Let’s go on. Your physician will also want to get:

• A family history of other members with dementia, especially of those having symptoms before the age of 50. There is now genetic testing of chromosomes that can determine if there is a genetic relationship. The possibility of genetic disease increases with one family member who is affected and is higher with two. Remember, even if genetic testing is positive there is usually only a 50% chance (or often less) that you will be affected.
• Input from family members.
• Copies of blood tests.
• A history of all medications taken.
• Sometimes MRI scans of the brain or even spinal taps are among the things that can be used to diagnose, or to rule out, other problems.
• Remember, dozens of reversible conditions can mimic dementia. It is essential to get a proper diagnosis and to treat symptoms promptly, when you or a loved one starts experiencing serious mental deterioration.

Early diagnosis of the cause of dementia with PET (positron emission tomography) scanning is now being researched at UCLA’s Brain Mapping Center. This new imaging research adds weight to a growing body of medical evidence strongly suggesting that Alzheimer’s disease begins with subtle neuronal changes decades before any observable symptoms of mental decline. This suggests that treatments, when they become available, can begin before the brain is severely affected.

PATHOLOGY OF ALZHEIMER’S DISEASE (This may be more than you want to know!)

• In Alzheimer’s disease there are sticky plaques outside the neurons and stringy tangles within them. No one, as yet, definitely knows why but research is ongoing.

• Beta Amyloid: a protein that forms on the outside of brain cells. This can form plaques. Plaques can grow so large that they cause an inflammatory reaction. Inhibitors that block production are being tested.
• Neuralfibrillary plaques: small pieces of protein which support the nerve cells and act as a circulatory system break down Again, we are hoping to develop drugs to prevent this.
• The mutant APP gene on Chromosome 21 accounts for less than 1% of Alzheimer’s with onset ranges from age 28 to 50. It is a dominant gene.
• Presenilin-1 Chromosome 14 accounts for perhaps 4% of Alzheimer’s with onset in the 40s to 50s. This is also dominant, meaning if inherited from one parent it will cause the disease.
• APOE4,Chromosome 19 is found in 65% of Alzheimer’s patients. However, it is not as damaging as the early-onset mutations, and many people who inherit it will never develop the disease, even in their 90s.
• It is believed that there are other Alzheimer susceptibility genes not yet discovered.

• Cerebral atrophy: with age all brains become smaller.

(We warned you that this was probably more than you wanted to know.)

Treatment

• Tacrine HCL (Cognex)
• Donepezil HCL (Aricept) This is probably the better medication, though only slightly so, and only in early stages. It is of no value in moderate or advanced disease.
• Vitamin E, 400 to 800 mg. daily
• Zyprexia for paranoia
• Treat hypoxia. 20% of your oxygen intake is used by the brain so, if you have low oxygen levels, it is essential to use your oxygen as prescribed. This isn’t news to you since we have been preaching this, month after month in the newsletter.
• Treat depression
• Treat hypothyroidism
• Treat Vitamin B12 deficiency
• Vaccinations: none available now but they may be available in the future.

Caretakers

It is essential that caretakers also take care of themselves! They need time off .

Here are the phone numbers of two of the most prominent organizations; there are many others.

Alzheimer’s Association 1-800-272-3900

AD Education and Referral Center (NIH) 1-800-438-4380

Preventative measures include

• good nutrition, including a low fat diet with lots of fruits and vegetables (have you heard that one before?)
• no smoking. (And you’ve heard that one a time or two also.)
• minimal amounts of alcohol. An excessive amount of hard liquor is especially apt to cause brain damage.
• Remain physically and mentally active. Challenge the brain by also remaining socially active. Play challenging games and puzzles. Higher intelligence and higher education seems to decrease the incidence of Alzheimer’s. This may, however, be due to a stimulating environment and a good diet.

The good news is that brain capacity can increase, even in older age, if you continue to exercise it and to use it. The adult brain can improve! Research breakthroughs with medications and vaccinations are expected with in the next 5 years, so keep watching for the latest medical announcements.

This information was obtained from a lecture by Robert Faran, MD as well as from several articles.