Alzheimer's and the Importance of Early Detection

Alzheimer's disease is one of the top 10 diseases Americans die from each year, but it is the only one on that list that is expanding as the other causes of death are declining. Alzheimer's disease is a degenerative brain disease and the most common form of dementia.

"Alzheimer's is becoming a more common cause of death as the populations of the United States and other countries age," notes the Alzheimer's Association. "While other major causes of death continue to experience significant declines, those from Alzheimer's continue to rise."

One reason for this difference is that the other leading fatal illnesses are preventable, such as stroke and heart disease, but Alzheimer's cannot be prevented with lifestyle changes. According to the Alzheimer's Association, preliminary data from between 2000 and 2008 showed that deaths attributed to Alzheimer's increased 66 percent, while those attributed to the No. 1 cause of death, heart disease, decreased by 13 percent.

Such statistics make the latest Alzheimer's research so vital for those who suspect they may get the disease, those already suffering from it and their friends and family, who may provide some level of in-home caregiver support during the long course of the disease.

Some of the biggest news about Alzheimer's currently is the importance of early detection.

"Biological changes associated with Alzheimer's disease are thought to begin 10 to 15 or perhaps 20 years before an individual displays symptoms," states Dr. Heather Snyder, senior associate director of medical and scientific relations at the Alzheimer's Association. "But there is no single generally accepted way to identify the disease in its earliest stages -- before symptoms are evident. At the same time, Alzheimer's therapies are in development that may be able to slow or stop the progression of the disease."

There are efforts underway to update the diagnostic criteria in a variety of ways, including biomarker measures. This spring, the National Institute on Aging (NIA) and the Alzheimer's Association published new diagnostic criteria guidelines for Alzheimer's disease in Alzheimer's and Dementia: The Journal of the Alzheimer's Association.

You might ask: If the disease cannot currently be stopped or cured, what difference does early detection make?

"The benefits of early detection are many," says Beth Kallmyer, senior director of constituent services at the Alzheimer's Association. "People who are diagnosed early can participate in the planning of their future -- they can talk to their families about advanced directives, how they want to have their finances handled, what they want to have happen when they can't drive anymore."

Not only does this allow the person with Alzheimer's disease to feel empowered, Kallmyer says, but it's a huge relief to their caregivers and loved ones who otherewise may have to make decisions under a great deal of stress later, when the disease is in its advanced stages.

We recently posted an article on Homewatch Caregivers that pulls from the Alzheimer's Association's own 10 Signs of Alzheimer's list. There is a distinct difference between the signs of normal aging and early Alzheimer's disease. For example, someone may answer the phone and simultaneously put down their keys, then not be able to find them a few minutes later. A normal aging brain will retrace their steps and remember the moment that they answered the phone, whereas an individual with Alzheimer's disease will not remember the phone call or be able to retrace their steps.

Kallmyer points out that the role of an in-home caregiver to someone with Alzheimer's is unique in the length of the disease and increased need. "It starts with helping with memory aides and then ends when the person with Alzheimer's can do nothing for themselves," she says.

Another benefit to early detection of Alzheimer's disease is that the individual can decide if they want to be part of future Alzheimer's research by signing up to participate in clinical trials. "When somebody has a fatal illness, clinical trials can be a great way for them to feel like they are making a change," Kallmyer says. "They might feel like they are making a difference for their kids and grandkids."

Ultimately, with hopes that there will be treatments for Alzheimer's disease, the time to intervene will be in the earliest stages of the brain disease. "This approach envisions what is now common practice in heart disease," says Dr. Snyder. "Where early signs of risk -- for example, in genetic markers or in blood cholesterol and/or blood pressure levels -- can be treated to reduce the chances of heart attack or stroke later on."

Dr. Snyder said there is a lot more research to be done on Alzheimer's disease. "There are many unanswered questions in Alzheimer's disease," she says. "We do not yet know the causes of the disease, we do not know risk factors associated with Alzheimer's disease."

 

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Comments

[Lane Simonian]

11:54 AM on 09/16/2011

I like the expression that the "absence of proof is not proof of absence." High blood pressure and high glucose levels (diabetic and pre-diabetic) have already been suggested as risk factors for Alzheimer's disease, so one might conclude that lowering blood pressure or glucose levels could prevent or delay the onset of Alzheimer's disease for some individuals. Moreover, there is some evidence from animal studies that certain foods, spices, and essential oils can reduce the risks for Alzheimer's disease. Phenolic compounds (such as curcumin, cinnamon extract, grape seed extract, rosmarinic acid, eugenol, and true cinnamon essential oil) and omega 3-fatty acids (in fish oil, for instance) appear to impede the pathways that lead to Alzheimer's disease (Cole et al.) and treat cognitive impairment itself. Ketones (from coconut oil, for instance) may be similarly beneficial. Human clinical trials using essential oils via aromatherapy or tinctures have produced major improvements in cognitive function in patients with dementia, including those with Alzheimer's disease (Jimbo et al. and Akhondzadeh et al.). There is indeed much more knowledge regarding Alzheimer's disease than the author suggests and this knowledge if put to concerted use probably would lead to the prevention and treatment of this disease.

[Robin2286]

11:04 PM on 09/14/2011

Excellent article, however there is significant research that suggests a link between diabetes and cardiovascular disease as contributing factors to Alzheimer's. The physiology is quite simple. In the case of diabetes (insulin resistance), amyloid protein, which is normal and common in the human brain, can not be properly metabolized. As a result, amyloid builds up into stacks (beta sheets) which disrupt synaptic function, and ultimately lead to neuron malfunction indicative of Alzheimer's.

Similarly with cardiovascular disease, the narrowing of blood vessels again leads to an inability to metabolize amyloid protein, allowing it to build up into malignant stacks of beta amyloid protein.

In summary, since we can not diagnose presently before cognitive onset, we do not know if lifestyle change or therapies can have a major effect, although the physiology and commonalities of diabetes, cardiovascular disease, and Alzheimer's appear to be quite inter-related. Therefore, diagnosis at the earliest stages (10+ years before cognitive onset), while still in the development phase, has the potential to knock down many of the obstacles confronting advanced Alzheimer's innovation.
--
CEO, Alzeca Biosciences

[caracappa]

10:02 AM on 09/14/2011

Leann,
Another excellent article! The other thing that early detection does is give families the time to prepare themselves for the role of caregiving that they will certainly play. This includes learning to deal with the emotional and physical stress that comes with the role (and so many caregivers burn out from).
Ed Caracappa CEO AtGuardianAngel.com
www.issueswithalzheimers.com

[karthalion]

09:30 AM on 09/14/2011

You write: "Alzheimer's cannot be prevented with lifestyle changes"

However, modern studies have shown that to NOT be true.

Please do more research on your topics before making definitive claims like this. I know AOL makes you rush out articles, because content = advertising $ - but this is really going to ruin your reputation fast.

http://www.webmd.com/alzheimers/news/20110719/lifestlye-changes-may-prevent-alzheimers

http://www.nlm.nih.gov/medlineplus/news/fullstory_114438.html

http://news.yahoo.com/lifestyle-changes-might-prevent-millions-cases-alzheimers-130805682.html

[caracappa]

10:05 AM on 09/14/2011

There is simply no proof at this time that any change in lifestyle is going to prevent Alzheimer's. Lots of research...ZERO proof. Interesting enough, we do know for a fact that living a healthy lifestyle will prevent heart disease (still one of the top killers in the US) yet, people continue to risk death by eating poorly and not exercising. If the risk of death doesn't get people to live heathly, I wonder what makes anyone think the risk of Alzheimer's will?

Ed Caracappa CEO AtGuardianAngel
www.issueswithalzheimers.com

[defortier]

05:34 PM on 09/14/2011

There may be "zero proof" that we can prevent Alzheimer's disease but there is lots of proof that we can sometimes slow its progression and often improve its symptoms. Those are two excellent reasons for diagnosing it early, although neither was mentioned in this otherwise well-written article. Yes, we need to understand the disease better and yes, we need treatments that clearly halt or reverse progression, but the treatment story is much more optimistic than many headlines imply. We review the literature in this field daily at the Brain Today blog: www.BrainToday.com