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Alzheimer's disease epidemic?

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Ten years ago, Charles Rios was diagnosed with Alzheimer's disease. He was 58 years old, and he was having trouble at work and couldn't remember certain things.

"Things just seemed to fall into place" after the diagnosis, says his wife, Della. "Conversations with him that were originally confusing to me, now made sense." Della Frazier Rios today serves as director of education and training at the Alzheimer's Association-NYC Chapter.

Estimates for the year 2002 suggest 4 million people in the U.S. have Alzheimer's disease. But in the next few decades, that number is expected to skyrocket by 350% as America's baby-boomers age.

"That is an astronomical leap," says Danielle Gray, Ph.D., a neuroscientist at Emory University in Atlanta who studies cognitive decline. "It's why we are mounting a great deal of collaborative efforts to do something about this illness."

In 2002, the Alzheimer's Association and Peter D. Hart Research Associates conducted a survey. The numbers they collected are staggering:

There is no cure for Alzheimer's disease. There are several medications now available, however, including Aricept, Reminyl, and Namenda, which can improve the cognitive and behavioral syptoms, and these options should be discussed with your doctor.

The earliest symptoms -- memory difficulties and problems with abstract thinking -- can be vague and are tough to pinpoint. Researchers admit the key to developing better treatments is a more thorough understanding of what leads to Alzheimer's and their ability to diagnose it earlier. Currently, an "official" diagnose of Alzheimer's is made by ruling out other possible causes for the cognitive decline.

EARLY HINTS

New research published in the journal Neuropsychology suggests that simple neuropsychological tests could be used to detect Alzheimer's before typical symptoms appear. Mark Jacobson, a research psychologist at the Veterans Affairs (VA) San Diego Healthcare System, says cognitive profiling combined with known changes in memory loss can identify people who may be in the early stages of the disease.

For the study, Jacobson and his colleagues at the VA and the University of California at San Diego (UCSD) recruited 20 normal elderly individuals and 20 potential Alzheimer's patients who showed little or no clinical signs of the disease. The 40 veterans participated in 2 neuropsychological tests, 1 focusing on their verbal naming ability and another to test visuospatial skills. The groups were split evenly in terms of those who excelled verbally and those with superior spatial skills.

"We found that the elderly patients who later developed Alzheimer's showed an asymmetric pattern, or uneven changes, in their cognitive test results several years before their diagnosis," says Jacobson, one of the study's authors.

Jacobson's team is also using a special MRI procedure called functional neuroimaging to record changes in brain blood flow in an attempt to learn whether the cognitive performance differences reflect anatomical or functional changes in brain function and structure.

Elsewhere in the country, researchers are studying the association between apolipoprotein E (ApoE), a gene that helps metabolize cholesterol, and the risk of Alzheimer's disease. Studies have shown that healthy middle-aged adults who carry a variation of the gene have difficulties in spatial attention and working memory similar to those clinically diagnosed with Alzheimer's.

In a study published in the journal Neuropsychology, researchers from the Catholic University of America and National Institutes of Health theorize that studies of those with the gene variation could lead to better methods for early Alzheimer's detection.

DON'T FORGET: HELP IS OUT THERE

Patients or families who need support or are interested in learning about Alzheimer's disease clinical trials can call the national Alzheimer's Association at 1-800-272-3900.

Update Date: 4/30/2004

Updated by: Michael Langan, M.D., Department of Geriatrics, Massachusetts General Hospital, Boston, MA. Written by Kelli Miller, freelance medical writer. Review provided by VeriMed Healthcare Network.

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