Microsoft word - 66 - hlthnotes - nov'11 - alzheim dementia
may forget new information, and later can become confused and irritable. Alzheimer’s is believed to be due to
by Marla Lichtsinn, RN, MPA, FCN, Parish Nurse
steady accumulation in the cerebral cortex of a protein
called “beta-amyloid”, that may begin decades before
NOVEMBER 2011: What’s happening in the brain…. Dr. Aloysius Alzheimer ALZHEIMER’S DISEASE
(who identified the disease in 1906) described abnormal clumps of a protein in the spaces between nerve cells –
and other forms of Dementia
these are now referred to as amyloid plaques. He also
described tangled fibers of another protein called tauDementia is the loss of mental functions that is severe
(rhymes with “wow”) that builds up inside cells – these are
enough to interfere with a person’s daily functioning.
now called neurofibrillary tangles. These plaques and
Dementia is not a disease itself, but rather a group of
tangles, along with the loss of nerve cell connections, are
symptoms that are caused by various diseases or
still the primary characteristics of the disease.
conditions. Symptoms can include changes in personality,
How it’s diagnosed… Alzheimer’s has been “diagnosed”
mood, behavior, memory and reasoning. In some cases,
largely by symptoms - changes in a person’s function – or
the dementia can be cured (if the cause is treatable). In
by changes in the brain when examined at autopsy. But
some cases, a person may appear to have dementia, but
the Food and Drug Administration (FDA) recently
severe depression can be causing the symptoms.
approved use of a PET (positron emission tomography)
Dementia caused by substance abuse, combinations of
scan tracer that can image amyloid plaque in a living
prescription medications, hormone changes or vitamin
person. In the future, these scans may be used to observe
imbalances can be treated. In most cases, however, a true
the development of amyloid because it’s a good marker
for the pre-symptomatic phase of the disease, when
Dementia develops when parts of the brain that are
involved with learning, memory, decision-making and
Family history… In general, if you have a first family
language are affected by one or more of a variety of
member (parent or sibling) who has had Alzheimer’s,
infections or diseases. The most common cause of
you’re 2-3 times more likely to get it yourself if you live to
dementia is Alzheimer’s disease (causing 50-80% of all
age 85,” says Alan Jacobs, MD a leading U.S. specialist in
dementias), but there are as many as 50 other known
Alzheimer’s, memory disorders and neuroendocrinology.
Mutations in the genes for amyloid precursor protein
It is very important that your doctor is thorough when
(APP) presenilin-1 and presenilin-2 clearly lead to familial
making the diagnosis, so as not to miss potentially
early-onset Alzheimer’s disease, which can affect people
treatable conditions (the frequency of treatable causes of
in their 20’s, 30’s and 40’s… This group constitutes about
1 out of 10,000 people or families with the disease, so it is
WHAT CAUSES DEMENTIA?
rare. Because it’s a simple model, this early onset version
▪ Diseases that cause degeneration or loss of nerve cells
will probably be cured in the near future.
in the brain such as Alzheimer’s, Parkinson’s and
Risk factors for developing Alzheimer’s… There’s a
strong link between serious head injury and developing
▪ Diseases that affect blood vessels, such as stroke, which
Alzheimer’s. Risk of dementias is increased if you have
can cause a disorder known as multi-infarct dementia
heart disease, cerebral vascular disease, stroke, high
▪ Toxic reactions, like excessive alcohol or drug use
blood pressure, high cholesterol, or diabetes (more
▪ Nutritional deficiencies, like vitamin B·12 and folate
research links insulin resistance in the brain to accumu-
lation of amyloid). Heavy drinking and low level of
▪ Infections such as AIDS and Creutzfeldt-Jakob disease
education are also connected to increased risk.
People with high educational and occupational attainment,
▪ Certain types of hydrocephalus (fluid in the brain) that
who are physically fit have more brain “connections” which
can result from developmental abnormalities, infec-
increases resilience. We know these people get the
disease less often rates or later in life, all of which is good!
▪ Head injury, either a single severe injury or repeated
Diet? Exercise? … If you gain a lot of weight or develop
diabetes in mid-life, it increases the likelihood that you’ll
▪ Illnesses such as kidney, liver and lung diseases, which
get the disease sooner rather than later, e.g., 65 rather
leave toxins in the body or deprive the brain of adequate
than 85. All of us will benefit from staying active, eating a
diet of colorful fruits and veggies, plenty of antioxidants,
HOW COMMON IS DEMENTIA?
less red meat, processed foods or sugars, more omega-3
Dementia caused by nervous system disease, especially
fish oils, maintaining a positive attitude and strong
Alzheimer’s disease, is increasing in frequency more than
most other types of dementia. Some researchers suspect
Treatment… No cure yet, but we have two classes of
that 5-8% of people over age 65 have some form of
drugs to treat the symptoms of Alzheimer’s…
dementia, and as many as half of all people over 80 years
cholinesterase inhibitors (Aricept®, Exelon®, Razadyne®)
of age develop dementia, usually Alzheimer’s disease.
For more information, talk with your healthcare provider, and visit
ALZHEIMER’S DISEASE What it is… Alzheimer’s disease causes problems with a
person’s memory, thinking and behavior. Initially, a person
www.mayoclinic.com/health/alzheimers-disease
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Editorial Response 7/17/08 4:28 PM Page 587 Publication Editorial Opinion Versus Real Data and t Knowledge of the Literature The March/April 2008 issue of the International Jour- Merck Co, Whitehouse Station, NJ) and showed nal of Oral and Maxillofacial Implants (JOMI) printedthe same correlation in their 1,999 patients. an unusual editorial by Dr Sreenivas Koka of the MayoMoreover