Alzheimer Disease

Alzheimer disease

Alzheimer disease is the most common form of the brain disorder called dementia. People with dementia experience difficulty in carrying out daily activities because of damage to the regions of their brains that control thought, language, and memory. While many older people have Alzheimer disease, it is not a normal part of aging. Currently, there is no cure.

The disease is named after the German physician Alois Alzheimer. In 1906, Alzheimer noticed changes over time in samples of brain tissue of a woman who died of mental illness. Specifically, Alzheimer noticed the development of clumps and tangled bundles of fibers in the brain. The clumps are now known as amyloid plaques, and the tangled regions are called neu-rofibrillary tangles. Both are hallmarks of Alzheimer disease.

Biology of Alzheimer disease

Other changes occur in the brain of a patient with the disease. For example, there is a loss of nerve cells in the brain, especially in the area of the brain associated with memory. In addition, there is a loss of the chemical neurotransmitter called acetylcholine. This

chemical aids in the transmission of signals from one nerve to another in the brain. The loss of acetylcholine means that brain signals are not transmitted through the brain as well as in people who do not have Alzheimer disease.

Alzheimer disease is a progressive disorder. The formation of the amyloid plaques, loss of nerve cells, and loss of acetylcholine occurs over time. Thus, the deterioration in brain function occurs gradually in an Alzheimer's patient. The disease is also associated more with older people (i.e., 60 and older) than with younger people. Only about three percent of people ages 65 to 74 have the disease, whereas nearly half of all those 85 and older may have the disease.

The reasons for the formation of amyloid plaques and neurofibrillary tangles are not clear.

Diagnoses and treatment of Alzheimer disease

Diagnosis of the disease often results from an awareness of a change in behavior or memory by an individual or his/her physician. A definitive diagnosis requires the observation of plaques and tangled fibers in samples of brain tissue. However, such a tissue examination is possible only after death. So, in practical terms, only a "possible" or "probable" diagnosis of Alzheimer's is possible prior to death.

The pharmaceutical industry is developing drugs for a variety of therapeutic approaches to treating Alzheimer disease. These include drugs that will inhibit the inflammatory response the brain appears to mount against plaques. In this approach, it is assumed that the inflammatory response contributes to cell death. By inhibiting it, the researchers hope to decrease the loss of brain cells in Alzheimer disease.

Another tact is the development of drugs that increase the amounts of acetylcholine in the brains of patients with Alzheimer disease. By preventing the breakdown of remaining acetylcholine, researchers hope to alleviate some of the symptoms of the disease. The drug called Tacrine stops the destruction of acetyl-choline that occurs normally, allowing acetylcholine to persist longer in the brain. Tacrine, which is currently one of a few drugs that has Food and Drug Administration (FDA) approval for the treatment of Alzheimer disease, appears to be helpful only in the early to middle stages of Alzheimer disease. Other drugs that exhibit similar effects include donepezil, rivastigmine, and galantamine.

Other efforts at preventing the onset of Alzheimer disease are focusing on the effects of hormones such as estrogen, drugs that reduce the inflammatory response (which might contribute to brain damage), drugs that decrease the oxidation of chemicals in the body, natural "remedies" such as gingko biloba, and increasing attention to the careful control of hypertension (specifically using calcium channel blockers).

Current research

Research into the cause of Alzheimer disease focuses on the nature of the basic biology of the disease and the development of drugs that will counteract or prevent the deterioration associated with the disease. These quests are difficult, as the cause of Alzheimer disease at the molecular level is still unknown. Similarly, the formation of amyloid plaques and why the connections between brain cells are destroyed are unclear. Until the exact biological causes of Alzheimer disease are identified, drug trials may be used more for research than therapy.

A key to understanding the disease and the best hope for an effective treatment may lie in a better understanding of the beta-amyloid protein that forms the plaques in the brain. The formation and biological function of beta amyloid protein is still unclear, even though its existence has been known since 1906, when Alois Alzheimer saw the protein in plaques in the brain of a patient with dementia.

Alzheimer Condition Simply by Katzman, Robert (EDT)/ Bick, Katherine D. or Katzman, Robert/ Bick, Katherine D. (EDT)

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