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The Basics
- What is Alzheimer’s disease?
- What causes Alzheimer’s disease?
- What are the different stages of Alzheimer’s disease?
- Alzheimer’s and women: the statistics
- How does Alzheimer’s affect women differently?
Diagnosis and Treatment
Empower Yourself
Alzheimer’s Disease
Discuss all medical advice, diagnosis, and treatment with your healthcare provider.
Alzheimers Resources
The Basics
What Is Alzheimer’s disease (AD)?
Alzheimer’s is the most common form of dementia, is a brain disorder that affects a person’s ability to carry out normal everyday activities, and affects the parts of the brain that control thought, memory, and language.
AD is named after a German doctor, Alois Alzheimer, who first discovered it in 1906. Alzheimer noticed abnormal brain tissue in a woman who died of an unknown mental illness and found abnormal clumps and tangled bundles of fibers in her brain. The clumps are now called amyloid plaques and the fibers are known as neurofibrillary tangles. These plaques and tangles are the two most notable signs of AD.
Other brain changes in people with Alzheimer’s include:
- A loss of nerve cells in parts of the brain that control memory and other mental abilities
- Lower levels of chemicals in the brain that carry messages between neurons
- Neurons die at increasing rates
- The brain shrinks
What causes Alzheimer’s disease (AD)?
We know frustratingly little about the causes of and risk factors for AD. Age is by far the biggest risk factor. The chances of getting Alzheimer’s doubles every 5 years after the age of 65.
Family history also seems to be a factor in the development of Alzheimer’s. Familial Alzheimer’s (FAS), a rare form of the disease that occurs in people between the ages of 30 and 60, is an inherited disease. However, this relationship doesn't seem to exist in the more common form of Alzheimer’s.
Apolipoprotein E (ApoE): This is a protein that helps carry cholesterol in the blood. The ApoE gene occurs in three different forms. One form actually protects a person from developing Alzheimer’s; another form seems to make a person more likely to develop the disease.
What are the different stages of Alzheimer’s disease (AD)?
The three accepted stages of AD are mild, moderate, and severe. The symptoms of each stage are outlined below.
Mild Alzheimer’s
- Loses spark or zest for life—does not start anything.
- Loses recent memory without a change in appearance or casual conversation.
- Loses judgment about money.
- Has difficulty with new learning and making new memories.
- Has trouble finding words—may substitute or use made-up words that sound like or mean something like the forgotten word.
- May stop talking to avoid making mistakes.
- Has shorter attention span and less motivation to stay with an activity.
- Easily loses way going to familiar places.
- Resists change or new things.
- Has trouble organizing and thinking logically.
- Asks repetitive questions.
- Withdraws, loses interest, is irritable, is not as sensitive to others’ feelings, and is uncharacteristically angry when frustrated or tired.
- Won’t make decisions. For example, when asked what she wants to eat, says “I’ll have what she is having.”
- Takes longer to do routine chores and becomes upset if rushed or if something unexpected happens.
- Forgets to pay, pays too much, or forgets how to pay—may hand the checkout person a wallet instead of the correct amount of money.
- Forgets to eat, eats only one kind of food, or eats constantly.
- Loses or misplaces things by hiding them in odd places such as putting clothes in the dishwasher, or forgets where things go.
- Constantly checks, searches, or hoards things of no value.
Moderate Alzheimer’s
- Changes in behavior; lack of concern for appearance, hygiene, and sleep become more noticeable.
- Misidentifies people, such as thinking a son is a brother or that a wife is a stranger.
- Poor judgment creates safety issues when the Alzheimer patient is left alone—may wander and risk exposure, poisoning, falls, self-neglect, or exploitation.
- Has trouble recognizing familiar people and own personal possessions; may take things that belong to others.
- Continuously repeats stories, favorite words, statements, or motions like tearing tissues.
- Has restless, repetitive movements in the late afternoon or evening, such as pacing, trying doorknobs, fingering draperies.
- Cannot organize thoughts or follow logical explanations.
- Has trouble following written notes or completing tasks.
- Makes up stories to fill in gaps in memory. For example, might say, “Mama will come for me when she gets off work.”
- May be able to read but cannot formulate the correct response to a written request.
- May accuse, threaten, curse, fidget, or behave inappropriately, such as kicking, hitting, biting, screaming, or grabbing.
- May become sloppy or forget manners.
- May see, hear, smell, or taste things that do not exist.
- May accuse spouse of an affair or family members of stealing.
- Naps frequently or awakens at night believing it is time to go to work.
- Has more difficulty positioning the body to use the toilet or sit in a chair.
- May think a mirror image is following him or a television story is happening to her.
- Needs help finding the toilet, using the shower, remembering to drink, and dressing appropriately for the weather or occasion.
- Exhibits inappropriate sexual behavior, such as mistaking another individual for a spouse. Forgets what is private behavior and may disrobe or masturbate in public.
Severe Alzheimer’s
- Doesn’t recognize self or close family.
- Speaks in gibberish, is mute, or is difficult to understand.
- May refuse to eat, chokes, or forgets to swallow.
- May repetitively cry out, pat, or touch everything.
- Loses control of bowel and bladder.
- Loses weight and skin becomes thin and tears easily.
- May look uncomfortable or cry out when transferred or touched.
- Forgets how to walk or is too unsteady or weak to stand alone.
- May have seizures, frequent infections, falls.
- May groan, scream, or mumble loudly.
- Sleeps more.
- Needs total assistance for all activities of daily living.
Alzheimer’s and women: the statistics
- Up to 4.5 million Americans suffer from Alzheimer’s disease (AD).
- Most Alzheimer’s sufferers are aged 60 and older although there are some people who get Alzheimer’s at a younger age.
- About 3% of Americans between the ages 65 and 74 have Alzheimer’s.
- Almost half of elderly people over the age of 85 may have Alzheimer’s.
- More than seven out of 10 people with AD live at home, where almost 75% of their care is provided by family and friends. The remainder is “paid” care costing an average of $19,000 per year. Families pay for almost all of this care out of pocket.
- Half of all nursing home residents have AD or a related disorder.
5. How does Alzheimer’s affect women differently?
Even though the likelihood for developing Alzheimer’s is nearly the same for men and women (though women are slightly more likely to develop Alzheimer’s), it affects more women because women have a longer life span. Therefore, there are more aged women, and thus more women with Alzheimer’s.
Estrogen
For a long time, researchers believed that the female hormone estrogen could prevent Alzheimer’s in women. Many women have been taking hormone therapy after menopause for various reasons, one of which was to prevent Alzheimer’s. Evidence for a protective effect of hormones is contradictory, though. At this point, researchers believe that there is not enough evidence to warrant taking hormone therapy to prevent Alzheimer’s.
Women as caregivers
Women are more often involved in caring for aging relatives with Alzheimer’s, a very difficult task. Not only do Alzheimer’s sufferers need a great deal of physical assistance, but those with severe Alzheimer’s may need assistance in every daily activity. Also, devoting your life to an Alzheimer’s patient can be emotionally devastating. Studies show that women who care for Alzheimer’s patients are at increased risk for depression and anxiety and twice as likely as other women to develop cardiovascular disease.
Diagnosis and Treatment
Diagnosis
The first symptoms of Alzheimer’s may be so mild that the person doesn’t even notice them. Memory loss, like problems remembering recent events or the names of familiar people, may appear. However, as the disease progresses, the symptoms become much more severe. It is important to catch Alzheimer’s early so that the sufferer can take an active part in planning for the future.
The only way to make an absolute diagnosis of Alzheimer’s is by looking at the brain tissue to identify plaques and tangles, which can only be done after death in an autopsy. Therefore, the best diagnosis doctors can give is a probable diagnosis. To make these “probable” diagnoses, doctors will take a complete medical history that will include questions about general health, past medical conditions, and any problems that person has had in carrying out daily tasks.
The doctor will then perform some medical tests, like taking blood or urine samples, to determine what other possible diseases could be causing the symptoms. He or she also may conduct a brain scan to see whether there is anything abnormal in the brain. The doctor may conduct several neuropsychological tests to measure memory, problem solving, attention, counting ability, and language.
Treatment
So far, there is no cure for Alzheimer’s, although a great deal of research is being conducted to try to find one. There are, however, certain treatments that can slow the worsening symptoms. These treatments are most likely to be effective when the illness is diagnosed early.
After people are first diagnosed, they usually live with Alzheimer’s for between 8 and 10 years, although some people may live for as many as 20 years. The development of the disease varies from person to person, and it depends on the stage at which Alzheimer’s is diagnosed. Namenda® is a drug approved for use in people with moderate-to-severe forms of the disease. Some people in the early and middle stages may benefit from other drugs. The following drugs may help prevent some symptoms from worsening for a limited amount of time: Cognex®, Aricept®, Exelon®, and Razadyne®.
Certain medicines that are used to help reduce the risk of heart disease may also help prevent Alzheimer’s and slow its progression.
People with Alzheimer’s often have high levels of an amino acid called homocysteine in the blood. Since folic acid and vitamins B6 and B12 help to reduce this amino acid, studies are now being conducted to see how these substances may be able to help slow rates of mental deterioration.
Vitamin E: Research has shown that increasing levels of vitamin E can help slow the progression of some consequences of Alzheimer”s disease. Vitamin E can be found in wheat germ oil, almonds, sunflower seeds, sunflower oil, hazelnuts, peanuts, spinach, broccoli, kiwis, mangoes, and other foods.
There are also certain medicines that may help control the behavioral symptoms associated with Alzheimer’s, like sleeplessness, agitation, wandering, anxiety, despression, and psychosis. By treating these symptoms, life may be easier for both patients and caregivers.
Empower Yourself
Living with Alzheimer’s
Alzheimer’s sufferers
Learning that you have Alzheimer’s is a shocking and scary thing. Alzheimer’s disease is a progressive disease, making some changes in the way you do everyday tasks is important so you can have more control of how your lifestyle changes. Some aspects of your life that you may want to think about are listed below.
Difficult tasks: Some tasks that once seemed simple, like cooking a meal or balancing your checkbook, may begin to be more difficult. It helps if you do these tasks at times in the day when you normally feel at your best. Don't rush through these activities; take your time. If you start to feel overwhelmed by a task, take a break and then go back to it. Make sure you ask for help if something is too difficult.
Communicating: Another effect of Alzheimer’s is that you may have trouble understanding what people are saying to you, or you may have a hard time expressing what you want to say. Be patient with yourself and take the time to choose the right words. Sometimes it helps to write down your thoughts instead of verbalizing them. If you want to have a specific conversation, find a quiet place where there is no distracting noise.
Driving: A time may come when it is no longer safe for you to drive. This may be difficult to accept, but it’s important to be honest with yourself. Discuss with your doctor and your family how and when you will make decisions about driving. Also make plans for other transportation options, involving family, friends, or community services.
Memory changes: When your memory begins to fail, you may need to have reminders for things that you may not have thought would slip your mind, like eating or going to the bathroom. The following suggestions can help you cope and maintain some independence:
- Post a schedule of your everyday activities, like mealtimes, exercise, and your medication schedule.
- Ask someone to call to remind you of appointments or medication schedule.
- Keep a book containing important notes, like people’s names, thoughts you don’t want to forget, and directions to your home.
- Post important phone numbers in large print next to the phone.
- Ask someone to help you label and store medications in a pill organizer.
- Keep a calendar and mark off days to keep track of time.
- Label photos of people you see often or of people you want to remember.
- Label cupboards and drawers with words or pictures that explain what’s inside.
- Post reminders to turn off appliances and lock doors.
Relationships: Your illness can be a difficult thing for the people close to you. Be honest about your diagnosis, and how it makes you feel. Encourage your family members and friends to do the same. Try to continue to participate in as many activities as you can and talk to your partner or loved ones about how they can help you. If you have a partner, it may help to seek counseling about the changes that may occur in your relationship as a result of your illness. Continue to seek ways that you and your partner can fulfill the need for intimacy.
Write, draw, or record your thoughts and feelings, any advice you may want to give people, and anything else you want to share. You can give these materials to the people close to you so they will know the things you want to tell them, which you may not be able to express eventually.
Families and friends: It is very difficult to watch a loved one suffer from Alzheimer’s. You may feel loss over the changes in your relationship with a loved one. Stress and despression are common symptoms of the people who care for a loved one with Alzheimer’s disease. It is important to acknowledge your feelings and to remember to care for yourself. Sometimes people get so involved in helping the person who is ill that they forget to care for themselves. You need to continue the activities you enjoy. Don’t give up your life because your loved one is suffering. There is a lot you can do to help them, and there are some things you cannot do. Forgive yourself for not being able to always make things okay. Support groups for the friends and family of Alzheimer’s sufferers can be helpful, or you can call 1-800-272-3900 to speak to a care consultant at the Alzheimer’s Association.
Frequently asked questions
What is dementia?
Dementia is a group of symptoms characterized by a decline in intellectual functioning severe enough to interfere with a person’s normal daily activities and social relationships. Alzheimer’s disease is the most common cause of dementia in older persons.
Are there drugs that can delay the onset of Alzheimer’s disease (AD)?
Aricept® (donepezil) is an AD treatment drug that appears to have a slowing though limited effect on the progression from mild cognitive impairment to AD, according to a study published in the April 2005 New England Journal of Medicine.
These patients had the memory-related syndrome of mild cognitive impairment, a transitional stage between the forgetfulness of normal aging and the more serious memory decline and behavioral problems associated with AD. Over the first year of the 3-year trial, mild cognitive impairment patients treated with Aricept had a reduced risk of progressing to AD compared with patients who took placebo, an inactive pill. The study found the effect of the Aricept treatment lasted longer (up to 2 to 3 years) in those patients carrying the ApoE4 gene. Previous studies have shown that people with the ApoE4 gene have a higher propensity to develop Alzheimer’s than the general population. The findings of this study open the door for discussion of donepezil treatment on an individual basis for patients with mild cognitive impairment. Source: Mayo Clinic, Rochester, Minnesota, and the National Institute on Aging.
Is Alzheimer’s disease (AD) hereditary?
Familial Alzheimer’s Disease (FAD) is a rare form of the disease, affecting less than 10% of AD patients. All FAD is early-onset, meaning the disease develops before age 65. It is caused by gene mutations on chromosomes 1, 14, and 21. Even if one of these mutated genes is inherited from a parent, the person will almost always develop early-onset AD. All offspring in the same generation have a 50/50 chance of developing FAD if one of their parents had it.
The majority of AD cases are late-onset, usually developing after age 65. Late-onset AD has no known cause and shows no obvious inheritance pattern. Although, in some families, clusters of cases are seen. Although a specific gene has not been identified as the cause of late-onset AD, genetic factors do appear to play a role in the development of this form of the disease. The ApoE gene on chromosome 19 has three forms—ApoE2, ApoE3, and ApoE4. Studies have shown that people who inherit the E4 version of the gene are more likely to develop the late-onset form of AD. Scientists estimate that an additional four to seven genes influence the risk of developing late-onset AD. Two of these genes are UBQLN1 and SORL1, which are located on chromosomes 9 and 11, respectively.
Genetic risk factors alone are not enough to cause the late-onset form of AD, so researchers are actively exploring education, diet, and environment to learn what role they might play in the development of Alzheimer’s.
Whom should I consult if I suspect Alzheimer’s disease?
First, see your regular family physician. The physician will probably conduct a variety of tests to determine whether you have probable Alzheimer’s. Neurologists, gerontologists, and geriatric psychiatrists may also become part of the treatment team.
What kind of information should I bring to my first doctors visit?
Bring any medical records and a list of the medicines you are currently taking to your first visit. If you don't know the names of the drugs, bring the pill bottles with you. A medication or a combination of medications can sometimes cause symptoms that resemble Alzheimer’s disease. It's a good idea to make a list of symptoms or behaviors in yourself or your loved one that you're concerned about and give it to your doctor.
What are the diagnostic tests used in Alzheimer’s disease (AD)?
The term “dementia” refers to a progressive deterioration of intellectual functions due to a brain disease, organ failure, toxins, or other causes. In western countries, AD accounts for more than half of dementia cases.
At present, the only way to diagnose AD definitely is to perform a brain autopsy. If a patient exhibits Alzheimer-like symptoms while alive and the brain tissue contains the microscopic abnormalities typical of AD, then a definitive diagnosis of AD can be made. While the patient is alive, physicians can correctly diagnose AD about 90% of the time on the basis of a physical examination, mental and behavioral symptoms, neuropsychological tests, and laboratory tests.
The physician first takes a history of mental and behavioral symptoms, using information provided by the patient and the family. In nearly 75% of cases, AD starts with the inability to remember recent events and to learn and retain new information. Early-stage AD patients experience memory problems that interfere with daily living and that become steadily worse.
Other early AD symptoms can include difficulty with managing money, driving, orientation, shopping, following instructions, abstract (conceptual) thinking, and finding the right words. There may also be other problems, such as poor judgment, emotional instability, and apathy. AD can be distinguished from other causes of dementia in part by the symptoms exhibited, the extent to which these symptoms occur, and the speed with which the disease progresses.
Neuropsychological tests identify behavioral and mental symptoms that are associated with brain injury or abnormal brain function. Determining which of the many neuropsychological tests to use with a particular patient depends on the symptoms the patient is exhibiting and how far advanced the dementia is. Usually, physicians start with a brief screening tool, such as the Mini-Mental Status Examination (MMSE), to help confirm that the patient is experiencing problems with intellectual functions. The MMSE includes tests of memory, attention, mathematical calculation, and language. In another section, the patient copies a design, such as intersecting pentagons.
If a patient has severe dementia, further neuropsychological testing beyond the MMSE and perhaps other screening tools, are usually not necessary. However, for patients with mild intellectual deficits, more tests may be needed to determine whether the patient is simply showing signs of advanced age or is developing AD. The patient may be referred to a neuropsychologist, who will administer a battery of tests to identify deficits more specifically.
A number of different laboratory tests can be performed in order to help identify the cause of dementia, although the American Academy of Neurology (AAN) recommends routine use of only three tests. One is the thyroid function test, which measures blood levels of hormones secreted by the thyroid, a gland located in the neck. A condition known as hypothyroidism, in which the thyroid fails to produce sufficient thyroid hormones, is common in the elderly and, in some cases, can cause dementia. Another test involves measuring the level of vitamin B12 in the blood. Vitamin B12 deficiency is also common in the elderly and can cause dementia.
Finally, the AAN recommends a brain scan, using computed tomography or structural magnetic resonance imaging. This can rule out other possible causes of dementia, including brain tumors, stroke, blood accumulation on the brain surface, or other conditions. In addition, the appearance in the brain scan of characteristic structural changes that occur in the brains of AD patients can lend support to an AD diagnosis. Using the patient’s history of symptoms and the results from the physical examination, neuropsychological and laboratory tests, the physician can accurately diagnose AD in nine out of 10 cases.
How long does Alzheimer’s disease (AD) last on average?
On average, patients with AD live for 8 to 10 years after they are diagnosed. AD can last as long as 20 years, and always ends in death.
Is there a genetic test to determine whether you have a predisposition to Alzheimer’s?
Because apolipoprotein is associated with an already well-studied condition—heart disease—a blood test is available to identify which ApoE alleles a person has. However, this blood test cannot tell people whether or when they will develop Alzheimer’s. Although some people want to know whether they will develop Alzheimer’s disease later in life, this prediction is not yet possible. In fact, some researchers believe that ApoE tests or other screening measures may never be able to predict Alzheimer’s with 100% accuracy.
Is there a connection between Alzheimer’s Disease (AD) and aluminum? Should I get rid of my aluminum pots and pans?
Metals have been implicated in neurodegenerative diseases, although it is unlikely that they are the sole cause for any of them. Interest in a possible connection between aluminum and AD arose when autopsies of the brains of Alzheimer’s patients revealed higher than normal concentrations of aluminum. The toxicity of aluminum has been the subject of much controversy in the past few decades. Although it is generally believed that the metal is harmless to human health, a role for aluminum in AD has been suggested. The exact mechanism of aluminum toxicity is not known, and a direct causal role has not been determined. Many scientists believe that the buildup of aluminum in the brain of Alzheimer’s patients is the result of damage to nerve cells, rather than the cause of this damage. Some studies have even suggested that the processing of the brain tissue at autopsy may artificially raise aluminum levels. However, there is some evidence showing that aluminum compounds may increase the formation of agents called reactive oxygen species. These substances, which are constantly formed in the human body, have been shown to damage proteins and play a role in various diseases. In relation to AD, these substances may be involved in nerve cell damage. Aluminum is also known to alter the activity of several key enzymes in the central nervous system. Furthermore, studies show an elevated risk of AD in areas where there is high concentration of aluminum in drinking water. In contrast, many studies examining antacid exposure and AD that have been largely negative (antacids contain thousands of times more aluminum than the amounts injested in drinking water). Exposure to aluminum from cooking utensils, baking powder, deodorants, or antacids is not sufficient to cause the disease. In total, these studies provide some evidence that potential links between aluminum and AD exist, but this area requires continued research efforts.
What is the cost of Alzheimer’s disease (AD)?
In terms of healthcare expenses and lost wages of both patients and their caregivers, the cost of AD nationwide is estimated to be $100 billion per year. The yearly cost of caring for one Alzheimer’s patient ranges from $18,400 to $36,100 depending on how advanced the disease is. The average direct cost of caring for an Alzheimer’s patient from diagnosis to death is $174,000. According to MetLife market surveys, on average, home health aides cost $19 per hour, the annual cost for an assisted living facility is $34,860, and the daily cost of a private room in a nursing home is $203, which totals $74,095 per year.
Is Alzheimer’s covered by Medicare and Medicaid?
Medicare is a federal health insurance program for people age 65 or older who are receiving Social Security retirement benefits. A person needs to meet specific eligibility requirements in order to receive assistance from this program. Medicare covers some, but not all, of the services a person with Alzheimer’s disease may require. Medicaid is a federal program for certain individuals and families with low incomes and resources, administered by each state, so eligibility and benefits vary from state to state. The program is typically administered by a state agency. Medicaid can cover all or a portion of nursing home costs. A person with Alzheimer’s can qualify for long-term care only if he has minimal income and cash assets. Medicaid may be applied for by calling your state's Department of Human Services or Medicaid Assistance Program.
Are memory problems an indication of Alzheimer’s disease (AD)?
Mild forgetfulness and memory delays often occur as part of the normal aging process. Older individuals simply need more time to learn a new fact or to remember an old one. We all have occasional experiences when it is difficult to remember a word or someone's name; however, those afflicted with AD will find these symptoms progressing in frequency and severity. Everyone from time to time will forget where they placed their car keys; an individual with AD, however, may not remember what the keys are for.
A condition called mild cognitive impairment (MCI), which consists of pronounced forgetfulness, but not dementia, has recently been identified as a major risk factor for developing AD. While all patients who develop some form of dementia go through a period of MCI, not all patients exhibiting MCI will go on to develop AD.
Many conditions may contribute to the development of memory problems and dementia; AD is just one of them. A decline in intellectual functioning that significantly interferes with normal social relationships and daily activities is characteristic of dementia, of which AD is the most common form. AD and multi-infarct dementia (a series of small strokes in the brain) cause the vast majority of dementias in the elderly. Other possible causes of dementia-like symptoms include infections, drug interactions, a metabolic or nutritional disorder, brain tumors, despression, or another progressive disease like Parkinson’s disease.
If memory loss increases in frequency or severity, makes an impression on friends and family, begins to interfere with daily activities (employment tasks, social interactions, and family chores, for example), it is advisable to seek out qualified professional advice. A physician with extensive knowledge, experience, and interest in dementia and memory problems should be involved in the evaluation process.
Glossary of Alzheimer’s terms
Accelerated living benefit: This benefit entitles the life insurance policyholder to collect the benefits before death.
Acetylcholine: A neurotransmitter released at autonomic synapses and neuromuscular junctions.
Acupuncture: The practice of inserting needles into the body with a therapeutic aim, such as to reduce pain or induce anesthesia.
Alleles: One of the different forms of a gene that can exist at a single locus (spot on a chromosome) or site.
Amyloid: A waxy, translucent substance consisting of protein in combination with polysaccharides that is deposited in some animal organs and tissues under abnormal conditions (as Alzheimer’s disease).
Amyloid plaque: Build up of amyloid protein and a primary hallmark of Alzheimer’s Disease.
Amyloid precurser protein: A gene that, when mutated, causes an abnormal form of the amyloid protein to be produced. See APP.
Antiagitation drugs: Broadly categorized type of drugs with strong sedating effects.
Antianxiety drugs: Also called anxiolytics, these drugs help manage a patient who has anxiety.
Antibiotics: A broad category of drugs used to address infections in patients.
Antidepressants: An antiagitation drug to manage behavioral problems of a patient who suffers from despression.
Antipsychotic drugs: Also called neuroleptics, this type of drug is used to help manage behavioral problems for a patient with a serious mental disorder.
Anxiolytic: A drug that relieves anxiety.
ApoE: The abbreviation for apolipoprotein E, a gene that codes for a protein in lipoproteins (complexes of fat and protein).
Apolipoprotein E (ApoE): A gene that codes for a protein in lipoproteins (complexes of fat and protein). The abbreviation for apolipoprotein E is ApoE.
APP: A gene, that when mutated, causes an abnormal form of the amyloid protein to be produced. APP stands for amyloid precurser protein.
Autosomal dominant inheritance: A gene on one of the autosomes (nonsex chromosomes) that, if present, will almost always produce a specific trait or disease.
Axon: A long fiber of a nerve cell (a neuron) that acts somewhat like a fiber-optic cable carrying outgoing messages.
Beta amyloid: An amyloid derived from a larger precursor protein that is a component of the neurofibrillary tangles and plaques characteristic of Alzheimer’s disease.
Beta-secretase: An enzyme that catalyses the splitting of interior peptide bonds in a protein. Beta-secretase acts by trimming off a protein protruding from a brain cell. This small snip is thought to be the first step in the buildup of microscopic balls of debris known as amyloid that are toxic to brain cells.
Blinded study: A research study in which participants do not know whether they are in the experimental or control group.
Care manager: In medicine or public health, one who applies his or her knowledge to the benefit of a community or individual.
Case manager: One who coordinates the care of a patient through the diagnosis and treatment of a disease
Celecoxib: An anti-inflammatory drug thought to reduce Alzheimer’s risk in persons with a family history of dementia.
Cerebrospinal: Of or relating to the brain and spinal cord or to both together with the cranial and spinal nerves that innervate voluntary muscles.
Cerebrovascular disease: Disease of the cerebrum and its blood vessels.
Cholinesterase inhibitors: Class of drugs known to delay the breakdown of acetylcholine.
Chromosome: A visible carrier of genetic information.
Circadian rhythm: The sleep/wake cycle.
Cognitive: Pertaining to cognition, the process of being aware, knowing, thinking, learning, and judging.
Congregate housing: Group housing or independent living facilities available to the elderly and disabled, with private living quarters and common dining and social areas.
Control group: The standard by which experimental observations are evaluated.
CT scan: Pictures of structures within the body created by a computer that takes the data from multiple X-ray images and turns them into pictures on a screen. CT means computerized tomography.
Declarative memory: Recalling newly learned information about people, places, and things.
Dementia: Significant loss of intellectual abilities, such as memory capacity, that are severe enough to interfere with social or occupational functioning.
Donepezil: A drug currently approved in preventing the development of Alzheimer's in people diagnosed with mild cognitive impairment.
Dopamine: An amino acid that occurs especially as a neurotransmitter in the brain.
Double-blind study: A research study in which neither the participants nor the study staff know which participants are receiving the experimental treatment and which ones are getting either a standard treatment or a placebo.
Double-masked study: A research study in which neither the participants nor the study staff know which participants are receiving the experimental treatment and which ones are getting either a standard treatment or a placebo.
Elder law attorney: A paid professional who helps ensure a loved one's eligibility for Medicaid and protect his or her assets.
Enzymes: Complex proteins that are produced by living cells and bring about specific biochemical reactions at body temperature.
Epidemiological: All the factors that deal with the incidence, distribution, and control of disease in a population.
Epidemiological study: Population-based research study.
Estrogen: Estrogen is a female hormone produced by the ovaries. Estrogen deficiency can lead to osteoporosis.
Family practice: The medical specialty that provides continuing and comprehensive health care for the individual and family. It is a specialty that integrates the biological, clinical, and behavioral sciences. The scope of family practice encompasses all ages, both sexes, each organ system, and every disease entity. (From the American Academy of Family Physicians)
Free radicals: A molecule or atom that contains an unpaired electron, but is neither positively or negatively charged. They are usually highly reactive and unstable.
Gamma secretase: An enzyme partly responsible for plaque buildup in the brain characteristic of Alzheimer’s.
Gastrointestinal: Of, relating to, affecting, or including both stomach and intestine.
Gene expression: The screening of large numbers of genes to see whether they’re active under certain conditions.
General practitioner: A physician whose practice is not limited to a specialty.
Geriatric care manager: Functions as a surrogate family member when the actual family is unable to interact with Medicaid.
Geriatric psychiatrist: A specialist in the branch of medicine concerned with both the prevention of psychiatric illness in older people.
Geriatrics: The branch of medicine concerned with the diagnosis, treatment, and prevention of disease in older people and the problems specific to aging.
Gingko biloba: A natural product currently the focus as a potential treatment for Alzheimer’s and vascular dementia.
Glia: Supporting tissue that is intermingled with the essential elements of nervous tissue, especially in the brain and spinal cord.
Guardian: A court-supervised decision maker appointed involuntarily by the court.
Hippocampus: An area buried deep in the forebrain that helps regulate emotion and memory.
Homocysteine: A group of corresponding amino acids found in proteins.
Hospice: A facility or program designed to provide a caring environment for supplying the physical and emotional needs of the terminally ill.
Ibuprofen: A nonsteroidal, anti-inflammatory drug used to relieve pain and fever.
Income test: A means-tested cash assistance program that forms an important part of the safety net for the elderly, blind, and disabled.
Indomethacin: A nonsteroidal, anti-inflammatory drug, or analgesic, used especially in treating arthritis.
Inflammation: A basic way in which the body reacts to infection, irritation, or other injury. Key features include redness, warmth, swelling, and pain. Inflammation is now recognized as a type of nonspecific immune response.
Internal medicine: A medical specialty dedicated to the diagnosis and medical treatment of adults.
Magnetic resonance imaging (MRI): A special radiology technique designed to image internal structures of the body using magnetism, radio waves, and a computer to produce the images of body structures.
Masked study: A research study in which participants do not know whether they are in the experimental or control group.
MCI: A syndrome of memory impairment that does not significantly impact daily activities and is not accompanied by declines in overall cognitive function. Abbreviation for mild cognitive impairment.
Medicare Part A: Federal insurance program that helps pay for care in a hospital or skilled nursing facility, home health care, and hospice care.
Medicare Part B: Federal insurance program that helps pay for doctors, outpatient hospital care, and other medical services not requiring hospitalization.
Mild cognitive impairment: A syndrome of memory impairment and diminished awareness or judgement.
Mitochondria: The mitochondria are round or long parts of a organelle or tissue cell. They consist of two sets of membranes and are located in the cell's cytoplasm outside the nucleus.
MRI: A special radiology technique designed to image internal structures of the body using magnetism, radio waves, and a computer to produce the images of body structures. MRI stands for magnetic resonance imaging.
Naproxen: An anti-inflammatory agent used in the treatment of rheumatoid conditions.
Neurodegenerative: Relating to or characterized by degeneration of nervous tissue.
Neurofibrillary tangles: A fine fiber found in cytoplasm signalling an abnormality of the hippocampus and neurons of the cerebral cortex that occurs especially in Alzheimer’s disease.
Neuroleptics: A term that refers to the effects of antipsychotic drugs on a patient, especially on his or her cognition and behavior.
Neurologist: A doctor who specializes in the diagnosis and treatment of disorders of the nervous system.
Neuron: One of the cells that constitute nervous tissue, and has the property of transmitting and receiving nervous impulses.
Neuropsychiatrist: A specialist in the branch of medicine concerned with both neurology and psychiatry.
Neuropsychological: Concerned with the integration of psychological observations on behavior and the mind with neurological observations on the brain and nervous system.
Neuropsychologist: A psychologist who has completed special training in the neurobiological causes of brain disorders and specializes in diagnosing and treating these illnesses using a predominantly medical (as opposed to psychoanalytical) approach.
Neurotransmitter: A substance (such as norepinephrine or acetylcholine) that transmits nerve impulses from one cell to another across a synapse.
Nonpharmacological: Various strategies aimed at managing problematic behaviors, including therapy, changes in the home or environment, and the use of appropriate communication techniques.
Nonsteroidal anti-inflammatory drugs: One of a number of commonly prescribed medications for the inflammation of arthritis and other body tissues, such as in tendinitis and bursitis. See NSAIDs.
NSAIDs: One of a number of commonly prescribed medications for the inflammation of arthritis and other body tissues, such as in tendinitis and bursitis. NSAIDs stands for nonsteroidal anti-inflammatory drugs.
Outpatient: A patient who visits a hospital, clinic, or facility for diagnosis or treatment, but is not hospitalized overnight.
Oxidative stress: Stress is caused by the release of molecules from normal cellular processes.
Paranoid delusion: An abnormal mental state characterized by suspiciousness and/or persecutory trends.
Pathological: Due to or involving disease.
Pathology: The study of the essential nature of diseases and especially of the structural and functional changes they produce.
Peptide: Small molecular fragments that come from two or more amino acids by combining the amino group of one acid to the carboxyl group of another. They are obtained by partial hydrolysis of proteins.
PET: Positron emission tomography, a highly specialized imaging technique using short-lived radioactive substances. The technique produces three-dimensional colored images.
Pharmacological: The properties and reactions of drugs, especially with relation to their therapeutic value and medical toxicology.
Phosphate: A form of phosphoric acid. Calcium phosphate makes bones and teeth hard.
Phosphorylation: Phosphorylation is a biochemical process that involves the addition of phosphate to an organic compound.
Placebo: A “sugar pill” or any dummy medication or treatment.
Plaque: A localized abnormal patch on a body part or surface.
Positron emission topography: A highly specialized imaging technique using short-lived radioactive substances. This technique produces three-dimensional colored images. See PET.
Prednisone: A drug used as an anti-inflammatory agent, especially in the treatment of arthritis, an antineoplastic agent, and as an immunosuppressant.
Presenilin 1: A gene that, when mutated, causes an abnormal presenilin 1 protein to be produced.
Presenilin 2: A gene that, when mutated, causes an abnormal presenilin 2 protein to be produced.
Progesterone: A female hormone that helps prepare the uterus (or womb) to receive and sustain the fertilized egg.
Protein kinases: An enzyme that catalyzes the transfer of phosphate groups from a high energy phosphate-containing molecule to a substrate.
Protein phosphorylation: A process that alters a given protein’s activity by changing its molecular structure through the addition or removal of a kind of decoration called “phosphate.”
Psychosis: In the general sense, a mental illness that markedly interferes with a person's capacity to meet life's everyday demands. In a specific sense, it refers to a thought disorder in which reality testing is grossly impaired.
Psychosocial: Pertaining to one’s psychological development in the context of one’s social environment.
Receptor: A cell or group of cells that receive stimuli.
Respite program: A program that enables caregivers to take needed breaks from caregiving while knowing their loved one is well taken care of.
Reverse mortgage: A way of converting the equity of one’s home into cash without having to sell the home.
Second messenger: A substance that mediates a biological effect.
Secretase: The enzyme involved in cutting amyloid into the shorter beta-amyloid form.
Sedatives: Drugs that calm a patient down, easing agitation and permitting sleep. Sedatives generally work by modulating signals within the central nervous system.
Selegiline: A drug sometimes used alone to treat endogenous despression or to treat dementia associated with Alzheimer’s Disease.
Signal transduction: A basic process in molecular cell biology involving the conversion of a signal from outside the cell to a functional change within the cell.
Synapse: The point of connection usually between two nerve cells. More specifically, a specialized junction at which a nerve cell (a neuron) communicates with a target cell.
Synapsing: To form a synapse or come together in synapsis.
Synaptic connection: The release of a chemical known as a neurotransmitter by a nerve cell, and its detection by its neighbor nerve cell.
Tangles: Twisted fibers that build up inside the nerve cells.
Tau: A protein that channels chemical messages inside nerve cells.
Thyroid: Pertaining to the thyroid gland or to a preparation made of mammalian thyroid tissue to treat hypothyroidism.
Thyroid gland: A gland located in the lower part of the neck below the Adam’s apple.
Transgenic: Having genetic material (DNA) from another species. The term can be applied to an organism with genes from another organism that have been incorporated either artificially or naturally.
Viatical benefits: The conversion of a life insurance policy into cash before the death of the insured.
Viatical settlement company: A company that purchases life insurance policies by offering an amount typically less than the face value of the policy and pays a lump sum amount or regular installments to the policyholder.
Ward: The person on whose behalf decisions are being made.
Alzheimer’s resources and tools
Government Agencies
*Accepts Spanish calls
National Institute on Aging Information Center
PO Box 8057
Gaithersburg, MD 20898-8057
1-800-222-2225 (toll-free)
1-800-222-4225 (TTY toll-free)
http://www.nia.nih.gov
ADEAR Center
PO Box 8250
Silver Spring, MD 20907 8250
800-438-4380
e-mail: adear@nia.nih.gov
http://www.alzheimers.nia.nih.gov
* National Women’s Health Information Center, OWH, HHS
8270 Willow Oaks Corporate Drive
Fairfax, VA 22031
Phone: (800) 994-9662
TDD: (888) 220-5446
Fax: (703) 663-6942
http://www.4women.gov
National Institute of Neurological Disorders and Stroke (NINDS), NIH, HHS
NIH Neurological Institute
PO Box 5801
Bethesda, MD 20824
Phone: (800) 352-9424
http://www.ninds.nih.gov
Department of Health and Human Services
Food and Drug Administration
5600 Fishers Lane
Rockville, Maryland 20857
Phone: (888) INFO-FDA
http://www.fda.gov/fdac/features/1998/498_dep.html
Office on Women’s Health, HHS
200 Independence Avenue, SW, Room 712E
Washington, DC 20201
Phone: (202) 690-7650
Fax: (202) 205-2631
http://www.womenshealth.gov/owh
* Agency for Healthcare Policy, Research and Quality (AHCPQ)
540 Gaither Road, Suite 2000
Rockville, MD 20850
Phone: (800) 358-9295
TDD: (888) 586-6340
http://www.ahrq.gov
* National Center for Complementary and Alternative Medicine, NIH, HHS
PO Box 7923
Gaithersburg, MD 20898
Phone: (888) 644-6226
TTY: (866) 464-3615
Fax: (866) 464-3616
http://nccam.nih.gov
Office of Research on Women’s Health, NIH, HHS
Building 1, Room 201
Bethesda, MD 20892-0161
Phone: (301) 402-1770
Fax: (301) 402-1798
http://orwh.od.nih.gov/index.html
Office of Women’s Health, CDC, HHS
Parklawn Building, Room 1561
5600 Fishers Lane
Rockville, MD 20857
Phone: (301) 827-0350
Fax: (301) 827-0926
http://www.fda.gov/womens/default.htm
Private Organizations
Alzheimer’s Association
225 North Michigan Avenue
Chicago, IL 60601-7633
800-272-3900 (toll-free)
http://www.alz.org
Mental Health America
Mental Health America
2000 N. Beauregard Street, 6th Floor
Alexandria, Virginia 22311
Phone: (800) 969-6MHA (6642)
TTY: (800) 433-5959
Fax: (703) 684-5968
http://www.nmha.org
Mayo Clinic
4500 San Pablo Road
Jacksonville, FL 32224
Phone: (904) 953-2000
http://www.mayoclinic.org
Black Women’s Health Imperative
1420 K St. SW, Suite 1000
Washington, DC 20003
Phone: (202) 548-4000
Fax: (202) 543-9743
http://www.blackwomenshealth.org
Boston Women’s Health Book Collective (Publications available in Spanish)
34 Plympton Street
Boston, MA 02118
Phone: (617) 451-3666
Fax: (617) 451-3664
http://www.ourbodiesourselves.org
National Women’s Health Network
514 10th Street, NW, Suite 400
Washington, DC 20004
Phone: (202) 628-7814
http://www.nwhn.org
Newsletters, Magazines, Reports
Healthy Women Today
The National Women’s Health Information Center
http://www.womenshealth.gov/newsletter
National Institute of Neurological Disorders and Stroke
Subscribe to the newsletter to get up-to-date news on research and breakthroughs.
http://www.ninds.nih.gov/funding/nindsnotes/nindsnoteslistserv.htm
National Institute on Aging
Check out all the excellent publications that can teach you more about Alzheimer’s and keep you up to date on research.
http://www.nia.nih.gov/HealthInformaton/Publications.htm
Tools
Alzheimer’s Association
Find a support group anywhere in the country.
http://www.alz.org/apps/findus.asp
Professional:
