“I don’t know who you are. And I want you out of my room and to leave me alone. Or I’m going to call for help!”
These and similar responses are not uncommonly heard in nursing homes and healthcare facilities across Alaska. They are harsh words indeed, and usually spoken by an aging parent to frustrated children, once familiar friends and even a loving spouse. The child is no longer recognizable. The friend is now a complete stranger. And the loving spouse is even perceived as an immediate threat. For the agitated, bewildered parent, he has little if any awareness of his deteriorative condition, and can seldom recall recent events though they be repeated over and over again. As matters stand, he is a victim of both short and long-term memory loss and is experiencing a gradual decline in mood, thinking and social and language skills. And unfortunately, he is not alone. Millions more like him in every corner of the globe are suffering from what was once considered a rare form of dementia: Alzheimer’s disease.
Peggy, an elderly woman who has been living in a nursing home in Anchorage, Alaska for the last five years is one of Alzheimer’s afflicted. Served three hot meals a day, she often forgets which is which: breakfast, lunch or dinner. “This supper looks like what I ate at breakfast yesterday. And I never did get lunch this afternoon!”
Attacking and destroying neurons, or the brain’s nerve cells, Alzheimer’s disease is a progressive, degenerative condition resulting not only in gradual then permanent memory loss, but causes a host of other debilitating behavioral changes. These neurons create a neurotransmitter (brain chemical) called acetylcholine which, when destroyed, produces a “disconnect” with other nerve cells. Over time, thousands among thousands of nerve cells die, finally leading to the last phase of
Alzheimer’s crippling condition, such as that which contributed to the death of former U.S. President Ronald Reagan. For even the wealthy and celebrated are not immune to the dreaded disease. Film star and Oscar winner Charlton Heston, after being diagnosed in 2001, campaigned for progress in Alzheimer’s Disease. In a public service announcement on American television and on behalf of the Academy of Molecular Imaging, he urged older people to use a new detection method called Positron Emission Tomography (PET). PET can scan the brain and diagnose Alzheimer’s very early on, and provide patients an opportunity to better enjoy their lives when they remain symptom-free of the illness.
As part of the National Institute on Aging in the United States, the National Alzheimer Coordinating Center has funded PET studies at the University of Michigan and elsewhere. PET is a major new breakthrough for helping Alzheimer’s disease because in the past it was near impossible to diagnose it from other diseases which imitate its symptoms. Only after death, could an autopsy confirm for certain the presence of the illness. “One of the challenges of trying to diagnose Alzheimer’s disease is that it doesn’t cause big changes that are visible on MRI and CT scans,” says Norman Foster, M.D., the neurologist guiding the research team at Michigan University. So PET can be used to reveal Alzheimer’s disease from other disorders and also help to determine how a person should be treated.
There are basically two main stages to the disease although it can take years of progressive degeneration before a patient is entirely ravaged by Alzheimer’s. The illness first kills neurons in the hippocampus region of the brain; and this is when short-term memory begins to fail. Later, when nerve cells are destroyed in the brain’s cerebral cortex, both judgment and language skills increasingly deteriorate until one becomes completely dysfunctional and physically disabled.
Despite all this, and continued skepticism as to it’s real cause, Alzheimer’s is not considered a normal part of growing old. Nor does it only manifest in seniors or older people. Some of Alzheimer’s obvious symptoms are:
- Feelings of stress and confusion in making decisions
- loss of interest in people and previously enjoyable activities
- Loss of appetite and other normal urges
- Feelings of anxiety, suspicion and undue caution
- Repetition of actions and speech
- Loss of train of thought when talking or doing something
- Losing or misplace things with increasing frequency
- Loss of memory of familiar places and how to get to them
- Forgetting people’s names, who familiar people are, dates and times, phone numbers and other familiar things
- Increasing depressed, disoriented and agitated
Still, Alzheimer’s is most common among older adults, as about one in ten develops it over the age of 65; and as many as five in ten people over the age of 85. Affecting about equally both males and females, and all races, in the United States alone an estimated four million people suffer from the degenerative condition. And numbers are continuing to climb there and in other developing nations, as well as in third-world countries.
Besides PET, medical researchers across the globe continue studying new ways to diagnose, treat and even prevent Alzheimer’s. A recent study that appears in the December 8, 2004 issue of The Journal of Neuroscience, found that a low-fat diet rich in fish and soy can cause an increase in the manufacture of IDE (insulin-degrading enzyme), which may assist in eliminating the amyloid peptides that create destructive plaque in the brain. Thus, researchers claim that such diets may protect against Alzheimer’s disease. They also conclude that the findings may explain why many people with type 2 diabetes and who are resistant to the benefits of insulin, are more inclined to develop Alzheimer’s disease due to their lack of the IDE protein in their body.
Another promising study being conducted is with the experimental antidepressant drug rolipram, which may offset some effects of Alzheimer’s. At the University of Columbia in New York, animal tests with rolipram have shown promise in improving memory. The drug was tested on mice with Alzheimer’s-like symptoms in which mice were injected with daily dosages of rolipram for three weeks. Afterwards, the ability of the mice to learn a task and remember what they learned was duly noted. Moreover, though younger mice showed improvement, even greater results were seen in older mice, and positive effects of rolipram remained long after the drug was last injected.
At present, a number or prescription medications are being used to treat Alzheimer’s disease. Foremost are Aricept, given in the early stages of the illness to help relieve memory loss; Exelon and Reminyl, two newer drugs also most effective during early stages of Alzheimer’s; Namenda, which is prescribed to treat moderate to severe Alzheimer’s and has increased benefit when used with other drugs; Cognex, which works by slowing down the deterioration of acetylcholine; and Vitamin E, which has shown some moderate progress in reducing the onset of dementia in some patients.
Though most medical experts agree that Alzheimer’s cannot be prevented nor cured, through recent painstaking studies, future stem-cell research and new drug tests, a number of medications and treatments now exist and are available to ameliorate its devastating symptoms, and even perhaps slow down its progression. One thing doctors do know: if diagnosed and treated early, people with Alzheimer’s may be able to keep higher memory and thinking skills far longer. And also perform daily tasks and activities for greater periods of time, as well as enjoy longer lasting relationships with family and friends, and remain in the community much longer. This may be sobering news and of little import to those suffering end stage Alzheimer’s. But it is a godsend to those recently diagnosed or who may be fearful of contacting the disease later in life.
HELP FOR ALASKA ALZHEIMER’S PATIENTS:
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