April 8, 2005
In the past 20 years, medical researchers have made remarkable strides in unraveling the underlying mechanisms that lead to the devastating memory loss of Alzheimer's disease. Beginning with cells in culture dishes, scientists conduct basic research that has led to a greater understanding of why the brain and memory fail in Alzheimer's disease, and what can be done to halt or prevent progression of the disease. It is this basic research that, day by day, draws us closer to new treatments and even a cure for Alzheimer's. Some of the key strides doctors have made in recent years in decoding the mystery of Alzheimer's and managing its devastating effects on the body and brain are highlighted below.
A leading cause of memory loss. When Dr. Alois Alzheimer first noted severe memory loss and personality changes in a 50-year-old woman nearly 100 years ago, the illness was thought to be a rare form of early age-related dementia. In recent years, doctors have come to recognize that Alzheimer's disease is by far the most common form of dementia in old age. Some 4.5 million Americans now suffer from the disease. That number is likely to triple in coming decades as the U.S. population ages, unless better treatments and prevention techniques are found.
Brain defects. Originally, nobody knew why Alzheimer's arose in certain people, or how it afflicted the brain. Doctors, including researchers at the Fisher Center for Alzheimer's Research Foundation at The Rockefeller University, have helped to uncover the important role that beta amyloid plays in the development of the disease. Beta amyloid, a toxic protein when produced in excess, builds up in the brains of those with Alzheimer's disease and is thought to play a key role in the relentless progression of the ailment.
The role of genes. While Alzheimer's crops up for unknown reasons in some people, researchers have now identified various genes that increase your risk for the disease. If you inherit one or more of these genes from one or both parents, it may mean you are more likely to develop Alzheimer's down the road. The most common form of Alzheimer's, which typically strikes people in their 70s, 80s, or later, is linked to a gene called Apo-E4. Not all people having this gene develop Alzheimer's, and many people who don't have the gene still get Alzheimer's. Other genes, such as altered forms of presenilin genes, are linked to an early-onset form of the disease that strikes much earlier in life. This is a rare form of Alzheimer's, but all people with the altered gene get the disease in their 20s, 30s, 40s or 50s. Doctors have also observed that people with Down's syndrome, a form of mental retardation, develop changes in their brains that resemble those that occur in Alzheimer's disease. Gene hunters are identifying many additional genes that play roles in Alzheimer's.
Environment and lifestyle. In addition to genes, experts believe that environmental and lifestyle factors also play a role in who develops Alzheimer's. Numerous studies are emerging, for example, that show that maintaining a heart-healthy lifestyle through a sound diet rich in fruits and vegetables and plenty of regular exercise can all help to lower your risk for Alzheimer's. Being overweight or having diabetes can also up the risk not just for heart attacks and strokes but also, apparently, Alzheimer's disease as well. What's good for the heart, research increasingly shows, is also good for the brain. Keeping the mind active and mentally alert through such stimulating activities as doing crossword puzzles, travel, or learning a new language may likewise provide some protective benefits.
New drugs and treatments. An understanding of the underlying causes of Alzheimer's has led to the development of new drugs and treatments for the disease in recent years. Medications such as Aricept, Exelon, Reminyl, and Namenda provide modest benefits for those with memory loss and other coginitive symptoms. Other medicines may offer benefits against aggression and other behavior problems related to the disease. Many promising drugs and vaccines are currently undergoing testing.
Better care. Better understanding of the tremendous stresses that Alzheimer's can inflict on both those with the disease and those who care for them has led to new techniques for easing the burden of caregiving. Pioneering research is now being coducted at such centers as New York University's Aging and Dementia Research Center and the Fisher Alzheimer's Disease Education and Resources Program at NYU. Research projects highlight the important role that counseling and support, in addition to medications, play in managing the difficult stages of a disease that may last for 10 years or longer.
Continued support and funding is essential in the search for new treatments for Alzheimer's. The Fisher Center for Alzheimer's Research Foundation (www.ALZinfo.org) plays a key role in working toward a cure. Your contributions go directly to fund critical scientific and clinical research that improves life for those afflicted with Alzheimer's and those who care for them.
Thomas D. Bird, M.D.: "Genetic Factors in Alzheimers Disease," New England Journal of Meidicne, March 3, 2005, page 862.
Dr. Mary Mittelman: Counseling the Alzheimer's Caregiver: A Resource for Health Care Professionals.
Robert D. Abbott, et al: "Walking and Dementia in Physically Capable Elderly Men." Journal of the American Medical Association, September 21, 2004;292: pages 1447-1453.
Jennifer Weuve, et al: "Physical Activity, Including Walking, and Cognitive Function in Older Women." Journal of the American Medical Association, September 21, 2004;292: pages1454 -1461.