Click Here to learn more about Multi-infarct Dementia, Parkinson's Disease, Huntington's Disease, Creutzfeldt-Jakob Disease, Picks Disease, Normal Pressure Hydrocephalus, Depression

Alzheimer's disease (pronounced Altz-hi-merz) is a progressive, degenerative disease that attacks the brain and results in impaired memory, thinking and behavior. It is the most common form of dementia that affects over 4 million Americans. More than 100,000 die of Alzheimer's Disease annually, which makes it the fourth leading cause of death in adults, after heart disease, cancer and stroke.

The disease, first described by Alois Alzheimer in 1907, knows no social or economic boundaries and affects men and women almost equally. Most victims are over 65; however, Alzheimer's Disease can strike in the 40s and 50s. Most Alzheimer's Disease victims are cared for at home, although many persons in nursing homes have dementia. Alzheimer's Disease is devastating for both victims and their families and has been called "the disease of the century."

The cause of Alzheimer's Disease is not known and is currently receiving intensive scientific investigation. The National Institute on Aging heads up the federal government efforts. Suspected causes include a genetic predisposition, a slow virus or other infectious agents, environmental toxins, and immunological changes. Other factors also are under investigation. Scientists are applying the newest knowledge and research techniques in molecular genetics, pathology, virology, immunology, toxicology, neurology, psychiatry, pharmacology, biochemistry and epidemiology to find the cause, treatment, and cure for Alzheimer's Disease and related disorders.

Symptoms include a gradual memory loss, decline in ability to perform routine tasks, disorientation in time and space, impairment of judgment, personality change, difficulty in learning, and loss of language and communication skills. As with all dementia's, the rate of disease progression in Alzheimer's patients varies from case to case. From the onset of symptoms, the life span of an Alzheimer's victim can range anywhere from 3 to 20 or more years. The disease eventually leaves its victims unable to care for themselves. While a definitive diagnosis of Alzheimer's disease is possible only through the examination of brain tissue, which is usually done at autopsy, it is important for a person suffering from any symptoms of dementia to undergo a thorough clinical examination. There is no single clinical test to identify Alzheimer's Disease. Before diagnosis of the disease is made, other conditions must be excluded. These include potentially reversible conditions such as depression, adverse drug reactions, metabolic changes, nutritional deficiencies, head injuries and stroke.  In fact, after a proper medical evaluation, approximately 20% of suspected Alzheimer's cases prove to be a medical condition other than Alzheimer's, sometimes treatable. For more information on related dementias, please read items below..

• Each person with possible Alzheimer's Disease symptoms should have a thorough evaluation. The evaluation should include a complete health history, thorough physical examination, neurological and mental status assessments, and diagnostic tests including blood studies, urinalysis, electrocardiogram and chest x-rays. Other studies often recommended include: computerized tomography (CT Scan), electroencephalography (EEG), removal from medication, formal psychiatric assessment, neuropsychological testing, and occasionally, examination of the cerebrospinal fluid by spinal tap. While this evaluation may provide a clinical diagnosis, confirmation of Alzheimer's Disease requires examination of brain tissue, which is usually performed at autopsy. 

Although no cure for Alzheimer's Disease is available at present, good planning and medical and social management can ease the burdens on the patient and family. Appropriate medication can lessen agitation, anxiety and unpredictable behavior, improve sleeping patterns and treat depression. Physical exercise and social activity are important, as are proper nutrition and health maintenance. A calm and well-structured environment may help the afflicted person to maintain as much comfort and dignity as possible.

Other Dementias and Related Disorders

What is Dementia?

Dementia is the loss of intellectual functions (such as thinking, remembering and reasoning) of sufficient severity to interfere with a person's daily functioning. It is not a disease in itself, but rather a group of symptoms which may accompany certain diseases or physical conditions. The cause and rate of progression of dementias vary. Some of the more well-known diseases that produce dementia include Alzheimer’s disease, Multi-infarct dementia, Huntington’s disease, Pick’s disease, Creutzfeldt-Jakob disease, Parkinson’s disease, Normal Pressure Hydrocephalus and depression. Other conditions which may cause or mimic dementia include depression, brain tumors, nutritional deficiencies, head injuries, hydrocephalus, infections (AIDS, meningitis, syphilis), drug reactions and thyroid problems. It is imperative that all persons experiencing memory deficits or confusion undergo a thorough diagnostic workup. This requires examination by a physician experienced in the diagnosis of dementing disorders and detailed laboratory testing. The examination should include a re-evaluation of all medications. This process will help the patient obtain treatment for reversible conditions, aid the patient and family in planning future care, and provide important medical information for future generations.

MULTI-INFARCT DEMENTIA

Multi-infarct dementia (MID), or vascular dementia, is a deterioration of mental capabilities caused by multiple strokes (infarcts) in the brain. The onset of MID may be relatively sudden as many strokes can occur before symptoms appear. These strokes may damage areas of the brain responsible for a specific function is well as produce generalized symptoms of dementia. As result, MID may appear similar to Alzheimer's disease. Multi-infarct dementia is not reversible or curable, but recognition of an underlying condition (high blood pressure) often leads to a specific treatment that may modify the progression of that disorder. Multi-infarct dementia is usually diagnosed through neurological examination and brain scanning techniques, such as computerized tomography (CT scan) or magnetic resonance imaging (MRI), in order to identify strokes in the brain.

PARKINSON'S DISEASE

National Parkinson's Foundation
www.Parkinsons.org
Call 1-800-327-4545

Parkinson's disease (PD) is a progressive disorder of the central nervous system which affects more than one million Americans. Individuals with PD lack the substance dopamine, which is important for the central nervous system's control of muscle activity. Parkinson's disease is often characterized by tremors, stiffness in limbs and joints, speech impediments and difficulty in initiating physical movement. Late in the course of the disease, some patients develop dementia and eventually Alzheimer's disease. Conversely, some Alzheimer patients develop symptoms of Parkinson's disease. Medications such as levodopa, which converts itself into dopamine once inside the brain and depreynl, which prevents degeneration of dopamine-containing neurons, are used to improve diminished or reduced motor symptoms in PD patients but do not correct the mental changes that occur.

HUNTINGTON'S DISEASE

Visit www.hdsa.org
Call 800-345-HDSA

Huntington's disease is an inherited, degenerative brain disease which affects the mind and body. The disease usually begins during mid-life, and is characterized by intellectual decline, and irregular and involuntary movements of the limbs or facial muscles. Other symptoms of Huntington's disease include personality change, memory disturbance, slurred speech, impaired judgement and psychiatric problems. Huntington's disease currently affects more than 25,000 Americans. The diagnostic process for Huntington's disease includes an evaluation of family medical history, recognition of typical movement disorders and CAT brain scanning. A genetic marker linked to Huntington's disease has been identified on chromosome 4 and researchers are working on locating the gene itself. Although there is no treatment available to stop the progression of the disease, the movement disorders and psychiatric symptoms can be controlled by drugs.

CREUTZFELDT-JAKOB DISEASE

Creutzfeldt-Jakob Disease (CJD) is a rare, fatal brain disorder caused by a transmissible infectious organism, probably a virus. Early symptoms of CJD include failing memory, changes in behavior, and a lack of coordination. As the disease progresses, usually very rapidly, mental deterioration becomes pronounced, involuntary movements (especially muscle jerks) appear, and the patient may become blind, develop weakness in the arms or legs, and ultimately lapse into a coma. The death of CJD patients is usually caused by infections in the bedridden, unconscious patient. Like Alzheimer's disease, a definitive diagnosis of CJD can be obtained only through an examination of brain tissue, usually at autopsy.

LEWY BODY DEMENTIA (LBD)

Visit www.lewybodydementia.org
Call 800-LEWYSOS

Lewy Body Dementia (LBD), a progressive brain disease, is the second leading cause of degenerative dementia in the elderly. Although symptoms vary, hallucinations and fluctuating cognition are usually present, along with other features of Alzheimer’s disease, Parkinson’s disease or both.

Causes:
In the early 1900s, the scientist Friederich H. Lewy discovered abnormal protein deposits that disrupt the brain’s normal functioning. These Lewy body proteins are found in an area of the brain stem where they deplete the neurotransmitter dopamine, causing Parkinsonian symptoms. In Lewy body dementia, these abnormal proteins are diffuse throughout other areas of the brain, including the cerebral cortex, causing disruption of perception, thinking and behavior. Advanced age is considered to be the greatest risk factor, although some cases have been reported much earlier. Having a family member with Lewy body dementia may increase a person’s risk.

Symptoms:
The symptoms vary from person and person, and can mimic other diseases, especially in the early years. A diagnosis of probable Lewy body dementia requires progressive cognitive decline plus two of the following: fluctuation of cognition and alertness, recurrent visual hallucinations or Parkinsonian symptoms, such as muscle stiffness and rigidity, frozen stance, balance difficulties and tremors.

Treatment:
There is no cure or definitive treatment for Lewy body dementia. Medical management is complex because of increased sensitivity to many drugs. Clinically proven medications are cholinesterase inhibitors (medications for Alzheimer’s disease) and drugs for Parkinsonian symptoms. However, some medications prescribed for Alzheimer’s disease and Parkinson’s disease can adversely affect people with Lewy body dementia. All prescription and over-the-counter drugs should be initiated at the lowest effective dose and managed by a Lewy body dementia-experienced physician.

PICKS DISEASE

Pick's disease is also a rare brain disorder which, like Alzheimer's disease, is usually difficult to diagnose. Disturbances in personality, behavior and orientation may precede and initially be more severe than memory defects. Like Alzheimer's disease, a definitive diagnosis is usually obtained at autopsy. 

NORMAL PRESSURE HYDROCEPHALUS

Normal pressure hydrocephalus is an uncommon disorder which involves an obstruction in the normal flow of cerebrospinal fluid. This blockage causes a buildup of cerebrospinal fluid on the brain. Symptoms of normal pressure hydrocephalus, include dementia, urinary incontinence and difficulty in walking. Presently, the most useful diagnostic tools are the neuroimaging techniques (ie., MRI). Normal pressure hydrocephalus may be caused by any of several factors including meningitis, encephalitis and head injuries. In addition to treatment of the underlying cause, the condition may be corrected by a neurosurgical procedure (insertion of a shunt) to divert the fluid away from the brain.

DEPRESSION

Depression is a psychiatric disorder marked by sadness, inactivity, difficulty in thinking and concentration, feelings of hopelessness, and sometimes suicidal tendencies. Many severely depressed patients will have some mental deficits including poor concentration and attention. When dementia and depression are present together, intellectual deterioration may be exaggerated. Depression, whether present alone or in combination with dementia, can be reversed with proper treatment.

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