MEDICAL SURFARI: ALZHEIMER'S STEALS THE BRAIN

Delicate durability describes the human body, and no where is this more apparent than in the human brain. For most of us, our mind serves us well until we no longer need it, that is, when we die. However, for others, we suffer from the ravages of dementia, a loss in intellectual function (thinking, remembering and reasoning); the mind may begin to resign before the rest of the body.

Alzheimer's disease (pronounced alz'-hi-merz) is a progressive, degenerative disease that attacks the brain and steals the mind. This results in memory loss, loss in communication abilities, and changes in behavior. It destroys one's ability to think and reason effectively. It can become so severe that it prevents one from taking care of their most basic needs. This may eventually result in death.

Misplacing your car keys, missing an appointment, or forgetting about something left cooking on the stove is normal absent-mindedness. Forgetting what your car keys are for, or why you have an appointment with your physician, or how to turn on the stove is more likely to be dementia.

Alzheimer's disease (AD) is the most common form of dementia. AD is the fourth leading cause of death in adults, only exceeded by heart disease, cancer, and stroke. Men and women are affected almost equally, and most are over the age of 65. People of any intellect, education, and lifestyle can and do get this disease. Although there are intensive efforts being made to develop a test to diagnose Alzheimer's disease, it has traditionally, and is currently, diagnosed by doctors through a process of elimination, ruling out other diseases and disorders that may affect the brain.

At this time, the only definitive way to diagnose AD requires sampling brain tissue to assess it for the telltale "senile plaques" that pock the brain of Alzheimer's victims. This is, of course, too dangerous to be a routine and practical screening method for this disease, so clinicians rely on medical and neuropsychological tests to rule out other causes of dementia. Often the patients with no other detectible cause for dementia are given the diagnosis of "probable AD". However, this can only be confirmed at autopsy after the patient dies.

A diagnosis of probable AD is generally 80 to 90 percent accurate and allows people to start appropriate therapies. Researchers still know little about what causes AD or how to stop its debilitating effects; however, recent developments have shed new light on the disease and offer hope for early diagnosis and treatment, as well as prevention.

Alzheimer's disease afflicts nearly 4 million Americans currently. But, because the risk of developing AD increases markedly with age, the disease is expected to balloon in the next two decades as baby boomers pass into their golden years. The Alzheimer's Association estimates the current cost to our society at 100 billion dollars a year, consequently, there has been an intense push to find a cure, or at the very least, a cost-effective therapy for this disease. Because of the enormous strain the disease imposes on our health care system and the large number of people affected, there has been an unusually high level of research activity lately.

Early and careful evaluation is important because many conditions, including some that are treatable or reversible, can cause dementia. Although no cure for AD is presently available, good planning and medical and social management can ease the burdens of the patient and the family.

November is National Alzheimer's Disease Month, a time to focus on the illness and its affect on individuals as well as the ripple affect upon their families and their communities.

World Wide Web Information Resources The World Wide Web is an extraordinarily rich resource for rapid access to information on a variety of medical topics -- Alzheimer's disease in no exception. The following resources are reliable and current and provide information that is useful to patients, families, and health care providers.

AD ASSOCIATION STATISTICS

Alzheimer's Disease: Fact Sheet

http://www.alz.org/dinfo/factsheet/ADFS.html

This site is sponsored by the Alzheimer's Disease Association which is a national voluntary organization dedicated to research for causes, symptoms, diagnosis and treatment of AD. The site content is easy to read and provides many interesting facts and a list of symptoms associated with AD.

-- One in 10 over age 65 and nearly half of those over 85 are affected.

-- A person with AD will live an average of 8 years and as many as 20 years or more from the onset.

-- The average cost for a person in a long-term care facility is $42,000 per year.

-- The average lifetime cost per patient is $174,000, the third most expensive disease in the United States.

WARNING SIGNS

http://www.alz.org/dinfo/brochures/10warningsigns/10warning.html

To help you know what warning signs to look for, the AD Association has developed a check list. Review the list and check the symptoms that concern you.

1. Memory loss that affects job skills

2. Difficulty in performing familiar tasks.

3. Problems with language.

4. Disorientation of time and place.

5. Poor or decreased judgment.

6. Problems with abstract thinking.

7. Misplacing things -- finding them in inappropriate places.

8. Rapid changes in mood or behavior.

9. Drastic changes in personality.

10. Loss on initiative requiring cues and prompting to become involved.

ADVANCES IN ALZHEIMER RESEARCH

http:/www.alz.org.medical/ainar/new/!advhome.htm

This site takes you to stories online about research, drug testing, dementia that is not AD, and cautions about magic pills and miracle cures.

ALZHEIMER'S ASSOCIATION OF ST. LOUIS

http://www.alzstl.org/

This site offers information on the regional AD Association that serves eastern Missouri and western Illinois. It lists a shortcut text to a variety of sites intended to educate and help concerned persons.

101 THINGS TO DO WHILE VISITING AN OLDER ADULT

http://www.alzstl.org/101(2)/html

I especially liked this site! All too often people don't know what to say, to do, or to share when visiting an older adult. There is a creative, insightful list that you and your elder friend or family member will likely find refreshing and enjoyable.

Dr. Scott Gibbs is a neurosurgeon and editor-in-chief of Mosby's Medical Surfari. You may e-mail questions to him at drgibbs@semissourian.com or write in care of the Southeast Missourian, P.O. Box 699, Cape Girardeau, Mo., 63701.