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Alzheimer's Disease Factsheet

by Benjamin W. Pearce

Until less than ten years ago, public awareness of Alzheimers was limited and there was still a widespread belief that senility was associated with old age. Scientists now know that the loss of mental capacity during the aging process is not inevitable. Not all older people become senile, however short term memory does decline with age. The main complaint of most older people with respect to their aging process is changes in their cognitive ability. Risk for Alzheimer's disease increases with advancing age. After age 65, the percentage of people who suffer from Alzheimer's disease doubles with every decade of life.¹ Alzheimer's disease, first discovered by German neurologist Alois Alzheimer in 1907 is a debilitating and ultimately fatal illness. The disease destroys mental functions including memory, speech, comprehension and awareness. Until recently the disease was difficult to diagnose, only positively confirmed by removing the brain after death which reveals nerve tangles and protein deposits, referred to as plaques which characterize the disease. Alzheimer's normally begins with memory deficit or difficulty performing routine tasks. As the disease progresses, victims can undergo severe personality changes, and experience confusion and ultimately the individual can no longer care for themselves. At this point, 24 hour supervision becomes necessary with ultimate transfer to a special care facility. Early on in the disease, residents can adjust their lifestyle by making notes to supplement memory loss, and establishing routines for their medications, location of keys, glasses, dentures and other important items. "There are many behaviors which are common to the Alzheimer's victim. Some of these are paranoia, agitation, pacing, fidgeting, verbal abuse and wandering. While each of these behaviors may be common to the Alzheimer's victim, it is important to realize that they may be manifest in different ways in different patients."²

Alzheimer's disease strikes families particularly hard. "It is normal for the care giver to react to an Alzheimer's victim by feeling helpless, angry, fearful, upset, or bewildered. The care giver must always remember they are in control and their reactions will either calm the resident or create bigger problems. It is important to realize that the resident may not be fully aware of his actions and the problem behavior may not necessarily have any meaning. It is critical for the care giver to react with warmth and tenderness."5 Considering the complexity of the disease and needs of the patiernts, its not suprising that families turn to professionals for help.

Intervention strategies and, if necessary, appropriate medication can lessen symptoms such as agitation and anxiety, and improve sleep and participation in activities.

There are currently four FDA-approved drug treatments specifically for Alzheimer's disease - tactrine (Cognex), donepezil hydrochloride (Aracept), and rivastigmine (Exelon), and galantamine hydrobromide (Reminyl). These drugs comes with the disclaimer, "Cognex is not a cure for Alzheimer's disease. Even in those people who are at first helped by Cognex, the drug's positive effects are likely to lessen as the disease itself gets worse." These drugs are designed to inhibit the progress of the disease allowing residents to progress through the disease at a slower rate. According to the Alzheimer's Association, the disease will cost the nation at least $100 billion a year, including $26 billion in workplace productivity loss to caregiver duties. Half of all persons who live in nursing homes suffer from Alzheimer's disease and related dementias.

A variety of evidence suggests that degeneration of cholinergic neurons may contribute to the cognitive impairments experienced by Alzheimer's victims. These impairments can be slowed or reversed by administration of acetylcholinesterase inhibitors.³ Galantamine is a reversible cholinesterase inhibitor that can be isolated from a number of different plant sources, including daffodil bulbs. Initial studies indicate that Galantamine can improve learning and memory performance. Obviously a genetic advantage by daffodils to remind grandma where she planted them so they can be properly cared for each spring.

Be cautious about labeling. The term "senility" is not a medical diagnosis, but has come to be used somewhat indiscriminately to cover a variety of symptoms and behaviors including forgetfulness, confusion, lack of responsiveness and depression. Many of these symptoms can be brought on by reversible causes such as malnutrition, anxiety, alcoholism, or adverse reaction to multiple medications.⁴ The Alzheimer's Disease and Related Disorders Association (ADRDA) is available to assist families and victims with educational materials and advise for the victim and care-giver alike.⁵

1. Progress Report on Alzheimer's Disease. National Institute on Aging, National Institutes of Health. 1995.
2. Willingham, N.M. "Understanding Alzheimer's" The Spectrum. November 1991, Pg. 30.
3. Sweeney, J.E.,Hohmann, C.F., Moran, T.H., and Coyle, J.T.A long-acting cholinesterase inhibitor reverses spatial memory deficits. Pharmacology and Behaviour, 31: 141-147, 1988.
4. Butler, R.N., M.D. Why Survive? Being Old In America. New York: Harper & Row, 1975.
5. The Alzheimer's Disease and Related Disorders Association can be reached at (800) 621-0379. The Alzheimer's Disease Education and Referral Center provides excellent resource materials (800) 438-4380, or visit their website at http://www.alzheimers.org/adear

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