Art Therapy for Alzheimer's

People often say that art “speaks” to them. When words and thoughts fail, as in the case of Alzheimer’s dementia, the symbolic language of art can tell a story, express an emotion or recreate a memory that may otherwise be left untold.

The Memories in the Making Art Program began in 1988 in Orange County, California, when Selly Jenny, whose mother had Alzheimer’s disease, explored the use of an art program to identify how much dementia patients could reveal about themselves through the medium of art. The program is now service of the Alzheimer’s Association, and has expanded to over 26 chapters across the nation.

While Alzheimer’s and dementia damage the portions of the brain that have to do with memory and planning complex tasks, the portions that is involved in emotion and in aesthetic appreciation remain intact for much longer.

Patients with the disease have difficulty with attention and concentration, but experts say that art therapy has provided an extraordinary outlet. Therapists have witnessed an increase in freedom and spontaneity, calming of agitation, relief of isolation, and improved communication through art sessions. Dr. Gene Cohen, director of the Center on Aging at George Washington University, has studied the effect of art on people with Alzheimer’s. “Art is a wonderful activity that taps into imagination. Even with the loss of memory, the capacity for imagination still has its place.”

There is research that suggests that art helps Alzheimer’s patients. In a small study, weekly sessions of art therapy helped patients focus their attention for up to 30 to 45 minutes, and the completion of the project brought pleasure and satisfaction. "It is an opportunity to express themselves even after some of their standard human communications abilities of expression have gone,'' said Peter Reed, director of care services for the Alzheimer's Association.

Art therapy can also help with the depression that comes along with the disease. A 1999 study at Brighton University found that Alzheimer’s sufferers who took part in art therapy showed a significant improvement to their symptoms after a ten-week course.

In addition to memory loss, the disease can affect muscle memory and coordination. Art therapy can help patients regain some function because it actively engages both hemispheres of the brain. For those who have problems carrying out movements, facilitators will use a hand-over-hand technique, which guides the artist so he or she can do it on their own.

Art therapy might be particularly beneficial to people with Alzheimer’s disease because though they gradually lose the ability to express themselves with words, other parts of their brain that deal with colors and composition can still be used and developed. Even people with advanced Alzheimer’s disease can continue to create art.

Just viewing art can have a therapeutic effect on Alzheimer’s patients as well. Patients with dementia often develop what doctors call the “four A’s” – anxiety, aggression, agitation, and apathy. The four A’s tend to fade in front of artwork, and have a calming effect. “Emotional memory” may come alive, and the patient begins to relate to people and places in their past.

Well-known Woodland Hills physician, Dr. Arnold Bresky, calling himself a “preventive gerontologist” has been successfully utilizing art therapy for patients that have Alzheimer’s and dementia. He claims he has achieved a 70% success rate with in improving his patient’s memories. Bresky assures that helping them to paint and draw reduces their memory loss.

Dr. Bresky calls his program a “Brain Tune Up” and says it’s a multi-disciplinary approach that also implements music. Bresky states that his art therapy program helps people with Alzheimer’s and dementia exercise their brains.

“The brain works through numbers and patterns,” Bresky says. “The numbers are on the left side of your brain, the patterns are on the right side. What I’m doing is connecting the two sides.”

“And we’re getting the brain to grow new cells. It’s called `brain plasticity.’ The brain changes physically to the environment.”

How Does Art Therapy Help Someone with Alzheimer’s?


A number of benefits are associated with art therapy. These include:

• New way to communicate. Art therapy allows people with Alzheimer’s disease to connect with others in a different, non-verbal way. And it's a healthy method of helping your loved one to express thoughts and feelings and let go of some of the negative emotions they may be experiencing.
• Improved concentration. Art therapy focuses on other possibly untapped areas of the brain and helps to improve concentration in people with Alzheimer's. Art therapy emphasizes abilities that are still available and can be developed rather than focusing on those that have been lost.
• Better behavior. Both viewing and creating art can have a calming effect on someone with Alzheimer’s disease. Similar to the effects of listening to music or playing with pets, "art therapy may promote relaxation, improve mood, and decrease disruptive behavior," says Dr. Faison.
• Closer relationships. Art therapy can bring a caregiver and a loved one with Alzheimer’s disease closer together. When other methods of contact become difficult, art therapy reminds the caregiver that the person with Alzheimer’s is still there.

How Can Caregivers Utilize Art Therapy at Home?


Though this form of therapy is done by professional art therapists in facilities, caretakers at home can also use some of the methods. Art therapy may provide significant benefits to the difficult task of caring for a patient with Alzheimer’s Disease. Art allows the patient to connect with others around them non-verbally, communicating in a way that can express thoughts, feelings, and emotions. The therapy may promote relaxation and decrease disruptive behavior. And most of all, art therapy can bring a caregiver closer to their loved one.

Here are some ways that you can incorporate the fundamentals of art therapy into your home-care regimen:

• Make an art project part of your regular routine. Don’t worry about the result; just let the person with Alzheimer’s enjoy the process.
• Provide safe and non-toxic materials. Watercolors are a good choice for painting; crayons and coloring books for adults work well; and sculpting with clay is also a good option for people with Alzheimer's.
• Establish friendships. You might consider enrolling your loved one in an art class with other people who have Alzheimer’s disease. This will help your loved one to get involved socially with others and can give you a much-needed break. Many Alzheimer’s adult day care centers have art therapy programs.
• Go to a museum. Seeing art is also a valuable part of this form of therapy and it gives you and your loved one the opportunity to share an activity together, get out of the house, and get some exercise.
• Scrapbooking. Making a scrapbook is an increasingly popular activity that both caregivers and persons with Alzheimer’s disease can do together. Picking out colorful backgrounds and placing favorite photographs into an album can wake up old memories and stimulate a sense of togetherness and shared happiness.

Review the video trailer to documentary "I Remember Better When I Paint", narrated by Oscar-winning actress Olivia de Havilland (of Gone with the Wind), and features a stirring interview with Yasmin Aga Khan, daughter of acclaimed American actress, and Alzheimer's sufferer, Rita Hayworth, who took up painting while struggling with the disease and produced beautiful works of art also featured in the film. The documentary deals with common myth about Alzheimer's that it is a veritable death sentence. That once diagnosed, a person will ultimately deteriorate into an unrecognizable shell of his/her former self. But as the filmmakers demonstrate, this need not be the case. The creative arts can reunite even a late stage Alzheimer's sufferer with parts of his/her former self. These non-medicinal options render success rates comparable to their pharmaceutical counter-parts. Indeed, art therapy can provide outlets of expression for an Alzheimer's sufferer where conventional means of expression prove insufficient.

I remember better when I paint

Sources and Additional Information:

http://www.emaxhealth.com/1506/91/34402/art-therapy-can-improve-quality-life-alzheimer’s-patients.html

http://www.everydayhealth.com/alzheimers/alzheimers-art-therapy.aspx

http://www.arttherapyblog.com/art-therapy-seniors/art-therapy-helps-alzheimers-patients-improve-memory/

http://www.huffingtonpost.com/rosalia-gitau/art-therapy-for-alzheimer_b_495914.html

Coping with Alzheimer's Disease: Overview

Introduction

Alzheimer’s disease will bring significant changes in your day-to-day experiences. Things you once did easily will become increasingly difficult. The following suggestions may help you cope with changes in your daily life and plan for changes that will occur in the future.

Doing difficult tasks

You may find familiar activities such as balancing your checkbook, preparing a meal or doing household chores more difficult. Try the following tips:

• Do difficult tasks during the times of the day when you normally feel best.
• Give yourself time to accomplish a task, and don’t let others rush you.
• Take a break if something is too difficult.
• Arrange for others to help you with tasks that are too difficult.

Communicating with others

You may begin to experience difficulty understanding what people are saying or finding the right words to express your thoughts. The following tips are important in communicating:

• Take your time.
• Ask the person to repeat a statement, speak slowly or write down words if you do not understand.
• Find a quiet place if there is too much distracting noise.

Driving

• Understand that at some point it may no longer be safe for you to drive. Discuss with your family and physician about how and when you will make decisions about driving.
• Make plans for other transportation options, such as family members, friends or community services.
• Contact your local chapter of the Alzheimer’s Association to learn what local transportation services are available.

Dealing with memory changes

While you may clearly remember things that happened long ago, recent events can be quickly forgotten. You may have trouble keeping track of time, people and places. You may forget appointments or people’s names. It might be very frustrating trying to remember where you put things. Suggestions for coping with memory loss:

• Post a schedule of the things you do every day, such as meal times, exercise, a medication schedule and bed time.
• Have someone call to remind you of meal times, appointments or your medication schedule.
• Keep a notebook handy containing important notes, such as phone numbers, people’s names, any thoughts or ideas you want to hold on to, appointments, your address and directions to your home.
• Post important phone numbers in large print next to the phone.
• Use an answering machine to keep track of telephone messages.
• Have someone help you label and store medications in a pill organizer.
• Mark off days on a calendar to keep track of time.
• Label photos with the names of those you see most often.
• Label cupboards and drawers with words or pictures that describe their contents.
• Have someone help you organize closets and drawers to make it easier to find what you need.
• Post reminders to turn off appliances and lock doors.
• Get an easy-to-read, digital clock that displays the time and date, and keep it in a prominent place.
• Keep a set of photos of people you see regularly; label the photos with names and what each does.

Living alone

Many individuals manage on their own during the earliest stages of Alzheimer’s disease, with support and assistance from others. The following suggestions may help if you live by yourself.

• Arrange for someone to help you with housekeeping, meals, transportation and other daily chores. To get information about assistance available in your community, talk to your local chapter of the Alzheimer’s Association.
• Make arrangements for direct deposit of checks, such as your retirement pension or Social Security benefits.
• Make arrangements for help in paying bills. You can give a trusted individual the legal authority to handle money matters.
• Plan for home-delivered meals if they are available in your community.
• Leave a set of house keys with a neighbor you trust.
• Make arrangements for someone to regularly check your smoke alarm.
• Have family, friends or a community service program call or visit daily.
• Keep a list of questions and concerns to discuss with them during your time together.
• Keep a list of things for them to check out around the house, such as electrical appliances, mail and food items.

Sources and Additional Information:

http://www.alz.org/living_with_alzheimers_coping_with_changes.asp

http://www.alz.org/national/documents/brochure_ifyouhave_earlystage.pdf

http://www.webmd.com/alzheimers/guide/coping-daily-life

Link between smell deterioration and Alzheimer's Disease

Alzheimer's disease, the plague of human civilization, appears to have strong connection with sense of smell. Russian scientists found out that parosmia or olfaction disorder can be the first sign of this terminal disease. Researchers from the Institute of Cell Biophysics developed a model, which allows early diagnostics and prevention of Alzheimer's disease.

Olfactory disorder: A loss in the ability to smell or a change in the way odors are perceived. Reduction of the sense of smell is termed hyposmia. Total inability to detect odors is termed anosmia. As for changes in the perception of odors, some people notice that familiar odors become distorted. Or, an odor that usually smells pleasant instead smells foul. Still other people may perceive a smell that is not present.

Modern neurology has several important parts, and one of them is studying factors, causing neurodegeneration in brain. Alzheimer's disease is a bright example of neurodegeneration. This pathological process leads to total degradation of personality and memory loss in elderly people, as well as deterioration of spatial orientation. Modern medicine has over 10 theories, trying to explain the nature of this disease. Most popular theory links beginning of Alzheimer's disease with accumulation of a specific protein in brain. This protein, called amyloid beta peptide, is toxic for neurons – nervous cells.

This protein does exist in an organism under normal conditions, but its concentration is extremely low. When the disease starts, this protein accumulates in brain in the form of plaques, similar to those of atherosclerosis. Initial stage of Alzheimer's disease is often notable for olfaction disorders. Russian scientists decided to find out whether link between smell deterioration and neurodegeneration existed. Alzheimer's disease progresses very slowly, thus a reliable model of this disease would have been a great help to medics.

Researchers investigated consequences, appearing in animals, which olfactory bulbs were removed, and found that defects in olfactory system formed same symptoms as Alzheimer's disease. Scientists explain this effect with direct links of olfactory system with a hippocampus, an important part of brain. The fact that hippocampus deterioration is a central stage in Alzheimer's disease development, is beyond question. Experiments revealed that when a link between an olfactory bulb and hippocampus is broken, biochemical shifts appear, which increase the amount of beta amyloid plaques, thus promoting the disease.

Olfaction disorder is the very first sign of Alzheimer's disease. The model, created by Russian scientists, allows not only diagnosing this disease, but also performing search of new pharmaceuticals. Now medics can examine olfaction system of a patient, while there are no visible signs of Alzheimer's disease, and advise some preventive measures. At this stage a patient has about 3-4 years to cope with his disease.

The results, obtained by Russian scientists comply with previous researches outcomes. There have been scattered reports of evidence suggesting that a diminished sense of smell is associated with Alzheimer’s disease. In 1987, Rezek reported on olfactory deficits as a neurological sign in dementia of the Alzheimer type. Talamo and his group examined changes in olfactory neurons in patients with Alzheimer’s disease. They indicated that there were histopathological changes in olfactory epithelium. In 1991, Hyman and colleagues suggested that neuroanatomical and neurochemical changes related to Alzheimer’s disease occur in the olfactory bulb of the brain, confirming prior studies. Other areas that exhibited degeneration included the anterior olfactory nucleus, the olfactory tubercle, the uncus and the subiculum. These studies could be challenged on methodological grounds, but still carry some weight.

Finally, researchers at the University of Pennsylvania School of Medicine have linked smell loss in mice with excessive levels of a key protein associated with Alzheimer's and Parkinson's disease in 2004.

"The loss of smell – or olfactory dysfunction – has been known for more than a decade as an early sign of several neurodegenerative diseases, but we have never been able to link it to a pathological entity that is measurable over time," said Richard Doty, PhD, Professor and Director of Penn's Smell and Taste Center, who is also the team leader of the study. "By tying decrements in the ability to smell to the presence of key disease proteins, such as tau, we may well be able to assess the degree of progression of selected elements of Alzheimer's disease and related disorders by scores on quantitative smell tests."

Sources and Additional Information:
http://www.russia-ic.com/education_science/science/breakthrough/930/
http://www.medterms.com/script/main/art.asp?articlekey=39215
http://www.sciencedaily.com/releases/2004/03/040312090410.htm
http://www.therubins.com/alzheim/alzpst10.htm

Is there a Link Between Level of Education and Alzheimer's Disease?

An interesting association between low education level and Alzheimer’s disease has been noticed by the professional, however the exact reason for this phenomenon is not clear. Some scientists believe it has to do with synaptic concentration (the amount of alternative routes a neuron can use to communicate with other neurons). The suggestion is that the higher your education level, the more synaptic connections your neurons have had to make in order to process all the information stored in your brain, and this is considered as cognitive or neurological reserve.

This threshold model proposes that a more educated person might have more synapses to lose before behavioral problems how up or that they exhibit dementia only if their cognitive reserve capacity falls below a specific threshold.

A 2008 research confirmed the theory that education can delay the onset of the dementia and cognitive decline that are characteristic of the disorder. Scientists at the Alzheimer's Disease Research Center at Washington University School of Medicine in St. Louis found that some study participants who appeared to have the brain plaques long associated with Alzheimer's disease still received high scores on tests of their cognitive ability. Participants who did well on the tests were likely to have spent more years in school.

"The good news is that greater education may allow people to harbor amyloid plaques and other brain pathology linked to Alzheimer's disease without experiencing decline of their cognitive abilities," says first author Catherine Roe, Ph.D., research instructor in neurology.

Roe and her colleagues at the Alzheimer's Disease Research Center used the study participants' education levels to approximate a theoretical quality called cognitive reserve: improved abilities in thinking, learning and memory that result from regularly challenging and making use of the brain. Neurologists have long speculated that this quality, roughly equivalent to the benefits that accrue in the body via regular physical exercise, can help the brain cope with the damage caused by Alzheimer's disease.

Doctors still cannot conclusively diagnose Alzheimer's disease in any manner other than post-mortem brain examination. But Washington University scientists have shown that an imaging agent for positron emission tomography scans, Pittsburgh Compound B (PIB), can reveal the presence of amyloid plaques, a key brain change that many neurologists suspect either causes Alzheimer's or is closely linked to its onset.

In addition to scanning the participants' brains with PIB, the participants took several tests that assessed their cognitive abilities and status. They also ranked their educational experience: high-school degree or less, college experience up to an undergraduate degree, and graduate schooling.

As expected, those whose brains showed little evidence of plaque buildup scored high on all the tests. But while most participants with high levels of brain plaque scored poorly on the tests, those who had done postgraduate work still scored well. Despite signs that Alzheimer's might already be ravaging the brains of this subgroup, their cognitive abilities had not declined and they had not become demented.

The obtained results were reproduced by the recent 2009 study at the Department of Psychiatry, Klinikum rechts der Isar, Technische Universität München, investigated the effects of formal education on the symptoms of Alzheimer's disease. They researchers were able to show that education diminishes the impact of Alzheimer's disease on cognition even if a manifest brain volume loss has already occurred. Dr. Robert Perneczky explains: "We know that there is not always a close association between brain damage due to Alzheimer's disease and the resulting symptoms of dementia. In fact, there are individuals with severe brain pathology with almost no signs of dementia, whereas others with only minor brain lesions exhibit a considerable degree of clinical symptoms."

These phenomena are often ascribed to the theoretical concept of cognitive reserve. A high level of cognitive reserve results in a strong individual resilience against symptoms of brain damage; cognitive reserve can therefore be seen as protective against brain damage.

However, while education level and brain activity has proven to allow certain delay (protection) for the Alzheimer’s disease development, but it is not able to slow memory loss once it starts, says another study. Reporting in the Feb. 3, 2009 issue of Neurology, scientists say they found that education does not appear to protect against how fast people lose memory once forgetfulness begins.

"This is an interesting and important finding because scientists have long debated whether aging and memory loss tend to have a lesser effect on highly educated people," says study author Robert S. Wilson, PhD, with the Alzheimer's Disease Center at Rush University Medical Center in Chicago. "While education is associated with the memory's ability to function at a higher level, we found no link between higher education and how fast the memory loses that ability."

He and colleagues tested the thinking skills of 6,500 people from the Chicago area with an average age of 72 and varying levels of education. The level of education of people in the study ranged from eight or fewer years of school to 16 or more years. Interviews and tests about memory and thinking functions were given every three years, up to 14 years.

When the study started, people with more education were found to have better memory and thinking skills than those with lesser education. The results remained the same regardless of other factors related to education, such as job status, race, and the effects of practice with the tests.

Further analysis, however, showed that the "rate of cognitive decline at average or high levels of education was slightly increased" during early years of follow-up study, but then decreased slightly later, compared to people with low levels of education. "The results suggest that education is robustly associated with level of cognitive function, but not with rate of cognitive decline," they conclude.

Sources and Additional Information:

http://mednews.wustl.edu/news/page/normal/12951.html

http://www.webmd.com/alzheimers/news/20090202/education-protects-against-alzheimers

http://www.medicalnewstoday.com/articles/164056.php

http://esciencenews.com/articles/2009/08/11/formal.education.lessens.impact.alzheimers.disease

Age is the Largest Risk Factor for Alzheimer’s Disease

There are multiple known risk factors for the development of Alzheimer’s disease, including family history, genetics, diabetes, gender, and vascular health; however the largest risk factor is age. The inherited form of Alzheimer’s, early onset, is rare and effects people under the age of 65. Once a person reaches the age of 65, the likelihood of developing Alzheimer’s increases, as the person ages.

• At 65 to 70 years your risk is about 1.5%
• At 70 to 74 years your risk is about 3.5%
• At 75 to 79 years your risk is about 6.8%

Experts estimate that the risk for Alzheimer’s disease doubles every five years after age 65 and by age 85, nearly half of all people have the disease.

According to the Alzheimer’s Association report (pg 6)

“By age group, the proportion and number of the 4.9 million Americans age 65 and over with Alzheimer’s disease breaks down as follows:

* Age 65-74: 2 percent … 300,000 people
* Age 75-84: 19 percent … 2,400,000 people
* Age 85 +: 42 percent … 2,200,200 people”

And they estimate that “By 2050, the number of individuals age 65 and over with Alzheimer’s could range from 11 million to 16 million unless science finds a way to prevent or effectively treat the disease. By that date, more than 60 percent of people with Alzheimer’s disease will be age 85+.”

Research
It is still a mystery, why age is the largest risk factor for the development of Alzheimer’s. Researchers at the University of Cambridge are seeking to find out why. By investigating the pathways (biochemical reactions) that regulate ageing and their interactions with the onset of Alzheimer’s disease they hope to find an answer.

Alzheimer’s disease is associated with the presence of amyloid protein plaques in the brain and the destruction of brain nerve cells. Researchers at the University of Cambridge are investigating what age related changes make the brain more susceptible to these plaques and consequent brain deterioration. Although the toxic proteins associated with Alzheimer’s are found in normal brains and develop throughout a regular human life cycle, they rarely cause disease in younger people.

An important insight into the ageing process has come from the discovery that the insulin-signaling pathway has a role in determining lifespan. It has been shown that a reduction in activity of this pathway in organisms such as flies, worms and mice increases lifespan. The aim of this project is to investigate the interactions between pathways involved in the regulation of ageing and Alzheimer’s disease using fruit flies (Drosophila) as a model.

The fruit fly models replicate many of the features of the human disease. The researchers, led by Dr Maria Giannakou, will use the model to determine how ageing affects the sensitivity of the fly brain to the toxic protein and how other processes or proteins interact with the ageing process to increase or decrease toxicity. A better understanding of the interaction between the ageing process and the formation of brain plaques in Alzheimer’s disease could lead to potential new targets for drug design.

Sources and Additional Information:

http://www.alzheimers-research.org.uk/research/currentresearch/grant.php?id=109&type=11

http://www.knowitalz.com/resources/about-alzheimer-s/risk-factors-of-alzheimers-disease.html

http://www.healia.com/healthguide/guides/alzheimers/what-are-the-risk-factors-for

http://www.blisstree.com/articles/staggering-statistics-about-alzheimers-disease-117/

Three common types of Alzheimer’s disease

There are three commonly known types of Alzheimer’s disease. They include:

Early-onset Alzheimer's

This is a rare form of Alzheimer's disease in which people are diagnosed with the disease before age 65. Less than 10% of all Alzheimer's disease patients have this type. Because they experience premature aging, people with Down syndrome are particularly at risk for a form of early onset Alzheimer's disease. Adults with Down syndrome are often in their mid- to late 40s or early 50s when symptoms first appear.

Younger people who develop Alzheimer's disease have more of the brain abnormalities that are associated with it. Early-onset Alzheimer's appears to be linked with a genetic defect on chromosome 14, to which late-onset Alzheimer's is not linked.

Mutations of three genes, namely presenilin 1, presenilin 2, and amyloid precursor protein, are associated with Early Onset Alzheimer’s disease. These genes in isolation do not cause Alzheimer’s, however, mutations of these genes, can cause the disease.

Changes in the brains of younger people affected by Alzheimer’s disease are microscopic, involving twisting of nerve cells “known as neurofibrillary tangles” and formation of structures called plaques by a sticky protein called beta amyloid. These plaques and tangles tend to damage healthy brain cells leading to shrinking and atrophy.

A condition called myoclonus which causes muscle twitching and spasms is much more common in people with early onset than those who develop the disease later in life. These will all combine to make it very difficult for someone in the younger age group to continue to work or even take part in normal family life.

Individuals with early-onset Alzheimer's disease will exhibit many of the same symptoms as those whose disease appears later in life. Memory loss, confusion, personality changes and difficulties performing simple tasks are all very common symptoms and as the disease progresses emotional and social withdrawal is the norm. Anyone who has this combination of symptoms should see a physician as soon as possible.

Alzheimer's diagnosis usually comes as a result of ruling out all other possibilities. The only way to biologically diagnose it is to examine brain tissue under a microscope, which is typically done only after death.

Late-onset Alzheimer's 

This is the most common type of the disease affecting about 90% of all those with Alzheimer’s. It affects people over the age of 65 with around 50% of all people over the age of 85 suffering from it. And the likelihood of developing late-onset Alzheimer’s doubles every five years after the age of 65. Late-onset Alzheimer's disease may not be hereditary.

It is also known as “sporadic Alzheimer’s” because it can affect any elderly person with no other common link other than the fact that they are all over 65.

Late onset Alzheimer’s causes memory loss, confusion and difficulties in carrying out even the simplest tasks. Eventually a person will need constant care as they will be unable to look after themselves.

On average people live roughly eight to ten years after diagnosis. Sometimes with sporadic Alzheimer’s, because it affects people so late in life, another disease associated with old age could also be the cause of death.

There is no cure and the jury is still out as to why some people get it and others don’t. It is indiscriminate of race, color, creed and lifestyle. In fact the only thing sufferers have in common appears to be old age.

Unfortunately finding genes for incredibly complex conditions like sporadic Alzheimer’s is a complicated business as there appears to be no link between who gets it and who doesn’t. So far researchers haven’t come across one single common factor to determine the eventual development of late-onset Alzheimer’s. What they have done, however, is identify a gene which may be a risk factor. Apolipoprotein E (ApoE) is interesting in that it has both a negative and positive side in the development of Alzheimer’s. The e4 type of the gene is found to carry a higher risk of Alzheimer’s while the e2 type is believed to offer protection against it. Having this gene doesn’t necessarily mean that a person will get Alzheimer’s – what it does mean is that it may increase their risk. Environmental factors, lifestyle and toxins can all play a part in weakening genes and making a person more susceptible to an illness.

Sporadic Alzheimer’s is a very difficult and complex disease for researchers because there is no real rhyme or reason to it. Until they can come up with an identifying factor other than age, there will be no cure.

Familial Alzheimer's disease (FAD)

This is a form of Alzheimer's disease that is known to be entirely inherited. In affected families, members of at least two generations have had Alzheimer's disease. FAD is extremely rare, accounting for less than 1% of all cases of Alzheimer's disease. It has a much earlier onset (often in the 40s) and can be clearly seen to run in families. In some extremely rare cases people in their 30s have been known to develop it.

Histologically, familial AD is practically indistinguishable from other forms of the disease. Deposits of amyloid can be seen in sections brain tissue (visible as an apple-green yellow birefringence under polarized light). This amyloid protein forms plaques and neurofibrillary tangles that progress through the memory centers of the brain. Very rarely the plaque may be unique, or uncharacteristic of AD; this can happen when there is a mutation in one of the genes that creates a functional, but malformed, protein instead of the ineffective gene products that usually result from mutations.

This type is genetically inherited due to a fault on chromosomes 1, 14 or 21. When this happens roughly 50% of the offspring of these sufferers will carry the genetic fault and all of them will go on to develop Alzheimer’s.

Mutations in three different genes -- the amyloid precursor protein (APP) gene and the presenilin 1 and 2 (PSEN1 and PSEN2) genes -- have been discovered in families with early-onset familial Alzheimer's disease. Taken together, these mutations only account for about 20-50% of familial Alzheimer's, indicating that other genes remain to be found in this disorder.

The APP gene encodes the beta-amyloid protein which accumulates abnormally in the brain in Alzheimer's disease. The protein products of the PSEN1 and PSEN2 genes interact with proteins are involved in signaling processes within and between cells.

Sources and Additional Information:

http://www.webmd.com/alzheimers/guide/alzheimers-types

http://www.omnimedicalsearch.com/conditions-diseases/alzheimers-disease-types.html

http://www.guide4living.com/alzheimers/types.htm

http://www.revolutionhealth.com/articles/types-of-alzheimers-disease/2341

http://alzheimers.about.com/lw/Health-Medicine/Conditions-and-diseases/Coping-With-Early-Onset-Alzheimers-Disease.htm

http://www.economicexpert.com/a/Familial:Alzheimer:disease.html

Signs and Symptoms of Alzheimer's Disease

Alzheimer's disease may start with slight memory loss and confusion, but it eventually leads to irreversible mental impairment that destroys a person's ability to remember, reason, learn and imagine. Please review the possible signs of the Alzheimer’s disease.

1. Memory changes that disrupt daily life                             

One of the most common signs of Alzheimer's, especially in the early stages, is forgetting recently learned information. Others include forgetting important dates or events; asking for the same information over and over; relying on memory aides (e.g., reminder notes or electronic devices) or family members for things they used to handle on their own. 

What's typical? Sometimes forgetting names or appointments, but remembering them later.

2. Challenges in planning or solving problems      

Some people may experience changes in their ability to develop and follow a plan or work with numbers. They may have trouble following a familiar recipe or keeping track of monthly bills. They may have difficulty concentrating and take much longer to do things than they did before.

What's typical? Making occasional errors when balancing a checkbook.

3. Difficulty completing familiar tasks at home, at work or at leisure     

People with Alzheimer's often find it hard to complete daily tasks. Sometimes, people may have trouble driving to a familiar location, managing a budget at work or remembering the rules of a favorite game. 

What's typical? Occasionally needing help to use the settings on a microwave or to record a television show.

4. Confusion with time or place                                             

People with Alzheimer's can lose track of dates, seasons and the passage of time. They may have trouble understanding something if it is not happening immediately. Sometimes they may forget where they are or how they got there. 

What's typical? Getting confused about the day of the week but figuring it out later.

5. Trouble understanding visual images and spatial relationships           

For some people, having vision problems is a sign of Alzheimer's. They may have difficulty reading, judging distance and determining color or contrast. In terms of perception, they may pass a mirror and think someone else is in the room. They may not realize they are the person in the mirror. 

What's typical? Vision changes related to cataracts.

6. New problems with words in speaking or writing           

People with Alzheimer's may have trouble following or joining a conversation. They may stop in the middle of a conversation and have no idea how to continue or they may repeat themselves. They may struggle with vocabulary, have problems finding the right word or call things by the wrong name (e.g., calling a "watch" a "hand-clock"). They might also repeat the same words again and again with no possible justification.

What's typical? Sometimes having trouble finding the right word.

7. Misplacing things and losing the ability to retrace steps  

A person with Alzheimer's disease may put things in unusual places. They may lose things and be unable to go back over their steps to find them again. Sometimes, they may accuse others of stealing. This may occur more frequently over time.

What's typical? Misplacing things from time to time, such as a pair of glasses or the remote control.

8. Decreased or poor judgment                                              

People with Alzheimer's may experience changes in judgment or decision-making. For example, they may use poor judgment when dealing with money, giving large amounts to telemarketers. They may pay less attention to grooming or keeping themselves clean. 

What's typical? Making a bad decision once in a while.

9. Withdrawal from work or social activities                        

A person with Alzheimer's may start to remove themselves from hobbies, social activities, work projects or sports. They may have trouble keeping up with a favorite sports team or remembering how to complete a favorite hobby. They may also avoid being social because of the changes they have experienced. 

What's typical? Sometimes feeling weary of work, family and social obligations.

10. Changes in mood and personality                                   

The mood and personalities of people with Alzheimer's can change. They can become confused, suspicious, depressed, fearful or anxious. They may be easily upset at home, at work, with friends or in places where they are out of their comfort zone. 

What's typical? Developing very specific ways of doing things and becoming irritable when a routine is disrupted.

People with suspicion on Alzheimer’s disease might also experience notable personality changes, appearing as

• Mood swings
• Distrust in others
• Increased stubbornness
• Social withdrawal
• Depression
• Anxiety
• Aggressiveness

Other Symptoms that may be but are not always present include:

• Firmly held false beliefs (delusions), such as that someone is stealing from the person.
• Seeing or hearing things that aren't really there (hallucinations).
• Lack of interest in surroundings or activities, or withdrawal from family and friends.
• Purposeless activity, such as opening and closing a purse, packing and unpacking clothing, pacing, or repeating demands or questions.
• Verbal and physical aggression.
• Inability to control impulses, which may lead to unusual or inappropriate actions. Men are somewhat more likely than women to exhibit behavior problems such as wandering, abusiveness, and social impropriety.

Sources and Additional Information:

http://www.alz.org/alzheimers_disease_10_signs_of_alzheimers.asp

http://www.helpguide.org/elder/alzheimers_disease_symptoms_stages.htm

http://www.mayoclinic.com/health/alzheimers-disease/DS00161/DSECTION=symptoms

http://health.yahoo.com/alzheimers-symptoms/alzheimer-s-disease-symptoms/healthwise--hw136643.html

http://www.aricept.com/signssymptoms.html

17 Myths and Facts about Alzheimer's Disease

According to the Alzheimer's Association, about 5 million Americans are living with Alzheimer's disease today -- a figure that's expected to increase as the baby boom generation ages. The disorder causes neurons, or cells in the brain, to malfunction and die. The onset of Alzheimer's usually happens after the age of 60, but early-onset Alzheimer's can affect younger people. Though scientists have learned much about the illness in the last decade, many questions remain about the causes, stages, and treatment of Alzheimer's. It's not surprising, then, that patients' and caregivers' understanding of the disease is often off-target. Myths and half-truths only add to fear of the disease, which can prevent people from getting help that could improve their quality of life.

Here are 17 common myths about Alzheimer's -- busted.

Myth: If you're forgetful, you're getting Alzheimer's disease.

Reality: Memory loss is a key symptom of Alzheimer's, but forgetfulness doesn't mean you have the disease. Even if your forgetfulness is due to more than simple aging, there are still many causes for dementia that lead to a decrease in cognitive function; physicians will make an Alzheimer's diagnosis only after other conditions have been ruled out.

Myth: Memory loss is a natural part of aging.

Reality: In the past people believed memory loss was a normal part of aging, often regarding even Alzheimer’s as natural age-related decline. Experts now recognize severe memory loss as a symptom of serious illness. Whether memory naturally declines to some extent remains an open question. Many people feel that their memory becomes less sharp as they grow older, but determining whether there is any scientific basis for this belief is a research challenge still being addressed.

Myth: Most people with Alzheimer’s are oblivious to their symptoms.

Reality: Typically someone in the early stage of Alzheimer’s disease does realize, at least part of the time, that something’s wrong. (Whether they recognize it as Alzheimer’s is another matter.) Most people with the disorder are aware that they’re experiencing memory lapses, for example, or that they’re starting to have trouble doing certain familiar tasks (following a favorite card game, cooking a particular recipe). Insight varies by individual, and the degree of awareness can shift from day to day.

Depending on their level of awareness and attitude toward correction, people with Alzheimer’s may appreciate being gently told when they make a mistake due to memory loss, disorientation, or another disease symptom. On the other hand, self-awareness of symptoms can make someone frustrated, angry, scared, or socially withdrawn. As the disease progresses and symptoms worsen, awareness of the situation is likely to decline.

Myth: An x-ray of the brain can diagnose Alzheimer's disease.

Reality: Unfortunately, the brain changes that cause Alzheimer's can not be seen with an x-ray. However, promising new tests using MRI and other imaging techniques are in development. Physical examination is important to rule out other conditions; the disease is then most often diagnosed by a series of tests of mental status.

Myth: If you have a family member with Alzheimer's, you'll get it, too.

Reality: In rare cases, early-onset Alzheimer's is inherited through genes. This familial form of Alzheimer's causes just 7% of all Alzheimer's cases. Genetics plays a small role for those people who don't have this form of Alzheimer's but who do get the disease later in life. If you have a parent, brother or sister with the disease, you have a slightly higher risk of getting it.

Myth: Aluminum in products we use causes Alzheimer's.

Reality: Most of us use products every day that contain aluminum. Food prepared in aluminum pots and pans carries trace amounts of the metal. Many underarm antiperspirants also contain aluminum. There is no scientific evidence that aluminum exposure causes Alzheimer's. Although the disease's exact cause is unknown, most research suggests that several factors, such as age, genetic susceptibility and overall quality of health, ultimately contribute to whether or not someone develops the disease.

Myth: Aspartame causes memory loss.

Reality: This artificial sweetener, marketed under such brand names as Nutrasweet and Equal, was approved by the U.S. Food and Drug Administration (FDA) for use in all foods and beverages in 1996. Since approval, concerns about aspartame's health effects have been raised.  According to the FDA, as of May 2006, the agency had not been presented with any scientific evidence that would lead to change its conclusions on the safety of aspartame for most people. The agency says its conclusions are based on more than 100 laboratory and clinical studies.

Myth: Flu shots increase risk of Alzheimer’s disease

Reality: A theory linking flu shots to a greatly increased risk of Alzheimer’s disease has been proposed by a U.S. doctor whose license was suspended by the South Carolina Board of Medical Examiners. Several mainstream studies link flu shots and other vaccinations to a reduced risk of Alzheimer's disease and overall better health. 

• A Nov. 27, 2001, Canadian Medical Journal report suggests older adults who were vaccinated against diphtheria or tetanus, polio, and influenza seemed to have a lower risk of developing Alzheimer’s disease than those not receiving these vaccinations.
• A report in the Nov. 3, 2004, JAMA found that annual flu shots for older adults were associated with a reduced risk of death from all causes.

Myth: Silver dental fillings increase risk of Alzheimer's disease.

Reality: According to the best available scientific evidence, there is no relationship between silver dental fillings and Alzheimer's. The concern that there could be a link arose because "silver" fillings are made of an amalgam (mixture) that typically contains about 50 percent mercury, 35 percent silver and 15 percent tin. Mercury is a heavy metal that, in certain forms, is known to be toxic to the brain and other organs.

Many scientists consider the studies below compelling evidence that dental amalgam is not a major risk factor for Alzheimer's. Public health agencies, including the FDA, the U.S. Public Health Service and the World Health Organization, endorse the continued use of amalgam as safe, strong, inexpensive material for dental restorations.

• March 1991, the Dental Devices Panel of the FDA concluded there was no current evidence that amalgam poses any danger.
• National Institutes of Health (NIH) in 1991 funded a study at the University of Kentucky to investigate the relationship between amalgam fillings and Alzheimer's. Analysis by University statisticians revealed no significant association between silver fillings and Alzheimer's. 
• October 30, 2003, a New England Journal of Medicine article concluded that current evidence shows no connection between mercury-containing dental fillings and Alzheimer's or other neurological diseases. 

Myth: All old people have Alzheimer's disease.

Reality: Even though age is an important risk factor for Alzheimer's, the majority of old people do not have the disease. It's important to note that normal aging doesn't necessarily include dementia or Alzheimer's.

Myth: Alzheimer’s disease affects only old people.

Reality: Though the majority of patients with AD are above 65 years old, there are also cases, when the disorder affects people in their 50^th or even 40^th. That is why it is important to understand that the symptoms of AD, such as memory problems, are not part of normal aging. The earlier the disorder is detected – the more effective management of it could be.

Myth: Men are at higher risk of developing Alzheimer's than women.

Reality: Alzheimer's disease affects both men and women that is true but it is believed to be more common in women. The reason for this claim is based on the unrelated fact that women live longer than their opposite sex so are more likely to develop the disease at some stage of their life.

Myth: Alzheimer's disease is preventable.

Reality: There is no treatment that can prevent Alzheimer’s disease. There is, however, a growing amount of evidence that lifestyle choices that keep mind and body fit may help reduce the risk. These choices include being physically active; eating healthy foods including fresh fruits, vegetables and fish; keeping your brain challenged; reducing stress, keeping an eye on your blood pressure, blood sugar and cholesterol levels; avoiding traumatic brain injury; and keeping socially active.

Myth: Alzheimer’s disease can be cured with pills, herbs, or supplements.

Reality: Currently there is no cure for Alzheimer’s disease. Modern pharmaceutical options can only slow down the progression of the disorder. The effect of herbs, such as ginkgo biloba, vitamins E, B and C, as well as folic acid and selenium, on patients with Alzheimer’s disease is also not yet fully understood, and the history of their use for AD treatment contains many controversies and vagueness. There are some evidences of beneficial effect of the said remedies, but it is definitely too early to claim that they are able of curing Alzheimer’s disease.

Myth: Alzheimer’s disease makes people hostile, violent, and aggressive.

Reality: As a matter of fact, Alzheimer’s disease affects different people in different ways. Some patients develop certain changes in their behavioral patterns, like becoming violent or aggressive, and some do not. It is important to understand that the symptoms of AD may be frightening and scary first of all for a patient himself; that is why it is important to educate yourself, as well as a patient, about the disorder, and what to expect from it in order to prevent aggressive responses from a patient. Try to improve his usual surroundings in accordance with his specific demands, do not expose him to stressful events, and make him feel comfortable even with his gradually decreased abilities.

Myth: People with Alzheimer's disease cannot understand what is going on around them.

Reality: Some people with Alzheimer's disease understand what is going on around them; others have difficulty. The disease does affect a person's ability to communicate and make sense of the world around them, although it affects each person differently. When we assume someone does not understand, feelings can be hurt unintentionally. The fact is a person with Alzheimer's disease is still the same person as before and needs to be treated with dignity and respect.

Myth: Life with Alzheimer's disease isn't worth living.

Reality: There is no single course for Alzheimer's disease, which typically can be a part of a person's life for many years. Memory loss and communication problems can cause frustration and anger. With help, though, a person with Alzheimer's can have a meaningful and productive life. According to the National Institute of Neurological Disorders, several medications have been approved for early- and middle-stage Alzheimer's, including Aricept(donepezil), Exelon (rivastigimine),  Namenda (memantine), and Razadyne (galantamine; formerly Reminyl). A number of other medications can be used to control anxiety, depression, sleeplessness, and agitation, any or all of which may accompany the disease.

Sources and Additional Information:

http://alzheimers.about.com/lw/Health-Medicine/Conditions-and-diseases/Myths-and-Realities-of-Alzheimers-Disease.htm

http://www.pillwatch.com/info/alzheimers-disease-myths-and-realities.html

http://www.alz.org/alzheimers_disease_myths_about_alzheimers.asp

http://www.memorystudy.org/alzheimers_myths.htm

http://www.poststat.net/rightathome/pub.59/issue.1059/article.4339/

What Is Alzheimer's Disease?

Alzheimer’s disease (AD) is a brain disorder named for German physician Alois Alzheimer, who first described it in 1906. Scientists have learned a great deal about Alzheimer’s disease in the century since Dr. Alzheimer first drew attention to it.

In spite the long history of the disease in the modern world, there is not much we know about its development mechanism, and even less on the possibilities of the successful medical treatments.

Today we know that Alzheimer’s:

• It is a form of dementia. Alzheimer's disease is a progressive, degenerative disease of the brain that results in dementia. The terms Alzheimer's and dementia are often used interchangeably, but there's a distinct difference between them. Dementia is a broader term than Alzheimer's and refers to any brain syndrome resulting in problems with memory, orientation, judgment, executive functioning, and communication. Alzheimer's disease is the most common form of dementia -- according to the Alzheimer's Association, 60% to 70% of dementia cases are due to Alzheimer's. However, many other diseases can cause dementia, such as stroke, Parkinson's disease, and Wernicke-Korsakoff syndrome. Some infectious diseases can also result in dementia, such as HIV or the extremely rare Creutzfeldt-Jakob disease.

• It is a progressive and fatal brain disease. As many as 5.3 million Americans are living with Alzheimer’s disease. Alzheimer's destroys brain cells, causing problems with memory, thinking and behavior severe enough to affect work, lifelong hobbies or social life. Alzheimer’s gets worse over time, and it is fatal. Today it is the seventh-leading cause of death in the United States. 

• The chances to get affected get worse with people aging. The likelihood of having Alzheimer's disease increases substantially after the age of 70 and may affect around 50% of persons over the age of 85. Nonetheless, Alzheimer's disease is not a normal part of aging and is not something that inevitably happens in later life. For example, many people live to over 100 years of age and never develop Alzheimer's disease.

• Is the most common form of dementia, a general term for the loss of memory and other intellectual abilities serious enough to interfere with daily life. Alzheimer’s disease accounts for 50 to 70 percent of dementia cases. Other types of dementia include vascular dementia, mixed dementia, dementia with Lewy bodies and frontotemporal dementia.

• Has no current cure. But treatments for symptoms, combined with the right services and support, can make life better for the millions of Americans living with Alzheimer’s. There is an accelerating worldwide effort under way to find better ways to treat the disease, delay its onset, or prevent it from developing.

• Brain is affected. There are three major hallmarks in the brain that are associated with the disease processes of AD.
• Amyloid plaques, which are made up of fragments of a protein called beta-amyloid peptide mixed with a collection of additional proteins, remnants of neurons, and bits and pieces of other nerve cells.
• Neurofibrillary tangles (NFTs), found inside neurons, are abnormal collections of a protein called tau. Normal tau is required for healthy neurons. However, in AD, tau clumps together. As a result, neurons fail to function normally and eventually die.
• Loss of connections between neurons responsible for memory and learning. Neurons can't survive when they lose their connections to other neurons. As neurons die throughout the brain, the affected regions begin to atrophy, or shrink. By the final stage of AD, damage is widespread and brain tissue has shrunk significantly.

Sources and Additional Information:

http://www.alz.org/alzheimers_disease_what_is_alzheimers.asp

http://www.nia.nih.gov/Alzheimers/Publications/adfact.htm

http://www.webmd.com/alzheimers/guide/alzheimers-disease-overview-facts

http://www.medicinenet.com/alzheimers_disease/article.htm

http://alzheimers.about.com/od/whatisalzheimer1/a/basics.htm