There are several organizations dedicated to educating patients, families, and caregivers about Alzheimer’s, providing helpful insights into where to go for help and support. These organizations are listed in the Resources section of this book.
Researchers have been studying the AD brain, with all its complexities, since Alois Alzheimer presented his patient in 1907. Science is now closer to finding some answers about what may cause AD, and therefore gaining momentum on what may prevent or treat the disease.
The changes that occur in the brain in Alzheimer’s disease provide some background to the medications used in this disease. It is important to keep in mind that there is currently no definitive explanation as to why this disease process begins. First, it is essential to have some knowledge of the functions of the brain to understand Alzheimer’s and how the medications are developed and utilized.
Wednesday, November 18, 2009
Sunday, October 25, 2009
The impact of Alzheimer’s
Alzheimer’s disease not only affects the patients but also the patient’s family. Almost one out of three households in the Figure 1.1 Alois Alzheimer (pictured here) is the German neurologist who is credited with discovering Alzheimer’s disease.
Defining Alzheimer’s Disease
United States is affected by AD. A little over half of the care provided to AD patients is at home; some estimates place the care at home closer to 75% (Figure 1.2). The combination of healthcare expenses and the loss of income of both the patient and the caregiver is approaching $100 billion nationwide. The Figure 1.2 Almost one out of three households in the United States is affected by Alzheimer’s disease. An estimated 75% of Alzheimer’s patients receive home care.
Over half of the nursing home residents in the United States have AD or some other form of dementia. The annual cost of caring for an AD patient ranges from $18,400 for mild symptoms to $36,132 for those with advanced symptoms. In addition, the average cost of nursing home care is almost $58,000 a year. Medicare and most health insurance plans do not cover the care of an AD patient since it is considered "custodial care".
Caregivers are a subset of the Alzheimer’s picture that is often overlooked. Stress and depression are reported frequently among caregivers: depression affects approximately 50% of caregivers, with stress occurring in at least 80%. Not surprisingly, the emotional, financial, and sometimes physical burden of witnessing a loved one decline mentally and physically is often overwhelming.
Defining Alzheimer’s Disease
United States is affected by AD. A little over half of the care provided to AD patients is at home; some estimates place the care at home closer to 75% (Figure 1.2). The combination of healthcare expenses and the loss of income of both the patient and the caregiver is approaching $100 billion nationwide. The Figure 1.2 Almost one out of three households in the United States is affected by Alzheimer’s disease. An estimated 75% of Alzheimer’s patients receive home care.
Over half of the nursing home residents in the United States have AD or some other form of dementia. The annual cost of caring for an AD patient ranges from $18,400 for mild symptoms to $36,132 for those with advanced symptoms. In addition, the average cost of nursing home care is almost $58,000 a year. Medicare and most health insurance plans do not cover the care of an AD patient since it is considered "custodial care".
Caregivers are a subset of the Alzheimer’s picture that is often overlooked. Stress and depression are reported frequently among caregivers: depression affects approximately 50% of caregivers, with stress occurring in at least 80%. Not surprisingly, the emotional, financial, and sometimes physical burden of witnessing a loved one decline mentally and physically is often overwhelming.
Defining Disease of Alzheimer
When Dr. Alzheimer’s patient died, he was able to study her brain at autopsy.
Alzheimer noted that the cerebral cortex, the outer layer of the brain responsible for numerous functions such as movement, perception, memory, and speaking, was thinner than normal and had severe atrophy. He also noted two other abnormalities. The first was “senile plaque” (now known as neuritic plaque) that had earlier been seen in the brains of the elderly. Second, there were neurofibrillary tangles within the cortex that had not been previously described. These hallmarks for which Alzheimer coined the term presenile dementia, are now known as Alzheimer’s disease (Figure 1.1). Neuritic plaques and neurofibrillary tangles will be discussed in more detail in Chapter 3. Interestingly, to this day, the only way to definitively know that a person has AD is at autopsy.
Who gets Disease of Alzheimer?
It is estimated that over 4 million Americans have Alzheimer’s disease. It is also estimated that by the year 2050, the number could increase to 14 million. One out of every ten persons 65 years of age and older develops AD, although some develop it in their 40s and 50s. Alzheimer’s affects approximately 20% of people between the ages of 75 and 84. The percentage of AD increases to almost 50% in Americans 85 years and older.
The clinical course of the disease is between 2 years and 20 years from the onset of symptoms until death, with an average of about 8 years. There are about 360,000 new cases of Alzheimer’s diagnosed every year and about 100,000 deaths each year from AD.1, 2 Alzheimer’s disease affects people from all walks of life.
The death of President Ronald Reagan from complications of AD has re-ignited an interest in finding a cure for the disease. Other famous people with Alzheimer’s include actors Charles Bronson, Rita Hayworth, Charlton Heston, Jack Lord, and James Doohan; sports stars Sugar Ray Robinson, Joe Adcock, Bill Quackenbush, and Tom Fears; E.B. White, the author of the children’s classic Charlotte’s Web, and Barry Goldwater, former senator of Arizona.
Alzheimer noted that the cerebral cortex, the outer layer of the brain responsible for numerous functions such as movement, perception, memory, and speaking, was thinner than normal and had severe atrophy. He also noted two other abnormalities. The first was “senile plaque” (now known as neuritic plaque) that had earlier been seen in the brains of the elderly. Second, there were neurofibrillary tangles within the cortex that had not been previously described. These hallmarks for which Alzheimer coined the term presenile dementia, are now known as Alzheimer’s disease (Figure 1.1). Neuritic plaques and neurofibrillary tangles will be discussed in more detail in Chapter 3. Interestingly, to this day, the only way to definitively know that a person has AD is at autopsy.
Who gets Disease of Alzheimer?
It is estimated that over 4 million Americans have Alzheimer’s disease. It is also estimated that by the year 2050, the number could increase to 14 million. One out of every ten persons 65 years of age and older develops AD, although some develop it in their 40s and 50s. Alzheimer’s affects approximately 20% of people between the ages of 75 and 84. The percentage of AD increases to almost 50% in Americans 85 years and older.
The clinical course of the disease is between 2 years and 20 years from the onset of symptoms until death, with an average of about 8 years. There are about 360,000 new cases of Alzheimer’s diagnosed every year and about 100,000 deaths each year from AD.1, 2 Alzheimer’s disease affects people from all walks of life.
The death of President Ronald Reagan from complications of AD has re-ignited an interest in finding a cure for the disease. Other famous people with Alzheimer’s include actors Charles Bronson, Rita Hayworth, Charlton Heston, Jack Lord, and James Doohan; sports stars Sugar Ray Robinson, Joe Adcock, Bill Quackenbush, and Tom Fears; E.B. White, the author of the children’s classic Charlotte’s Web, and Barry Goldwater, former senator of Arizona.
Alzheimerts Disease, History
A German neuropathologist and psychiatrist named Alois Alzheimer (see “Alois Alzheimer” box) studied a 51-year-old female patient with severe dementia. The woman started experiencing symptoms five years earlier, such as memory loss and trouble reading and writing. She rapidly declined to hallucinations and was unable to take care of herself.
Dr. Alois Alzheimer was born on June 14, 1864, in Bavaria.
He attended the universities of Aschaffenburg, Tubingen, Berlin, and Wurzburg, where he received a medical degree in 1887. The following year, Alzheimer joined the medical staff at the city mental asylum in Frankfurt, Germany. While he first began his career in psychiatry, Alzheimer quickly devoted himself to his great interest of neuropathology, the study of the causes, nature, and effects of brain diseases.
In 1903, he moved to the university psychiatric clinic in Munich. He recorded his findings on his first AD patient in 1907. For the next ten years, he studied patients with syphilis, Huntington’s disease, epilepsy, and a pseudosclerosis of the brain now known as Wilson’s disease. Alois Alzheimer died on December 19, 1915, at the age of 51, due to cardiac failure following endocarditis, inflammation of the membrane that lines the heart and forms part of the heart valves.
Dr. Alois Alzheimer was born on June 14, 1864, in Bavaria.
He attended the universities of Aschaffenburg, Tubingen, Berlin, and Wurzburg, where he received a medical degree in 1887. The following year, Alzheimer joined the medical staff at the city mental asylum in Frankfurt, Germany. While he first began his career in psychiatry, Alzheimer quickly devoted himself to his great interest of neuropathology, the study of the causes, nature, and effects of brain diseases.
In 1903, he moved to the university psychiatric clinic in Munich. He recorded his findings on his first AD patient in 1907. For the next ten years, he studied patients with syphilis, Huntington’s disease, epilepsy, and a pseudosclerosis of the brain now known as Wilson’s disease. Alois Alzheimer died on December 19, 1915, at the age of 51, due to cardiac failure following endocarditis, inflammation of the membrane that lines the heart and forms part of the heart valves.
Wednesday, October 14, 2009
Alzheimer’s disease
Did you ever briefly forget your friend’s name or have trouble recalling the name of a song on the radio? Many of us joke that it is an “early form of Alzheimer’s.” However, if you are younger than 60, the likelihood that you have Alzheimer’s disease is slim. The memory loss that most people experience can be attributed to many different reasons, such as lack of sleep, too much on their mind, anxiety, or depression. This memory loss tends to be brief, occasional, and has little impact on daily life.
Memory loss that occurs more frequently and that begins to impact a person’s life, however, is usually a type of dementia.
Dementias are usually irreversible and not curable.Dementia primarily affects the elderly and can have many origins. Alzheimer’s disease is the most common form of dementia, occurring about 65% of the time. However, it is also important to rule out other forms of dementia (differential diagnosis).
Some lists potential causes of dementia (sometimes referred to as "senility").
Neurologic disorders:
Stroke, Transient ischemic attack, Biswanger’s disease, Alzheimer’s disease, Lewy body dementia, Parkinson’s disease, Huntington’s disease, Pick’s disease, Creutzfeldt-Jakob disease.
Infections:
Encephalitis, Meningitis.
Metabolic disorders:
Thyroid, Pancreatic, Adrenal.
Cardiovascular disorders:
Vascular occlusion.
Medications:
• Anticholinergics—blocks action of acetylcholine, a nerve transmitter
• Sedative/hypnotic—sleeping pills
• Antihypertensives—blood pressure medicine
Toxins:
Heavy metals
Mental illness:
Schizophrenia, Depression, Substance abuse.
Vitamin deficiencies:
B12, Folate.
Intracranial causes:
Tumors, Subdural hematoma, Hydrocephalus, Abcesses.
Many of these causes, such as those listed under infections, metabolic disorders, medications, and vitamin deficiencies, can be treated and the dementia abates.
Since there are many possible reasons for dementia-like attributes, it is important to see a neurologist. A neurologist is a medical doctor who specializes in the brain and the disorders that affect the brain.
Neurologists often specialize in a particular brain disorder. For instance, one neurologist may treat primarily patients who have had a stroke (temporary or permanent loss of some body functioning),while other neurologists may treat primarily Alzheimer’s patients. Therefore, choosing an appropriate neurologist is one of the first steps in determining the correct diagnosis.
The neurologist will then assist in determining if a patient has a form of dementia. If it is concluded that it is dementia, the neurologist will further attempt to determine the likely cause.
Memory loss that occurs more frequently and that begins to impact a person’s life, however, is usually a type of dementia.
Dementias are usually irreversible and not curable.Dementia primarily affects the elderly and can have many origins. Alzheimer’s disease is the most common form of dementia, occurring about 65% of the time. However, it is also important to rule out other forms of dementia (differential diagnosis).
Some lists potential causes of dementia (sometimes referred to as "senility").
Neurologic disorders:
Stroke, Transient ischemic attack, Biswanger’s disease, Alzheimer’s disease, Lewy body dementia, Parkinson’s disease, Huntington’s disease, Pick’s disease, Creutzfeldt-Jakob disease.
Infections:
Encephalitis, Meningitis.
Metabolic disorders:
Thyroid, Pancreatic, Adrenal.
Cardiovascular disorders:
Vascular occlusion.
Medications:
• Anticholinergics—blocks action of acetylcholine, a nerve transmitter
• Sedative/hypnotic—sleeping pills
• Antihypertensives—blood pressure medicine
Toxins:
Heavy metals
Mental illness:
Schizophrenia, Depression, Substance abuse.
Vitamin deficiencies:
B12, Folate.
Intracranial causes:
Tumors, Subdural hematoma, Hydrocephalus, Abcesses.
Many of these causes, such as those listed under infections, metabolic disorders, medications, and vitamin deficiencies, can be treated and the dementia abates.
Since there are many possible reasons for dementia-like attributes, it is important to see a neurologist. A neurologist is a medical doctor who specializes in the brain and the disorders that affect the brain.
Neurologists often specialize in a particular brain disorder. For instance, one neurologist may treat primarily patients who have had a stroke (temporary or permanent loss of some body functioning),while other neurologists may treat primarily Alzheimer’s patients. Therefore, choosing an appropriate neurologist is one of the first steps in determining the correct diagnosis.
The neurologist will then assist in determining if a patient has a form of dementia. If it is concluded that it is dementia, the neurologist will further attempt to determine the likely cause.
The Use of Drugs
The problem that faces our society today is how to break the connection between our demand for drugs and the willingness of largely outside countries to supply this highly profitable trade. This is the same problem we have faced since narcotics and cocaine were outlawed by the Harrison Narcotic Act of 1914, and we have yet to defeat it despite current expenditures of approximately $20 billion per year on "the war on drugs". The first step in meeting any challenge is always an intelligent and informed citizenry. The purpose of this series is to educate our readers so that they can make informed decisions about issues related to drugs and drug abuse.
Drug Addiction
The issues associated with drug use and abuse in contemporary society are vexing subjects, fraught with political agendas and ideals that often obscure essential information that teens need to know to have intelligent discussions about how to best deal with the problems associated with drug use and abuse.
Drugs: The Straight Facts aims to provide this essential information through straightforward explanations of how an individual drug or group of drugs works in both therapeutic and non-therapeutic conditions; with historical information about the use and abuse of specific drugs; with discussion of drug policies in the United States; and with an ample list of further reading.
From the start, the series uses the word "drug" to describe psychoactive substances that are used for medicinal or nonmedicinal purposes. Included in this broad category are substances that are legal or illegal. It is worth noting that humans have used many of these substances for hundreds, if not thousands of years. For example, traces of marijuana and cocaine have been found in Egyptian mummies; the use of peyote and Amanita fungi has long been a component of religious ceremonies worldwide; and alcohol production and consumption have been an integral part of many human cultures’ social and religious ceremonies. One can speculate about why early human societies chose to use such drugs.
Perhaps, anything that could provide relief from the harshness of life—anything that could make the poor conditions and fatigue associated with hard work easier to bear—was considered a welcome tonic. Life was likely to be, according to the seventeenth century English philosopher Thomas Hobbes, "poor, nasty, brutish and short". One can also speculate about modern human societies’ continued use and abuse of drugs. Whatever the reasons, the consequences of sustained drug use are not insignificant—addiction, overdose, incarceration, and drug wars—and must be dealt with by an informed citizenry.
Drugs: The Straight Facts aims to provide this essential information through straightforward explanations of how an individual drug or group of drugs works in both therapeutic and non-therapeutic conditions; with historical information about the use and abuse of specific drugs; with discussion of drug policies in the United States; and with an ample list of further reading.
From the start, the series uses the word "drug" to describe psychoactive substances that are used for medicinal or nonmedicinal purposes. Included in this broad category are substances that are legal or illegal. It is worth noting that humans have used many of these substances for hundreds, if not thousands of years. For example, traces of marijuana and cocaine have been found in Egyptian mummies; the use of peyote and Amanita fungi has long been a component of religious ceremonies worldwide; and alcohol production and consumption have been an integral part of many human cultures’ social and religious ceremonies. One can speculate about why early human societies chose to use such drugs.
Perhaps, anything that could provide relief from the harshness of life—anything that could make the poor conditions and fatigue associated with hard work easier to bear—was considered a welcome tonic. Life was likely to be, according to the seventeenth century English philosopher Thomas Hobbes, "poor, nasty, brutish and short". One can also speculate about modern human societies’ continued use and abuse of drugs. Whatever the reasons, the consequences of sustained drug use are not insignificant—addiction, overdose, incarceration, and drug wars—and must be dealt with by an informed citizenry.
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