Alzheimer's disease is the seventh leading cause of all deaths in the United States and the fifth leading cause of death in Americans who are 65 years of age or older. The reason that the number of people afflicted with Alzheimer's is growing so fast is simple: the baby boom generation is quickly becoming the older generation. This paper presents factual data about this dreaded disease, and unfortunately it reflects that fact that the literature available in scholarly and in popular publications does not seem optimistic about a formula for prevention or for a cure. As of 2008, about 5.2 million Americans had Alzheimer's; of those, 5 million were 65 years of age or older. In fact one in eight persons 65 or over -- that is 13% -- currently are afflicted with Alzheimer's. The data available indicates that every 71 seconds someone in the U.S. develops Alzheimer's; in forty years that number will change to every 33 seconds. The overall number of people with Alzheimer's is expected to reach 7.7 million by 2030. But millions upon millions of dollars of federal and private money are being poured into research, so there is a reason to hope for a positive outcome. Meanwhile, this paper reflects the failed research projects of the past, the potential remedies still unproven for the future, and it also reviews the price that caregivers pay in terms of their emotional, physical, and their psychological health.
Basic Information on Alzheimer's
Alzheimer's disease is a brain disease that seriously interferes with a person's memory, a person's thinking and hence the behavior of the person is greatly impacted as well. The Alzheimer's Association (AA) explains that the symptoms generally arrive "slowly" but they get "worse over time, becoming severe enough to interfere with daily tasks." Alzheimer's is the most common form of "dementia," which is a general term for the loss of memory and the loss of the ability to reason and think with clear intellectual faculties. Fifty to seventy percent of cases of dementia are categorized as Alzheimer's, according to the AA. This paper will delve into the literature on Alzheimer's, including the discouraging lack of preventative or curative solutions, the realities for those who have Alzheimer's as well as those who will be (or already are) caregivers, and the data on how many people can expect to be afflicted with the disease in the near future. The exact chemical dynamics that take place in the brain will also be reviewed.
Body of Paper
Is Alzheimer's just a normal part of growing old? Absolutely not, the AA reports, albeit the "greatest risk factor is increasing age." The majority of people with Alzheimer's are indeed over 65 but five percent of those afflicted with the disease have what is called "early-onset" -- that effects mainly people in their 40s and 50s (AA). And it is pertinent to mention that just because a person is getting up in age and is becoming somewhat forgetful, doesn't mean that Alzheimer's is setting in. There are a variety of causes to explain memory loss, but rather than guess at the reason for the memory loss the professionals strongly suggest a visit to the doctor to determine the exact cause of the forgetfulness. The Alzheimer's Association has a "helpline" that is available night and day [HIDDEN] ); AA will refer callers to doctors in their area who have professional experience evaluating memory problems.
The progressive nature of Alzheimer's takes a toll on sufferers, AA reports. At first the symptoms are there, and they are for the most part mild in the early stages. But over the years the individual with Alzheimer's begins to lose the ability to carry on a simple conversation, or respond appropriately to what is going on in the environment around them. The person who has the disease can live roughly eight or so years after their symptoms have become obvious, AA explains, but some people live up to twenty years after being diagnosed with Alzheimer's.
Is there a cure? No, there is no cure known to healthcare professionals at this time, but there is a great deal of research ongoing. In fact though there are treatments that "temporarily slow the worsening of symptoms" and that "improve the quality of life for those with Alzheimer's," and improves the quality of lives their families and other caregivers experience, AA continues. Ninety percent of what is known to scientists about Alzheimer's has been learned over the past 15 years, and worldwide there are multiple research teams working on finding a cure, or at least a deeper understanding of why people fall prey to this debilitating disease.
Are there any remedies for prevention of Alzheimer's? A scholarly journal article in CNS Drugs (Sano, et al., 2008, p. 887) points to the disappointments that have been reported in several clinical trials over the past twenty years. To wit, while observational studies and animal models have offered "promising findings" and have "generated excitement," the truth is that observational studies aren't recognized as valid or helpful, Sano explains (p. 887). What is required are placebo-controlled clinical trials, Sano writes, and there have been clinical trials involving: a) symptomatic treatments; b) cholinesterase inhibitors; c) antioxidants; d) NSAIDs; e) hormone replacement; f) nutritional supplements; and g) "non-pharmacological interventions" (Sano, 2008, p. 887).
Sano and colleagues agree that while success in the area of "true prevention" of Alzheimer's right now could be thought of as "fiction" it is nonetheless "fiction with a hopeful theme" (p. 888). While most of the money spent on research emphasizes a cure, Sano believes that there are "many advantages" to zeroing in on prevention, "including the fact that it would expand the period of high quality-of-life in aging populations (p. 888). Indeed, if some form of prevention could be made available, the delay of the onset of Alzheimer's by "as little as 1 year" could "reduce prevalence by 25% over the next 50 years" (Sano, 2008, p. 888).
The problem with launching preventative research is that "…trials to assess this type of intervention must enroll large numbers of subjects…with long periods of observation and monitoring," Sano explains (p. 889). This boils down to a great expense, and it is clear that most of the money going into research is being funneled into cure, not prevention. But that hasn't stopped some scholars, including Sano, from researching for possibilities. For example, there is evidence that there is a link between cholesterol and Alzheimer's, Sano asserts (p. 890). There is also a reported connection between the reduction of hypertension and a reduced risk of "cognitive impairment and dementia," Sano reports, as she reviews the possible approaches to finding a preventative solution (p. 893).
And while it appears that cardiovascular risk "worsens the clinical presentation of Alzheimer's disease" it is not clear if it effects the "pathology of Alzheimer's disease," Sano continues on page 893.
Sano and colleagues may be a bit idealistic by working towards a prevention for Alzheimer's, especially following the report of an expert panel that gathered in April, 2010, under the auspices of the National Institutes of Health (Traynor, 2010, p. 960-61). The panel looked at existing research into drugs, dietary supplements, exercise, diet, "social and cognitive engagement" along with other factors that are believed to be potentially useful in preventing Alzheimer's. But the report's findings were "negative" (in terms of any potential breakthrough for prevention) and the reasons for the negative results are several, Traynor explains. There is a lack of "well-conducted, randomized clinical trials" and there is a lack of "standardized methods for diagnosing Alzheimer's disease and cognitive decline," Traynor concludes (p. 961).
What are the earliest symptoms? What testing can be done to verify that the person in question indeed has Alzheimer's? The Alzheimer's Association reports that the most common symptom that people experience is "…difficulty remembering newly learned information." That is, the part of the brain that affects learning begins to fail and that leads to the following: "disorientation; mood and behavior changes; deepening confusion about events, time and place; unfounded suspicions about family, friends and professional caregivers; more serious memory loss and behavior changes; and difficulty speaking, swallowing and walking" (AA).
How does Alzheimer's affect the brain? The AA materials (www.alz.org) explain that the brain has approximately 100 "nerve cells" that are also called "neurons," and every nerve cell links (microscopically) with "many other" cells to create networks of communication. Every cell group has a specific task to perform in the brain; some cell groups assist leaning, thinking and remembers while other cell groups provide sight, hearing and smell, AA explains. The cell groups behave a bit like "tiny factories" because they do things that factories do.
For example, the cell groups receive supplies, they generate energy and they actually build equipment within the brain. Also, cell groups get rid of waste and coordinate with each other thanks to available oxygen they use for fuel. (It is common knowledge that when a person's oxygen supply to the brain is cut…