Alzheimer Disease

Overview

Alzheimer Disease is the most widespread of a large category of disorders known as "dementias" the main features being a progressive deterioration of thinking (cognitive impairment) and of memory. There are two forms of the disease but Sporadic Alzheimer Disease accounts for 90 to 95 per cent of all cases. Familial Autosomal Dominant Alzheimer Disease is a less common form which can be passed directly from one generation to another.

Currently an estimated 280000 Canadians over 65 have Alzheimer Disease and at the predicted rate approximately 509000 Canadians over 65 will be diagnosed by the year 2031. More women are affected by the disease than men: women account for over 2/3 of all those over 65 with the disease Whilethere is no single known cause for Alzheimer Disease and no cure you can reduce your risk by adopting a healthy lifestyle.

Causes

Scientists do not yet fully understand what causes Alzheimer Disease but they do know that it is not a normal part of aging.

Alzheimer's disease is named after Dr. Alois Alzheimer a German doctor. In 1906 he noticed changes in the brain tissue of a woman who had died of an unusual mental illness. He found abnormal clumps and tangled bundles of fibres. The clumps are now called amyloid plaques and the tangles are called neurofibrillary tangles. Today these plaques and tangles in the brain are considered hallmarks of Alzheimer disease.

Scientists also have found other brain changes in people with Alzheimer's disease. There is a loss of nerve cells in areas of the brain that are vital to memory and other mental abilities. There also are lower levels of chemicals in the brain that carry complex messages back and forth between nerve cells. Researchers believe Alzheimer's disease may disrupt normal thinking and memory by blocking these messages between nerve cells.

Research suggests that the disease develops when enough known risk factors operating in combination cross a certain threshold. This is the point when their combined effect overwhelms the natural self-repair and self-healing mechanisms in the brain that normally maintain the nerve cells in a healthy state.

While no one single cause of Alzheimer Disease has been identified age is the most important known risk factor. The number of people with the disease doubles every 5 years beyond age 65.

Other risk factors include family history previous head injury Down syndrome Mild Cognitive Impairment (MCI) and evidence of brain inflammation. Recently diabetes has also been recognized as a risk factor. Scientists are also studying education diet and environmental factors to learn what role they might play in the development of this disease.

Symptoms

Alzheimer Disease develops slowly starting with mild memory problems and ending with severe brain damage. The course the disease takes and how fast changes occur varies from person to person. On average those with Alzheimer's live from 8 to 10 years after they are diagnosed though the disease can last for as many as 20 years.

Ten common symptoms

Memory loss that affects day-to-day function.
Difficulty performing familiar tasks
Problems with language.
Disorientation of time and place.
Poor or decreased judgment.
Problems with abstract thinking.
Problems misplacing things.
Dramatic changes in mood or behaviour
Extreme changes in personality.
Loss of initiative.

Treatment

No treatment can stop Alzheimer Disease. However for some people in the early and middle stages of the disease certain drugs may help prevent some symptoms from becoming worse for a limited time. Also some medicines may help control behavioral symptoms such as sleeplessness agitation wandering anxiety and depression. Treating these symptoms often makes patients more comfortable and makes their care easier for caregivers.

Developing new treatments is an active area of research. Scientists are testing a number of drugs to see if they prevent Alzheimer's slow the disease or help reduce symptoms.

Prevention

The medical and scientific communities have yet to find a way to prevent Alzheimer Disease. However they do recognize that delaying the onset of the disease has a significant impact on the person with the disease. It has been estimated that a delay in onset by five years could translate into a 50 per cent decrease in prevalence of Alzheimer Disease and a delay of 10 years would result in virtual disappearance of the disease.

Except for the genetic risk factors aging and the post-menopausal state most risk factors or their adverse effects can be reduced by adopting a healthy lifestyle that includes:

Exercise

We all know that exercise is beneficial for weight loss and good health but researchers are now finding that regular physical activity may also help in other important ways. A 5 year long study of Canadian men and women over the age of 65 concluded that exercise helps cut the risk of mental decline dementia and Alzheimer's especially in women.

In fact the study also showed that the more a person engaged in exercise the more protection was afforded to the brain. Those who engaged in the highest amount of activity were half as likely as inactive people to develop Alzheimer's and about 40% less likely to incur other dementias and mental decline.

Even people who engaged only in light exercise experienced a lowered incident of mental decline and Alzheimer's.

Drugs: anti-inflammatory (aspirin) and cholesterol lowering statins

You may have heard that taking an aspirin a day helps ward off cardiovascular disease. New studies indicate that regular use of anti-inflammatory drugs including aspirin can also help reduce the incidence of dementia if taken for more than two years. To be beneficial however these drugs need to be taken prior to the onset of dementia.

Other studies have led scientists to believe that drugs designed to lower blood cholesterol can also help protect against the development of Alzheimer's. Research has shown that high cholesterol levels can lead to greater mental decline. It's well known that people with high cholesterol have a build up of plaque in their arteries that can lead to heart disease. Scientists say the same principle applies to the arteries in the brain. Studies show that people who take statins to lower their cholesterol have less mental impairment than those who do not.

Folic acid and vitamins

People who have Alzheimer's disease often have low levels of folic acid and high levels of amino acid in their blood. Studies have shown that these people have nearly twice the risk of developing Alzheimer's disease. Increasing the amount of folic acid by eating foods rich in this nutrient or through supplements could be beneficial in protecting the brain from developing dementia. Foods rich in folic acid include fruits such as papayas pea's asparagus broccoli strawberries and oranges. Vitamins B6 and B12 help boost folic acid levels. These can be taken as a vitamin supplement or in foods such as hot cereal whole wheat bread or pasta brown rice leafy green vegetables and citrus fruits. By eating more of these foods you can also reduce your risk of stroke or heart disease.

One recent study shows that Vitamins C and E when taken in combination more effectively reduce the incidence of Alzheimer's. These vitamins are both antioxidants which help protect against neuron damage in the brain which is associated with mental decline.

Stimulate your mind

Some people who retire from an exciting career seem to go down hill quite rapidly. It could be because they aren't getting the intellectual stimulation their brain needs. Think of it as exercise for the mind. Just like muscle tissue you use it or lose it. Using the brain in intellectual activities helps to build connections between the neurons in the brain which in turn help stave off impending dementia.

Some activities that may be used to stimulate your mind are reading taking new courses in whatever interests you playing games such as cards checkers chess and that old standby- doing crossword puzzles.

The lesson to be learned from all of this research is that as one begins to age you need to develop the kind of habits that will keep you both physically and mentally alert; exercise regularly eat a healthy diet rich in antioxidants folic acid and essential vitamins stop smoking and have your doctor check your cholesterol and take steps to keep it under control.