Alzheimer's disease
Alzheimer's disease (AD) or senile dementia of Alzheimer's type is a
disorder of loss of mental functions resulting from brain tissue changes;
the causes are yet to be fully elucidated (at least two genes predisposing
to AD have been identified). The main characteristic of AD is memory loss.
Alzheimer's disease is also manifested in behavorial changes, which may even
include sudden periods of defiance, abusive behavior, violence, etc. in
people who have no previous history of such behavior (rarely, an affected
person experiences euphoria). Thus, Alzheimer's disease presents a problem
in patient management, as well. The symptoms of the disease as a distinct
nosologic entity were first identified by Emil Kraepelin, and the
characteristic neuropathology was first observed by Alois Alzheimer in 1906.
In this sense, the disease was co-discovered by Kraepelin and Alzheimer, who
worked in Kraepelin's laboratory. Because of the overwhelming importance
Kraepelin attached to finding the neuropathological basis of psychiatric
disorders, Kraepelin made the generous decision that the disease would bear
the name of Alzheimer.
These changes include loss of brain tissue cells (with a typical upward
progression through memory centers such as the entorhinal cortex and the
hippocampus) and collection of specific inclusions such as neurofibrillary
tangles and senile plaques. It is not yet certain, whether these changes are
primary (the cause of the disease) or secondary (the result of the
disintegration of brain tissue). Alzheimer's disease is the most frequent
reason for dementia in the elderly and affects almost half of all patients
with dementia. There is no known definitive treatment, although there are
drugs which enhance neutrotransmitter transmission which delay the memory
loss associated with the disease.
The disease was thought to be uncommon, until the 1960s when it was realized
that much of what had been regarded as the normal process of aging was
actually the result of this disease. Alzheimer's is considered to be a major
public health challenge as a result of the aging population. Typically only
3% of persons aged 65 show signs of the disease while 50% of persons aged 85
have symptoms of Alzheimers. However the proportion of persons with
Alzheimer's begins to decrease after age 85 because of the increased
mortality due to the disease, and relatively few people over the age of 100
have the disease.
There are ongoing tests of Alzheimer's disease vaccine. Initial results in
animals were promising. However when the first vaccines were used in humans,
brain inflammation resulted and the trials were stopped. It is hoped that
research will provide a better formulation and that in the future it can be
of use in families with history of Alzheimer's Disease.
Unfortunately, a definitive diagnosis of Alzheimer's disease must await an
autopsy, at present. However, many increasingly sophisticated diagnostic
tests have been proposed (including: brain scans, behavioral tests and
testing for genetic predisposition).
Famous Alzheimer's Sufferers
* Winston Churchill
* Perry Como
* Barry Goldwater
* Rita Hayworth
* Charlton Heston
* Former Queen Juliana of the Netherlands
* Iris Murdoch
* Maurice Ravel
* Ronald Reagan
* Sugar Ray Robinson
* Cyrus Vance
* E.B. White
* Harold Wilson
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