I attended the funeral recently

of a dear old man who died after suffering for more than a decade from

Alzheimer's disease.

I stood at the casket with

a lady who told me her own father had just succumbed to the disease. I

came home troubled. It is not possible to be exposed to this disease in

any way and not be troubled. So I checked out the latest information from

the National Institute of Health and today I share a summary with you.

Alzheimer's disease is named

after Dr. Alois Alzheimer, a German doctor. In 1906, Dr. Alzheimer noticed

changes in the brain tissue of a woman who had died of an unusual mental

illness. He found abnormal clumps (now called amyloid plaques) and tangled

bundles of fibers (now called neurofibrillary tangles). Today, these plaques

and tangles in the brain are considered hallmarks of AD.

Scientists also have found

other brain changes in people with AD. There is a loss of nerve cells

in areas of the brain that are vital to memory and other mental abilities.

There also are lower levels of chemicals in the brain that carry complex

messages back and forth between nerve cells. AD may disrupt normal thinking

and memory by blocking these messages between nerve cells.

Every day scientists learn

more, but right now the causes of AD are still unknown, and there is no

cure. There probably is not one single cause, but several factors that

affect each person differently. For instance, the number of people with

the disease doubles every five years beyond age 65. Also, scientists believe

familial AD, a rare form of AD that usually occurs between the ages of

30 and 60, can be inherited. Scientists are studying genetics and looking

at education, diet, environment and viruses to learn what role they might

play.

AD begins slowly. At first,

the only symptom may be mild forgetfulness. There may be trouble remembering

recent events, activities, or the names of familiar people or things.

Simple math problems may become hard to solve. People in the later stages

of AD may forget how to do simple tasks, like brushing their teeth or

combing their hair. They can no longer think clearly. They begin to have

problems speaking, understanding, reading or writing. Later on, people

with AD may become anxious or aggressive, or wander away from home. Eventually,

patients need total care.

An early, accurate diagnosis

of AD helps patients and their families plan for the future. It gives

them time to discuss care options while the patient can still take part

in making decisions.

Early diagnosis also offers

the best chance to treat the symptoms of the disease. Today, the only

definite way to diagnose AD is to find out whether there are plaques and

tangles in brain tissue. To look at brain tissue, doctors must wait until

they do an autopsy, which is an examination of the body done after a person

dies. Therefore, doctors must make a diagnosis of "possible"

or "probable" AD.

At specialized centers, doctors

can diagnose AD correctly up to 90 percent of the time, using several

tools, including: A complete medical history includes information about

the person's general health, past medical problems and any difficulties

the person has carrying out daily activities. Medical tests, such as tests

of blood, urine or spinal fluid, help the doctor find other possible diseases

causing the symptoms. Neuropsychological tests measure memory, problem

solving, attention, counting, and language. Brain scans allow the doctor

to look at a picture of the brain to see if anything does not look normal.

Information from the medical

history and test results help the doctor rule out other possible causes

of the person's symptoms. For example, thyroid problems, drug reactions,

depression, brain tumors, and blood vessel disease in the brain can cause

AD-like symptoms. Some of these other conditions can be treated successfully.

For some people in the early

and middle stages of AD, the drugs tacrine (Cognex), donepezil (Aricept),

rivastigmine (Exelon), or galantamine (Reminyl) may help prevent some

symptoms from becoming worse for a limited time. Also, some medicines

may help control behavioral symptoms of AD such as sleeplessness, agitation,

wandering, anxiety, and depression.

Developing new treatments for

AD is an active area of research. Scientists are testing a number of drugs

to see if they prevent AD, slow the disease, or help reduce behavioral

symptoms. There is evidence that inflammation in the brain may contribute

to AD damage. Scientists believe that anti-inflammatory drugs such as

NSAIDs might help slow the progression of AD. Rofecoxib (Vioxx) and naproxen

(Aleve) are two NSAIDs currently being studied.

Research has shown that vitamin

E slows the progress of some consequences of AD by about seven months.

Recent research also suggests that ginkgo biloba, an extract made from

the leaves of the ginkgo tree, may be of some help in treating AD symptoms.

There is no evidence that ginkgo will cure or prevent AD. Scientists now

are trying to find out whether ginkgo biloba can delay or prevent dementia

in older people. Scientists now are trying to find out whether estrogen

can prevent AD in women with a family history of the disease.

To find out more about ongoing

studies or clinical trials, contact the NIA's Alzheimer's Disease Education

and Referral Center at 1-800-438-4380.

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