Alzheimer's Disease

Alzheimer's disease is a form of dementia, a term used to describe a group of brain disorders that cause memory loss and a decline in mental function over time. In fact, Alzheimer's disease is the most common form of primary dementia -- which is dementia caused by changes in the brain that are not the result of another condition, such as a stroke.

There are other forms of dementia not related to Alzheimer's disease, such as vascular dementia, dementia with Lewy bodies, and frontal lobe dementia. Vascular dementia is different from Alzheimer's disease in that it is often caused by strokes or other vascular events. Although the first symptoms of Alzheimer's disease are often confused with the changes that take place in normal aging, it's important to remember that Alzheimer's disease is not a normal part of aging.4

Alzheimer's disease currently affects about 4.5 million men and women in the United States, a number that is expected to rise to 16 million by the year 2050.1 The incidence of Alzheimer's disease increases with age, and it is very rare among people younger than 60. It affects up to 50 percent of people older than 85, and the risk increases with age.2 For example, for every 5-year increase over the age of 65, the percentage of people with Alzheimer's disease doubles.3 Although the first symptoms of Alzheimer's disease are often confused with the changes that take place in normal aging, it's important to remember that Alzheimer's disease is not a normal part of aging.4

The diagram below charts the projected rapid progression of Alzheimer's disease in the United States. This progression is generally due to the aging of "baby boomers."

Right now more than 34 million people are 65 or older, a number that is going to increase rapidly over the next few years as the "baby boom" generation reaches 65.3 Since there is increasing incidence, it's important to educate yourself in areas such as risk factors, symptoms, and treatments -- and keep in mind that researchers are discovering new advances all the time.

Doctors and scientists are making steady progress in understanding some of the ways in which Alzheimer's disease affects the brain, but the cause is still unknown.3 They do know, however, many factors that can potentially lead to Alzheimer's disease. For example, family history and genetics are related factors that may play a role. Studies have shown that people with a parent or sibling with Alzheimer's disease have twice the risk of developing the disease than people with no family history. Additionally, researchers have found a gene that can increase a person's risk of developing Alzheimer's disease after age 65. This risk is even greater in people who inherit the gene from both parents. Research has also found that the likelihood of developing Alzheimer's disease is higher in people with Down syndrome, as well as those with high cholesterol or high blood pressure.2

The two types of Alzheimer's disease that exist are familial and sporadic. In familial type, there are family members affected by Alzheimer's disease. In sporadic type, there doesn't appear to be a genetic predisposition for developing Alzheimer's disease.2

http://www.alzheimersonline.com/understand/index.aspx

Family members' attitudes toward telling the patient with Alzheimer's disease their diagnosis

Conor P Maguire, research registrar in geriatric medicine,a Michael Kirby, research registrar in psychiatry,a Robert Coen, psychologist,a Davis Coakley, professor,a Brian A Lawlor, consultant psychogeriatrician,a Desmond O'Neill, consultant geriatrician a

a Mercer's Institute for Research on Ageing, Saint James's Hospital, Dublin 8, Republic of Ireland

Correspondence to: Dr Maguire.

Advances in the accuracy of the diagnosis of Alzheimer's disease as well as progress in the genetics, aetiopathology, and therapeutics of the condition have stimulated a debate on whether patients should be informed of their diagnosis. We report the results of a survey of family members on their attitudes to the disclosure of the diagnosis.

Patients, methods, and results

A total of 100 consecutive family members accompanying patients with diagnosed Alzheimer's disease to a memory clinic were asked three questions by the assessing physicians (CPM, MK): should the patient with Alzheimer's disease be told their diagnosis; would they themselves want to be told their diagnosis should they develop Alzheimer's disease; and would they make use of a predictive test for Alzheimer's disease should it become available? They were also asked to state the reasons for their decisions.

Only 17 family members said that the patient should be told the diagnosis; 83 said that they should not. The main reason given was that the diagnosis would upset or depress the patient (table 1). In contrast, 71 family members wanted to be told their diagnosis should they develop Alzheimer's disease; most stated that it would be their right to be told their diagnosis. Seventy five family members would use a predictive test for Alzheimer's Disease; 42 of these said it would give them the opportunity to make provisions for their future and thereby reduce the burden on their families.

Table 1--Family members' views (n = 100) on telling the diagnosis of Alzheimer's disease

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Yes No

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Should the patient be told?

Patient is aware that he/she is ill 7 Diagnosis would depress/agitate patient 51

Patient's right to know 5 Patient has a dread of developing 12

Alzheimer's disease

Patient would cope better 4 Would not

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