counter medication.

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Alzheimer's disease treatment

Your specific treatment for Alzheimer's disease will be determined by your doctor based on:
Your age, overall health, and medical history
Extent of the disease
Your tolerance for specific medicines, procedures, and therapies
Expectations for the course of the diseas
Your opinion or preference
At this time, there is no cure for Alzheimer's disease, there is no way of slowing the progression of the disease, and there is no treatment available to reverse its effects. But medicines can help patients with Alzheimer's disease.
In general, healthy lifestyle changes that protect the body from strokes and heart attacks tend to protect the brain from cognitive decline. Older adults who exercise, maintain their normal body weight, avoid head trauma, have no more than one standard alcoholic beverage daily, and stay socially engaged maintain their cognitive abilities best. These recommendations are appropriate at all stages of disease but need to be tailored to the individual's preferences and abilities.

Adults in early stages could attend courses at a local community college, take classes at a senior center, or participate in library book clubs. Those with moderate or severe disease may benefit from organized activities in an adult day-care setting. Also, treatment of hypertension is important in protecting the brain against cognitive decline, as are prevention and treatment of diabetes with exercise and medications.
Researchers continue to study drugs and other substances as possible treatments for Alzheimer's disease. Carefully designed and conducted studies are necessary to give a clear picture of safety and effectiveness before any approval may be considered. In addition, clinical trials are being conducted on a vaccine to prevent and possibly reverse plaque formation.
Treating mild-to-moderate disease
For now, there is no cure for Alzheimer's disease, there is no way of slowing the progression of the disease, and there is no treatment available to reverse its effects. But medicines known as cholinesterase inhibitors can help patients with mild and moderately severe Alzheimer's disease.
Cholinesterase inhibitors block the action of acetylcholinesterase, the enzyme responsible for the destruction of acetylcholine, a chemical that helps nerve cells in the brain transmit impulses. Reduced levels of acetylcholine in the brain are believed to be responsible for some of the symptoms of Alzheimer's disease. By blocking the enzyme that destroys acetylcholine, these medications increase the concentration of acetylcholine in the brain. This increase is believed to be responsible for the improvement in memory and cognition seen with these medications.
Cholinesterase inhibitors include:
Tacrine (Cognex): Side effects of tacrine include nausea, vomiting, diarrhea, abdominal pain, skin rash, and indigestion. In addition, tacrine can damage the liver, so regular monitoring is necessary. Tacrine is rarely prescribed now because of the liver side effects.
Donepezil (Aricept): Donepezil is the drug most widely used for Alzheimer's disease. Donepezil has fewer and milder side effects than tacrine. Side effects include diarrhea, vomiting, nausea, fatigue, insomnia, and anorexia. Like tacrine, Donepezil does not cure Alzheimer's or slow its progression.
Rivastigmine (Exelon) or galantamine (Razadyne): These newer drugs also work by inhibiting the breakdown of acetylcholine and are similar in benefits and side effects.
In all cases, the drugs seem to primarily help those with mild or moderate symptoms of Alzheimer's disease. The improvement is modest, and the drugs do not halt progression of the disease. These improvements may help reduce caregiver burden, delay nursing home placement, and improve neuropsychiatric problems (such as apathy and agitation). There is some evidence that these benefits may be sustained with treatment of more advanced disease.
Treating moderate to severe disease
Memantine (Namenda) is approved by the FDA for treatment of moderate-to-severe Alzheimer's disease. It blocks the neurotransmitter glutamate from activating special receptors on nerve cells, keeping the cells healthier. Memantine is the first drug to be approved for moderate-to-severe dementia; the cholinesterase inhibitors currently are approved only for mild-to-moderate symptoms.
Clinical studies have found that patients with moderate-to-severe Alzheimer's disease who took memantine performed better on scales measuring the common activities of daily living such as eating, walking, using the toilet, bathing, and dressing as compared with patients on placebo. The lower-functioning patients may benefit the most.
Memantine appears to be safe and effective alone or when used together with a cholinesterase inhibitor. However, as with the cholinesterase inhibitors, the effect on cognition and abilities is modest and may decline after about six months. Research is ongoing to determine long-term benefits.
Memantine is thought to play a protective role in the brain by regulating a chemical messenger called glutamate. Glutamate plays a key role in learning and memory by acting as a kind of "gatekeeper" of some of the brain's other chemicals--allowing certain amounts of these other chemicals (such as calcium, which is required for information storage) to enter the brain's nerve cells. Allowing too much calcium into the nerve cells can damage and destroy them. Memantine keeps the glutamate under better control, which keeps the calcium under better control, which helps keep the brain's nerve cells functioning more normally.
Very few side effects have been reported by patients taking memantine. From the clinical trials, the most commonly reported side effects--and those that were reported at a frequency 2 percent or more than placebo recipients--include dizziness, headache, and constipation.
Other medications and dietary supplements
Vitamin E: Vitamin E, an antioxidant, may be modestly effective in slowing progression in some patients with dementia. One study demonstrated benefit of vitamin E in high doses (1,000 international units twice daily) in people with moderate dementia. The use of vitamin E delayed the time to death, institutionalization, loss of the ability to perform basic activities of daily living, or severe dementia. Other studies have shown little or no benefit, and high doses of the vitamin may have adverse effects on cardiovascular health.
Ginkgo: Ginkgo biloba, an extract from the leaves of the ginkgo tree, has been touted by many as a memory enhancer. Although a 1997 study suggested that a ginkgo extract may be of some value in treating the symptoms of Alzheimer's disease and other forms of dementia, there is no evidence that ginkgo biloba will cure or prevent Alzheimer's disease. Other studies, however, imply that daily use of ginkgo biloba may cause side effects, such as excessive bleeding (especially when combined with daily use of aspirin). To date, there simply is not enough information available for doctors to recommend the broad use of ginkgo biloba for Alzheimer's disease or other forms of dementia.
Selegiline: The drug selegiline may have a benefit equivalent to vitamin E but has more side effects.
Estrogen: Estrogen does not improve cognition when administered to a woman with Alzheimer's disease. In one initial study, researchers at the National Institute on Aging found evidence that giving estrogen to postmenopausal women might lower susceptibility to the changes in the brain associated with Alzheimer's disease. But other studies have found no decrease in risk of developing Alzheimer's disease or any cognitive improvement using estrogen replacement therapy. Because ERT may cause uterine bleeding and its long-term use may be associated with an increased risk of breast cancer, ERT is not routinely used in women with Alzheimer's disease.
Nonsteroidal anti-inflammatory drugs (NSAIDs): Studies of NSAIDs, a class of painkillers that includes ibuprofen and the cox-2 inhibitors, have not shown an ability to treat dementia, and these medications have significant side effects in older adults.
Studies are ongoing with cholesterol-lowering medications, certain diabetes medications, and folic acid supplements.

http://www.medicalnewstoday.com/medicalnews.php?newsid=37260

http://www.medicalnewstoday.com/medicalnews.php?newsid=37266

Tests your doctor might recommend

Your doctor may order these tests to help diagnose Alzheimer's disease, to understand the disease, or to rule out other disorders that cause symptoms similar to those of Alzheimer's disease.
Laboratory tests: When a doctor is diagnosing a disorder, he or she often orders laboratory tests on certain fluids and tissue samples from the body. These tests can help identify problems and diseases. There are hundreds of laboratory tests available to help a doctor make a diagnosis. The most common are blood tests and urinalysis. Blood tests involve a series of tests routinely done on blood to look for abnormalities associated with various diseases and disorders. A number of studies are generally recommended, including blood count, chemical survey, thyroid screen, vitamin B12 level, and usually a serologic test for syphilis. Blood tests also may be used to look for the presence of a specific gene that has been identified as a risk factor for Alzheimer's disease. (Genetic testing for Alzheimer's disease occurring after age 60 is not generally recommended.) A urinalysis is a test in which a urine sample is evaluated to detect abnormalities, such as improper levels of sugar or protein. This test may be used by the doctor to help rule out other disorders that may be causing symptoms similar to those of Alzheimer's disease.
Neuropsychological testing: This studies the relationship between the brain and behavior. It is used when the patient is having serious problems with short- and long-term memory, attention and concentration, word and name association, language understanding, and other symptoms that persist or worsen over time. These tests help in the diagnosis and treatment of conditions that affect thinking, emotion, and behavior. These include Alzheimer's disease, various psychiatric problems (depression, anxiety disorders), medication-related conditions, substance abuse, strokes, and tumors. Neuropsychological tests accompany a comprehensive interview with the patient and may include tests to assess attention, memory, language, ability to do arithmetic, the ability to plan and reason, and the ability to modify behavior, as well as assessments of personality and emotional stability. Neuropsychological testing also can help the doctor and family better understand the impact of a disorder on a patient's everyday functioning.
Electrocardiogram (ECG or EKG): A recording of the heart's electrical activity. This activity is registered as a graph or series of wavy lines on a moving strip of paper. This gives the doctor important information about the heart. For example, it can show the heart's rate and rhythm. It also can help show decreased blood flow, enlargement of the heart, or the presence of damage due to a current or past heart attack. EKGs are non-invasive, quick, safe, and painless, and are routinely done if a heart condition is suspected. This test may be used by the doctor to help rule out other disorders that may be causing symptoms similar to those of Alzheimer's disease.
This section also discusses:
Brain imaging for diagnosing Alzheimer's disease
Brain imaging for diagnosing and monitoring the progression of Alzheimer's disease

Brain imaging for diagnosing AD
These tests help a doctor rule out strokes, tumors, or other brain abnormalities that could cause the symptoms.
Computed tomography (CT or CAT) scan: a technique in which multiple X-rays of the body are taken from different angles in a very short period. These images are fed into a computer, which creates a series of cross-sectional "slices" of the body. Contrast material (such as barium) can be given to help distinguish organs from muscle and other tissue. CT imaging creates the images by measuring how quickly the body and organs absorb the X-rays. CT scans often can reveal certain changes that are characteristic of Alzheimer's disease in its later stages. These changes include a reduction in the size of the brain (atrophy), widened indentations in the tissues, and enlargement of the fluid-filled chambers called cerebral ventricles.
Magnetic resonance imaging (MRI): a test that produces very clear pictures, or images, of the human body without using X-rays. Instead, MRI uses a large magnet, radio waves, and a computer to produce these images. The MRI is a very sensitive test that is very helpful for imaging "soft tissues," such as organs. MRI is beneficial in ruling out other causes of dementia, such as tumors or strokes. It also may help to show the physical and functional changes in the brain that are associated with Alzheimer's disease.
Electroencephalography (EEG): a medical imaging technique that measures brain function by analyzing the electrical activity generated by the brain. This activity is measured through special electrodes applied to the scalp. EEG is a completely noninvasive procedure--meaning that nothing is inserted into the body. EEG can be used repeatedly in adults and children with virtually no risks or limitations and is helpful in the diagnosis of brain disorders. Because the EEG procedure is noninvasive and painless, it often is used to study various brain processes, such as perception, memory, attention, language, and emotion, and is most helpful in identifying disorders that can mimic Alzheimer's disease.
Brain imaging for diagnosing and monitoring AD
In addition, the following tests also may be done to help diagnose and monitor the progression of Alzheimer's disease:
Positron emission tomography (PET) scan: an imaging scan that measures the level of functional activity of the brain by measuring its use of glucose. PET scanning is a non-invasive, three-dimensional imaging technique that can show how the heart, brain, or other internal organs are functioning, unlike X-ray, CT, or MRI, which show only body structure. PET can provide information to pinpoint and evaluate diseases of the brain. PET imaging can show the region of the brain that is causing a patient to have seizures and is useful in evaluating degenerative brain diseases such as Alzheimer's. PET scans can show the difference in brain activity between a normal brain and one affected by Alzheimer's disease; they can also help differentiate Alzheimer's disease from other forms of dementia.
Single photon emission computed tomography (SPECT) scan: a procedure that measures blood flow in different areas of the brain. SPECT is a noninvasive technique for creating very clear, three-dimensional pictures of a major organ, such as the brain or heart. SPECT scans use radionuclide imaging--a technique that involves the injection of a very small amount of a radioactive substance called a tracer. Energy from the tracer in the body is detected by a special camera, which then takes the pictures. SPECT can map blood flow in certain regions of the brain, and is useful in evaluating specific brain functions. This may reveal abnormalities that are characteristic of Alzheimer's disease.
Magnetic resonance spectroscopy imaging (MRSI): A test that allows the doctor to observe certain substances throughout the brain without the use of radioactive materials. MRSI is a noninvasive imaging technique that is used to study metabolic changes in brain tumors, strokes, seizure disorders, Alzheimer's disease, depression, and other diseases affecting the brain. It also has been used to study the metabolism of other organs. MRSI can be done as part of a routine MRI, but they are different tests. An MRI creates an image, and an MRSI creates a graph of the types and quantity of chemicals in the brain or other organs.

Alzheimer's Disease: Tests

There is no a single test for diagnosing Alzheimer's disease. Your doctor can only diagnose probable Alzheimer's disease after a thorough medical, psychiatric, and neurological evaluation, to rule out all other possible causes of dementia. Alzheimer's disease cannot be positively diagnosed until after death, when the brain can be closely examined for certain microscopic changes caused by the disease. However, through thorough testing and a "process of elimination," doctors today can diagnose probable Alzheimer's with almost 90 percent accuracy. Diagnosing Alzheimer's often entails:
Taking a detailed medical history
Performing general and neurological examinations
Giving specific tests that measure cognitive skills
Performing certain blood studies
Analyzing images of the brain
This section has more on:
Why dementia should be evaluated by a doctor
What your doctor may well do first
Tests your doctor might recommend
Why dementia should be evaluated by a doctor
An early and accurate diagnosis of the cause of dementia is important for the following reasons:
To identify any treatable condition and initiate treatment as appropriate
To rule out Alzheimer's disease and so ease the patient's and his or her family's concern
To identify Alzheimer's disease at the earliest possible stage, which gives the patient and family time to plan for the future needs and care of the patient
Alzheimer's disease is the single most common form of dementia, but a number of other causes are also known, some of which may be at least partially reversible. Evaluation for dementia includes a search for alternative causes--chemical or metabolic disorders such as hypothyroidism or vitamin B12 deficiency, effects of chemical substances including tranquilizers and alcohol, depression, and structural processes such as tumors, strokes, or enlargement of the ventricles (fluid sacs) within the brain.
In addition, some Alzheimer's disease symptoms--such as incontinence and depression--can be effectively treated. Therefore, it is very important to diagnose the cause of the dementia early and correctly.
What your doctor may well do first
The following diagnostic tools may be used to help make a diagnosis of Alzheimer's disease:
Patient history: A patient history helps the doctor assess an individual's past and current health situation. It also helps the doctor evaluate any medical problems, develop a plan of treatment, and monitor the patient's health over time. During this evaluation, the doctor asks the patient a series of questions. A thorough patient history includes:
Patient's identifying information
Chief complaint
History of current illness
Past medical history
Current health status
Psychosocial history (marital status, living conditions, employment, sexual history, significant life events)
Mental status
Family history (including any illnesses that seem to run in the family)
Review of symptoms
Physical exam: The physical examination is part of the patient care process. The exam enables the doctor to assess the overall physical condition of the patient. If the patient has a medical complaint, the physical exam provides the doctor with more information about the problem, which helps the doctor determine an appropriate plan of treatment. The physical exam includes an evaluation of the following:
Vital signs (temperature, blood pressure, pulse)
Height and weight
Skin
Head, eyes, ears, nose
Throat/neck
Chest, including lungs and heart
Breasts
Abdomen
Bones and muscles
Nerves
Rectal/genital area
Chest X-ray (may be used by the doctor to help rule out other disorders that may be causing symptoms similar to those of Alzheimer's disease)

In a large study of twins, Alzheimer's disease appears to be highly heritable and genetic factors may also influence timing of the disease, according to an article in the February Archives of General Psychiatry, one of the JAMA/Archives journals.

PLD1 protein is implicated in Alzheimer's brain damage

Symptoms of Alzheimer's disease

Alzheimer's disease generally affects memory and the ability to think logically. Other important skills that may be impaired include language, complex motor activities, perception, and organizational skills. In its most severe form, Alzheimer's disease can interfere with a person's ability to perform daily tasks, such as dressing, bathing, and eating.
Alzheimer's disease is the single most common cause of dementia. Dementia is a sustained decline in thinking, with memory loss and at least one other area of deficit in great enough degree to interfere with social or occupational activities.
Most patients' symptoms progress slowly over a number of years. Symptoms may not be noticed early on. Sometimes, it is only when family members look back that they realize when the changes started to occur. The symptoms of Alzheimer's disease may resemble those of other medical conditions or problems, so it is important to talk to your doctor for an accurate diagnosis.
This section includes:
A list of symptoms of Alzheimer's disease
A discussion of memory and normal aging
Alzheimer's symptoms
It is important to visit a doctor if you or a loved one experience any of these symptoms so you can receive the proper evaluation and diagnosis. Other conditions--including depression and head injuries--can also produce many of the following symptoms.
The changes in the brain associated with Alzheimer's disease can begin long before symptoms appear. But the key warning signs include:
Impaired memory and thinking. The person has difficulty learning new information and remembering things, including personal information, such as his or her place of birth or occupation.
Difficulty performing familiar tasks. The person begins to have difficulty performing daily tasks, such as eating, dressing, and showering. A person with Alzheimer's disease might prepare a meal and forget to serve it or even forget that he or she prepared it.
Problems with language. The person can't recall words or understand the meaning of common words. A person with Alzheimer's disease may substitute inappropriate words, making it difficult to understand what he or she is saying.
Disorientation and confusion. People with Alzheimer's disease may get lost when out on their own and may not be able to remember where they are or how they got there. They also may not recognize formerly familiar places and situations.
Inability to follow directions. The person has difficulty understanding simple commands or directions. The person may get lost easily and begin to wander.
Poor or decreased judgment. The person has difficulty making decisions and cannot fully grasp consequences. People with Alzheimer's disease may leave the house on a cold day without a coat or shoes, or they may go to the store wearing pajamas.
Problems with abstract thinking. Many people find balancing a checkbook challenging. But someone with Alzheimer's disease may have difficulty recognizing numbers or understanding what to do with them.
Misplacing things. The person forgets where he or she put things used every day, such as glasses, a hearing aid, keys, etc. The person also may put things in strange places, such as leaving glasses in the refrigerator.
Changes in mood or behavior. People with Alzheimer's disease tend to have rapid mood swings.
Changes in personality. The person may experience a dramatic change in personality, becoming suspicious, fearful, angry, or quiet.
Loss of motivation or initiative. People with Alzheimer's disease may become passive and lose interest in their usual activities. They may require extra encouragement to become involved.
Social withdrawal. The person begins to spend more time alone and is less willing to interact with others.
Loss of appetite.
Normal aging and memory
Our ability to remember and to recall our past is what links us to our families, our friends, and our communities. As we age, subtle changes in memory occur. Simple forgetfulness (the "missing keys") and delay or slowing in recalling names, dates, and events can be part of the normal process of aging. Most normal changes in memory and thinking are of little importance. Not every memory problem becomes dementia, and not every cause of dementia is Alzheimer's disease. But when memory loss prevents us from performing daily tasks and our accustomed roles in life, it becomes a health concern that needs further evaluation by healthcare professionals.
Memory has various forms that might be affected differently by aging. As we age, we maintain remote memory, procedural memory (performing tasks), and semantic recall (general knowledge). However, our ability to learn something new and recall it declines.
Other changes can also occur with normal aging:
Language comprehension (understanding the rules of language) is preserved as we age, as are vocabulary and one's understanding of syntax--the way in which words are put together. But some modest decline is seen in our ability to dredge up words and in verbal fluency--one's ability to "get the words out."
While one's vocabulary remains unchanged as one ages, the speed with which one processes information gradually slows. For instance, one's ability to solve problems can decline.
In normal aging, so-called executive functions (like planning or abstracting) remain normal for everyday tasks but are slowed when one multitasks or is faced with novel tasks.
A slowing of the speed of cognitive processing and reaction time ("hitting the buzzer") occurs with aging.

Prana Alzheimer's drug well tolerated in study

Brain scans may predict cognitive decline in normal people

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Alzheimer's Disease Prevention

There is no way to prevent Alzheimer's. Because the controllable risk factors for Alzheimer's disease are not yet known, it is not possible to reduce the risk of developing the disease. Some studies, however, suggest that a lifetime of learning and keeping the mind active can help protect against the disease.
One of the most exciting new areas of research involves the risk factors that affect how likely it is that a person will develop Alzheimer's disease. An examination of the possible risk factors for Alzheimer's--such as aging, family history, past significant head injury, genetic factors, and low education--leads to theories about how these risks produce plaques, tangles, and cell loss, characteristics that are common in Alzheimer's disease. Similarly, examination of possible anti-Alzheimer's factors--including the use of anti-inflammatory medication, certain genetic factors, antioxidant therapies, and high education or occupational demand--generates other theories. Many potential therapies suggested by these theories are now being tested, will be tested in the near future, or are under development.

Link Discovered Between Depression And Changes In The Brain In Alzheimer's Diseasemore...

http://www.medicalnewstoday.com/medicalnews.php?newsid=37092

Receptor Critical In Neurodegeneration Reduces Alzheimer's PlaqueMedical News Today (press release) - UK... "Using an Alzheimer's model in mice, we demonstrated that decreasing the level of NogoReceptor causes more of the Alzheimer's beta-amyloid to build up in the ...
Alzheimer: Genetic Origin WarningPrensa Latina - Havana,Cuba... Swedish twins over 65 years suggest a genetic origin of Alzheimer"s in more than 80 percent of cases. A small, abnormal protein -beta-amyloid peptides- is ...
Brain scans may predict cognitive decline in normal peopleEurekAlert (press release) - Washington,DC,USA... called apolipoprotein E, or apoE, as a major genetic risk factor for Alzheimer's disease. ApoE is associated with the buildup of beta amyloid plaques in the ...
Yale scientists find telltale Alzheimer's proteinYale University Daily News - New Haven,CT,USA... "The first question we asked was whether the amyloid-beta peptide, [the protein] commonly thought to be the cause of Alzheimer's disease, interacts with ...

Risk factors
Age: Your risk of developing Alzheimer's disease increases as you grow older. At 65 years, 1 percent of the population is affected; at age 85, 30 percent to 50 percent has the disease. While it has been suggested that everyone might develop dementia after living long enough, it should be emphasized that Alzheimer's is a disease and not simply an exaggeration of normal aging.
Family history: If you have relatives who have Alzheimer's, you are more likely to develop the disease, although a clear, inherited pattern of Alzheimer's disease exists for fewer than 1 percent of all cases. Alzheimer's disease strikes early and fairly often in certain families, often enough to be singled out as a separate form of the disease and given a label: early-onset familial Alzheimer's disease, or FAD.
Sex: Alzheimer's disease is more prevalent among women than among men.
Head injury: Some studies have shown an association between Alzheimer's disease and a history of significant head injury.
Education: Some studies have shown that low education levels are related to an increased risk for Alzheimer's disease, although why this might be the case is not clearly understood.
Down syndrome: People with Down syndrome often develop Alzheimer's disease in their 40s and 50s.
One of the most publicized and controversial theories concerns aluminum, which became a suspect in Alzheimer's disease when researchers found traces of this metal in the brains of patients with Alzheimer's disease. Many studies since then have either not been able to confirm this finding or have had questionable results. Aluminum does turn up in higher amounts than normal in some autopsy studies of Alzheimer's patients but not in all. Various studies have found that groups of people exposed to high levels of aluminum do not have an increased risk. On the whole, scientists can say only that it seems unlikely that exposure to aluminum plays a role in Alzheimer's disease.

Nogo Protein May Attack Alzheimer's

PBT2 Successfully Completes Initial Phase I Clinical Trial Program

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Alzheimer's disease causes.

Studies show that chemical and structural changes occur in the brains of people with Alzheimer's disease. These changes interfere with a person's ability to process, store, and retrieve information. It is not known why these changes occur.
Scientists have found two significant abnormalities in the brains of people with Alzheimer's disease: twisted nerve cell fibers, known as neurofibrillary tangles, and a sticky protein called beta amyloid, which forms structures called plaques. Plaques and tangles are associated with damage to healthy brain cells, causing the brain to atrophy and shrink.
Another characteristic of Alzheimer's disease is the reduced production of certain chemicals in the brain that are necessary for communication between nerve cells. These chemicals, called neurotransmitters, include acetylcholine, serotonin, and norepinephrine.
In the area of the brain responsible for memory, the hippocampus, there is a loss of nerve cells, and decreases occur in the levels of chemicals needed for carrying messages back and forth between the nerve cells.

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Types and stages of Alzheimer's

Many doctors and researchers categorize Alzheimer's in two different ways--by the type of disease and by the stages people with Alzheimer's progress through.
This section includes information on early-onset, late-onset, and familial Alzheimer's.

Early-onset Alzheimer's: This is an uncommon form in which individuals are diagnosed with the disease before age 65. Fewer than 10 percent of all Alzheimer's disease patients have this type. Because of their genetic abnormality, people with Down syndrome are particularly at risk for a form of early-onset Alzheimer's disease. Adults with Down syndrome often are in their mid- to late 40s or early 50s when symptoms first appear.
Late-onset dementia: The most common form of Alzheimer's disease, late-onset dementia usually strikes after age 65. It occurs in almost half of all people over the age of 85 and may or may not be hereditary. Late-onset dementia is also called sporadic Alzheimer's disease.
Familial Alzheimer's disease (FAD): This form of Alzheimer's disease is known to be entirely inherited. FAD is extremely rare, accounting for fewer than 1 percent of all cases of Alzheimer's disease. It has a much earlier onset (often in the 40s) and follows clear patterns of inheritance.
In addition to age of onset, there are other differences among the types of Alzheimer's.
Younger people who develop Alzheimer's disease have more of the microscopic changes found in the brains of people with Alzheimer's disease. These changes include the twisted nerve cell fibers, known as neurofibrillary tangles, and a sticky protein called beta amyloid, which forms structures called plaques. Plaques and tangles are associated with damage to healthy brain cells and result in brain shrinkage or atrophy. It may be, though, that younger brains simply need to be more damaged before a person starts to show symptoms, so this may not reflect a true difference in the nature of the disease.
A condition called myoclonus--muscle twitching and spasm--is more commonly seen in early-onset than late-onset Alzheimer's.
Some research suggests that people with early-onset Alzheimer's disease decline at a faster rate than do those with late-onset Alzheimer's disease.
Younger people who are diagnosed with the disease tend to be more physically fit and active, and many still have family and career responsibilities. As a result, they tend to feel more powerless, frustrated, and depressed upon diagnosis.

Fit body helps to improve mental function, too

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