Search for a Cure
By Lindsey Townsend
Can you imagine not being able to recognize the spouse that you’ve spent the last 30 years of your life with? Or not being able to remember the names of your children? Sadly, it’s happened to people who have Alzheimer’s disease. And there are currently more than four million Americans who suffer from it, including former President Ronald Reagan.
Alzheimer’s disease (AD) is a progressive, degenerative disease that attacks the brain and results in impaired memory, thinking, and behavior. While it may strike when a person is in his or her forties, it is most common in older Americans, afflicting 10 percent over the age of 65, and as many as 50 percent of those over 85. And as the American population continues to age, that number is expected to increase to about 14 million Alzheimer’s victims by 2030.
The disorder usually has a gradual onset, with early symptoms such as difficulty remembering certain events and performing familiar tasks. The Alzheimer patient may also experience confusion, personality change, behavior change, impaired judgment, and difficulty finding words, finishing thoughts, and following directions. Ginny Chambers,74, remembers all too clearly the symptoms that her husband, Jay displayed during an eight-year battle with Alzheimer’s. She says, “It started with odd little things...he was always such a perfectionist about changing his clothes, and then one day he wouldn’t let me wash them. He wanted to wear them all the time...We’d been going to the same church for 30 years, and he wouldn’t recognize his friends there anymore. He’d go up to people who looked familiar and talk to them, and then he’d ask me later, ‘Who was that in the gray suit?’...Eventually, he became totally incapacitated. I had to bathe and change him. The last six months of his life, he would smile at me, but he didn’t talk at all.”
Diagnosis of Alzheimer’s
According to Julia Lothrop, M.S., assistant professor in the department of gerontology and geriatric services at UT Southwestern Medical Center at Dallas and director of the Education Core activities for the Alzheimer’s Disease Center, “A clinical diagnosis of AD is made by first eliminating other possible conditions such as depression, metabolic changes, nutritional deficiencies, adverse drug reactions, and stroke.” Alzheimer’s is now known to be characterized by a specific set of physiological changes in the brain. Nerve fibers surrounding the hippocamus, the brain’s memory center, become tangled, and information is no longer carried properly to and from the brain. Alzheimer patients have been found to lack the brain chemical acetylcholine, which is involved in the processing of memory by the brain.
In addition, Dr. Roger Rosenberg, director of the Alzheimer’s Disease Center at UT Southwestern and professor of neurology and physiology, notes that researchers studying AD are now finding a number of genetic mutations related to chromosomal abnormalities.Because the disease seems to run in families, researchers believe that there may be a genetic factor.
Ongoing Research Continues
Although there is currently no treatment available to stop or reverse the mental deterioration characteristic of AD, there is real hope on the horizon. There are currently several experimental drugs being studied for the treatment of Alzheimer’s disease at study sites nationwide. The Alzheimer’s Disease Center (ADC) at UT Southwestern evaluates people for Alzheimer’s disease at its Harry Hines Boulevard location and at satellite clinics across Dallas. It is one of only 28 centers in the U.S. to receive funding from the National Institutes of Health for research on Alzheimer’s.
Dr. Myron Weiner, vice chairman for clinical services for the Department of Psychiatry, director of UT Southwestern’s Alzheimer's Disease Center’s Clinical Core, and holder of the Harbin Chair for Alzheimer’s Disease Research, says, “We are encouraged by the number of new medications being developed for Alzheimer’s...Although only two drugs are currently approved for use in the U.S. (Cognex and Aricept), two additional drugs, Exelon and metrifonate, are expected to be approved by the FDA soon for use in the U.S.--possibly as early as this year.”
Exelon was approved for use by the Swiss government in August of 1997 based on a study of more than 3,300 European and American Alzheimer’s sufferers. Compared with those taking a placebo, those taking Exelon retained their memories longer and were better able to handle activities of daily living. The other promising new drug, metrifonate, acts similarly to Cognex and Aricept. All three are cholinesterase inhibitors, agents that slow the breakdown of acetylcholine, a neurotransmitter crucial to cognitive functioning. In a 26-week study of metrifonate with more than 400 participants with diagnoses of mild to moderate Alzheimer’s, those taking the placebo deteriorated significantly, but those taking metrifonate did not, except for some minor cognitive loss at the end of the six-month trial.
Other research to date has revealed a number of interesting clues, many which point to nutritional deficiencies. For example, people with Alzheimer’s tend to have low levels of vitamin b12 and zinc in their bodies, which are important in cognitive functioning.Levels of antioxidant vitamins A and E and the carotenoids also tend to be low. Many researchers also believe that beta-amyloid, which is produced in virtually every cell in the body as a result of the degeneration of tissue, may be a key player in the disease.
Although all of these findings offer hope, science does not yet have a conclusive answer on what can be done to prevent the mental deterioration. Even diagnosis of the disease is not a precise science. Right now, there is no single laboratory procedure or biochemical marker that can definitely confirm the disorder in a living person.
However, many researchers are becoming cautiously optimistic that in the not-too-distant future, new treatments should be able to delay the onset of the disease, and to slow the debilitating mental deterioration that it causes. According to Lothrop, “There are a number of health care professionals who are predicting that in the 21st century, it will become a reasonably manageable chronic illness.”
Is it Alzheimer’s or Normal Memory Loss?
As they age, many people worry that their forgetfulness is a sign of Alzheimer’s disease. According to Doris Svetlik, administrative director of UT Southwestern Medical Center’s clinic for Alzheimer’s, “Some families often assume elderly relatives are developing Alzheimer’s disease when they fail to remember a conversation or lose their car keys. Some memory loss due to lack of concentration is normal for all of us. But persistent confusion and memory loss interfering with normal, routine activities can indicate a medical disorder, and a thorough medical evaluation should be sought.”
A good example of the difference between dementia and forgetfulness is the following: if you don’t remember where you put your glasses, that is forgetfulness; if you do not remember that you wear glasses, that may be sign of dementia.
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