Frequently Asked Questions
Are there treatments available for Alzheimer’s disease? [ 08/30/13 ]
Yes, while there is no cure for Alzheimer's disease as yet, there are medications that can help control its symptoms and to help manage conditions such as agitation, depression, or psychosis (hallucinations or delusions), which may occur as the disease progresses:
Cholinesterase inhibitors: People with Alzheimer's disease have low levels of a key nerve messenger, called acetylcholine, believed to be important for memory and thinking. Four drugs called cholinesterase inhibitors make more of that messenger available by slowing its breakdown, enabling greater cell-to-cell communication and slowing the progress of cognitive impairment in some patients with early- to middle-stage Alzheimer's disease. The four cholinesterase inhibitors are:
- Razadyne® (galantamine)
- Exelon® (rivastigmine)
- Aricept® (donepezil)
- Cognex® (tacrine)
All four have been approved by the Food and Drug Administration (FDA) for early- to middle-state Alzheimer's disease; Aricept® is also approved for severe-stage symptoms. Cognex® was the first approved cholinesterase inhibitor but is rarely prescribed today due to safety concerns.
Namenda® (memantine) The first FDA-approved drug for moderate to severe Alzheimer's disease, Namenda is thought to protect brain cells by regulating a nerve communication chemical, called glutamate, that is released in great quantities by Alzheimer's-damaged cells. Glutamate is normally involved with learning and memory, but when released in excess by damaged cells, it attaches to “docking sites” called NMDA receptors that in turn accelerate cell damage.
Treatment for mental illnesses People with the later stages of Alzheimer's disease often experience depression, agitation, paranoia, delusions, and/or hallucinations, which can in turn cause screaming, repetitive questions, hoarding, pacing, hyperactivity, and aggressive behavior.
These symptoms can arise from non-medical triggers as well as medical causes. The former could take the form of a change in the person's environment (a new place to live, a new caretaker, a change in routine) or from frustration at the inability to communicate. If the trigger can be identified, the environment can be modified to change the behavior.
If non-medical intervention doesn't work, or the patient becomes a danger to himself or others, a physician should be asked to evaluate the need for medical treatment.
Sources for financial assistance for Alzheimer's disease prescription drugs can be found at www.brightfocus.org/alzheimers/resources/alzheimers-disease.html. Always consult a physician before taking any medications.
Are there drugs that can delay the onset of Alzheimer's disease? [ 08/30/13 ]
Aricept (donepezil), an Alzheimer's disease treatment appears to have a slowing effect—though limited—on the progression from mild cognitive impairment (MCI) to Alzheimer's disease, according to a study published in April 2005 by the New England Journal of Medicine. Those with MCI, such as the study participants, experience memory problems, but are able to function independently; however, MCI is often a transitional stage that leads to the serious cognitive decline of Alzheimer's disease. Over the first year of the three-year trial, MCI patients treated with Aricept had a reduced risk of progressing to Alzheimer's disease compared to patients who took a placebo, an inactive pill. The study found the effect of the Aricept treatment lasted longer (up to two to three years) in those patients carrying the ApoE4 gene. Previous studies have shown that those with the ApoE4 gene have a higher risk of developing Alzheimer's than the general population. Source: Mayo Clinic, Rochester and the National Institute on Aging
Are memory problems an indication of Alzheimer's disease? [ 08/30/13 ]
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 difficulty remembering a word or someone's name; however, those with Alzheimer's disease (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 Alzheimer's may not remember the purpose of the keys.
There has been recent interest in a condition called mild cognitive impairment (MCI). Individuals with MCI have memory impairment (pronounced forgetfulness), but are able to perform routine activities without assistance. However, MCI has 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 can 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, depression 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), seek out qualified professional advice and evaluation by a physician with extensive knowledge, experience and interest in dementia and memory problems.
Is Alzheimer's covered by Medicare/Medicaid? [ 08/30/13 ]
Medicare is a federal health insurance program for people age 65 or older who receive Social Security retirement benefits. To receive assistance from Medicare, a person must meet specific eligibility requirements. Medicare covers some, but not all, of the services a person with Alzheimer's disease may require. For example, the program does not cover long term healthcare. Medicaid is a federal program for certain individuals and families with low incomes and resources, typically administered by state agencies; eligibility and benefits vary from state to state. Medicaid can cover all or a portion of nursing home costs. A person with Alzheimer's can qualify for long term care only if there are minimal income and cash assets. Medicaid may be applied for by calling each state's Department of Human Services or Medicaid Assistance Program.
What is the cost of Alzheimer's disease? [ 08/30/13 ]
In terms of health care expenses and lost wages of both patients and their caregivers, the cost of Alzheimer's disease 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 the stage of the disease. 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 calculates to $74,095 per year.
Is there a connection between Alzheimer's disease and aluminum or other metals? [ 08/30/13 ]
Metals have been implicated in neurodegenerative diseases, although it is unlikely that any are the sole cause. For example, interest in a possible connection between aluminum and Alzheimer's disease arose over 40 years ago, and the toxicity of aluminum has been the subject of much controversy since that time. However, aluminum has never been proven to be a direct cause of Alzheimer's, and increasingly, evidence shows that Alzheimer's disease is likely caused not by one, but by a combination of factors.
Zinc, copper and iron have also been implicated in the formation of beta amyloid protein plaques that are part of Alzheimer's disease. Zinc and copper interact with amyloid beta precursor protein (APP) and beta amyloid itself, although their role is not clear. While copper promotes free radical formation, zinc is an antioxidant. However, high levels of zinc may contribute to the aggregation of beta amyloid. One particular way in which copper binds to beta amyloid appears to be toxic. Clearly, further research is necessary to determine the exact role of metals in Alzheimer's disease.
Is there a test to detect a predisposition to Alzheimer's? [ 08/30/13 ]
There is a test currently available that can identify which forms of apolipoprotein (ApoE) are present in the blood. One form, ApoE4, is associated with an already well-studied condition, heart disease, and appears to increase the risk of developing Alzheimer's as well. However, this blood can only detect whether ApoE4 is present, not if and when the person will develop Alzheimer's.
In 2007, researchers at Stanford University published some promising study results in which 18 blood proteins (and resultant chemical signals) were tested to determine the risk of advancement from mild cognitive impairment (MCI) to Alzheimer's disease. In the study, the scientists were able to predict whether the subjects would progress to Alzheimer's with 90% accuracy. However, this study tested a relatively small number of people, and larger studies will need to be undertaken.
Is Alzheimer's disease hereditary? [ 08/30/13 ]
Familial Alzheimer's disease (FAD) or early-onset Alzheimer's is an inherited, rare form of the disease, affecting less than 10 percent of Alzheimer's disease patients. FAD develops before age 65, in people as young as 35. It is caused by one of three gene mutations on chromosomes 1, 14 and 21. If even one of these mutated genes is inherited from a parent, the person will almost always develop FAD. All offspring in the same generation have a 50/50 chance of developing FAD if one parent has it.
The majority of Alzheimer's disease cases are late-onset, usually developing after age 65. Late-onset Alzheimer's disease has no known cause and shows no obvious inheritance pattern. However, in some families, clusters of cases are seen. Although a specific gene has not been identified as the cause of late-onset Alzheimer's disease, genetic factors do appear to play a role in the development of this form of the disease. A gene called Apolipoprotein E (ApoE) appears to be a risk factor for the late-onset form of AD. There are three forms of this gene: ApoE2, ApoE3 and ApoE4. Roughly one in four Americans has ApoE4 and one in twenty has ApoE2. While inheritance of ApoE4 increases the risk of developing AD, ApoE2 substantially protects against the disease.
Scientists believe that several other genes may influence the development of Alzheimer's disease. Two of these genes, UBQLN1 and SORL1, are located on chromosomes 9 and 11. Researchers have also identified three genes on chromosome 10, one of which produces an insulin degrading enzyme that may contribute to the disease. A gene, called TOMM40, appears to significantly increase one's susceptibility to developing Alzheimer's when other risk factors are present, such as having the ApoE-4 gene. Several recently discovered genes that influence Alzheimer's disease risk are CLU (also called APOJ) on chromosome 8, which produces a protein called clusterin, PICALM on chromosome 11 and CR1 on chromosome 1.
In October of 2013, an international group of researchers reported on the identification of 11 new genes that offer important new insights into the disease pathways involved in Alzheimer's disease.The new genes (HLA-DRB5/HLA0DRB1, PTK2B, SLC24A4-0RING3, DSG2, INPP5D, MEF2C, NME8, ZCWPW1, CELF1, FERMT2 and CASS4) add to a growing list of gene variants associated with onset and progression of late-onset Alzheimer's.
Genetic risk factors alone are not enough to cause the late-onset form of Alzheimer's disease, so researchers are actively exploring education, diet and environment to learn what role they might play in the development of this disease.
Disclaimer: The information provided here is a public service of the BrightFocus Foundation and should not in any way substitute for the advice of a qualified healthcare professional; it is not intended to constitute medical advice. Please consult your physician for personalized medical advice. BrightFocus Foundation does not endorse any medical product or therapy. All medications and supplements should only be taken under medical supervision. Also, although we make every effort to keep the medical information on our website updated, we cannot guarantee that the posted information reflects the most up-to-date research.
Some of the content in this section is adapted from other sources, which are clearly identified within each individual item of information.
Last Review: 08/21/13