There are now more than 5 million people in the United States living with Alzheimer’s.
Every 72 seconds, someone develops Alzheimer’s. Daniel Tranel, PhD, a professor of both of neurology and psychology at University of Iowa Hospitals and Clinics, talks about Alzheimer’s:
What is Alzheimer’s?
Alzheimer’s is a progressive brain disease that affects the brain cells and affects the mind.
What causes Alzheimer’s?
Unfortunately, we don’ know what causes Alzheimer’s despite a lot of research. We have not yet found the cause. We’ve found some risk factors but not the cause.
What are the risks factors to develop Alzheimer’s?
The leading risk factor is age, getting older. After about age 65, the incidence of Alzheimer’s begins to increase, and into the 80s and 90s, the incidence goes up quite a bit. So age is far and away the leading risk factor.
What happens to the brain when it develops Alzheimer’s?
Essentially the brain cells or neurons are attacked and lose their ability to function properly. There’s a disease process that affects both the material inside the cell and also material outside the cell and prevents the brain cells from working properly. That disease process begins in the memory networks of the brain and that’s why we see memory dysfunction as a hallmark symptom. And that tends to spread into other areas and eventually renders the brain basically pretty dysfunctional.
What happens to the mind when a person has Alzheimer’s?
The memory is kind of the first to go—and that’s a classic, well-recognized sign—and then other higher functions like the ability to speak and understand speech; the ability to comprehend information; the ability to modulate emotions and make good decisions. So the higher functions of the mind are gradually destroyed by the disease.
Who is affected by Alzheimer’s?
Primarily the elderly. We do see cases down into the 50s and even 40s, but those are very rare—it’s primarily a disease of old people. And it doesn’t seem to respect demographic boundaries. So we see about an equal number of men and women affected (or an equal proportion), about an equal proportion of people with different backgrounds, different countries, different racial groups, and so forth. It tends to cut across a pretty wide swath that way and affect people fairly equally.
How is Alzheimer’s diagnosed?
There are a couple of important components of the diagnosis: one is to have a full, careful neurological exam by a neurologist, and the second part is a neuropsychological test, which is done by a neuropsychologist and which measures the higher functions of the brain (like memory, IQ, problem-solving, and emotion).
And then a brain scan is typically done, and then other tests like blood work and so forth are used to kind of rule out other possible diseases. Once those are ruled out, you can kind of boil it down to a diagnosis of Alzheimer’s. And I should add that the diagnosis is always probable or possible; it’s never confirmed because we can’t diagnosis it with a specific test in a living person, for sure.
Are there promising new medications to slow the progress of Alzheimer’s?
Yes. Probably the most commonly used one right now is Aricept. Namenda is another, and there are a couple of newer ones that are being used on a fairly limited basis. But they have some promise in slowing—that’s exactly how you asked the question—they kind of slow the progress. They don’t cure the disease or turn it around in a dramatic way, but they can slow the progress a little bit.
Are there other therapies that are important for the treatment of Alzheimer’s?
Yes. Those involve things like counseling, management of activities—a lot of practical things about the structure of the environment (keeping things familiar, keeping reminders of the time and place in easy to see locations so people can stay oriented)—and that’s where we can do a lot of good as health care providers in helping families and patients deal with the disease, deal with the symptoms of the disease.
Is UI Hospitals and Clinics involved in any research studies with regard to Alzheimer’s?
Yes. In addition to medication trials, which we usually have some of those going on at any given point in time, we’re also doing some interesting behavioral studies. For example, a study being done right now by some of my students involves teaching Alzheimer’s patients, in an interactive situation with a familiar communication partner, how to learn new information. And we’ve discovered a situation where they actually do seem to learn new information that involves a kind of a give and take over a series of different exchanges. So we’re very excited by those kinds of findings and have been pursuing those to try to identify, essentially, ways that we can take full advantage of the remaining healthy brain cells in an Alzheimer’s patient to sort of maximize the work that those cells can do. |
