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Alzheimer's disease epidemic?

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Ten years ago, 58-year-old Charles Rios was diagnosed with Alzheimer's disease. He was having trouble at work and couldn't remember certain things.

"Things just seemed to fall into place" after the diagnosis, says his wife, Della. "Conversations with him that were originally confusing to me, now made sense." Today, Della Frazier Rios serves as director of education and training at the Alzheimer's Association-NYC Chapter.

Approximately 4.5 million people in the U.S. have Alzheimer's disease. But in the next few decades, that number is expected to skyrocket by 350% as America's baby-boomers age.

"That is an astronomical leap," says Danielle Gray, Ph.D., a neuroscientist at Emory University in Atlanta who studies cognitive decline. "It's why we are mounting a great deal of collaborative efforts to do something about this illness."

In 2002, the Alzheimer's Association and Peter D. Hart Research Associates conducted a survey. Among the findings:

• 95% of Americans say Alzheimer's disease is a serious health threat
• 57% worry they'll get the disease
• 68% believed more funding is needed to help treat and/or prevent Alzheimer's
• More than four in 10 Americans know someone with Alzheimer's
• Nearly 1 in 5 has someone in their family with the disease

There is no cure for Alzheimer's disease. However, there are several medications now available,  including Aricept, Razadyne (formerly Reminyl), and Namenda, which can improve cognitive and behavioral symptoms.

The earliest symptoms -- memory difficulties and problems with abstract thinking -- can be vague and are tough to pinpoint. Researchers admit the key to developing better treatments is a more thorough understanding of what leads to Alzheimer's and the overall ability to diagnose it earlier. Currently, an "official" diagnose of Alzheimer's is made by ruling out other possible causes for the cognitive decline.

EARLY HINTS

Research published in the journal Neuropsychology suggests that simple neuropsychological tests could be used to detect Alzheimer's before typical symptoms appear. Mark Jacobson, a research psychologist at the Veterans Affairs (VA) San Diego Healthcare System, says cognitive profiling combined with known changes in memory loss can identify people who may be in the early stages of the disease.

For the study, Jacobson and his colleagues at the VA and the University of California at San Diego (UCSD) recruited 20 normal elderly individuals and 20 potential Alzheimer's patients who showed little or no clinical signs of the disease. The 40 veterans participated in 2 neuropsychological tests, 1 focusing on their verbal naming ability and another to test visual-spatial skills. The groups were split evenly in terms of those who excelled verbally and those with superior spatial skills.

"We found that the elderly patients who later developed Alzheimer's showed an asymmetric pattern, or uneven changes, in their cognitive test results several years before their diagnosis," says Jacobson, one of the study's authors.

Jacobson's team is also using a special MRI procedure called functional neuroimaging to record changes in brain blood flow in an attempt to learn whether the cognitive performance differences reflect anatomical or functional changes in brain function and structure.

Elsewhere in the country, researchers are studying the association between apolipoprotein E (ApoE), a gene that helps metabolize cholesterol, and the risk of Alzheimer's disease. Studies have shown that healthy middle-aged adults who carry a variation of the gene have difficulties in spatial attention and working memory similar to those clinically diagnosed with Alzheimer's.

DON'T FORGET: HELP IS OUT THERE

Patients or families who need support or are interested in learning about Alzheimer's disease clinical trials can call the national Alzheimer's Association at 1-800-272-3900.

References

Jacobson MW, Delis DC, Bondi, MW, Salmon DP. Do neuropsychological tests detect preclinical Alzheimer's disease: Individual-test versus cognitive-discrepancy score analyses. Neuropsychology. 2002 Apr Vol 16(2) 132-139.

Hebert LE, Scherr PA, Bienias JL, Bennett DA, Evans DA. Alzheimer Disease in the U.S. Population: Prevalence Estimates Using the 2000 Census. Arch. Neurol. August 2003; 60(8):1119-1122.

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