Frequently Asked Questions

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.

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.

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.

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.

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.

Dementia is a decline in thinking, reasoning, and/or remembering. People with dementia have difficulty carrying out daily tasks they have performed routinely and independently throughout their lives. Vascular dementia, a hardening of the arteries in the brain that causes blockage in blood flow, is one of the two most common forms of dementia; the other is Alzheimer's disease. These two conditions account for the vast majority of cases; both are irreversible, although sometimes their symptoms can be managed.

A doctor can accurately determine whether a person is suffering from Alzheimer's disease or another form of dementia. If a person appears to be losing mental abilities to a degree that interferes with daily activities and social interactions, consult a doctor.

Familial or early-onset Alzheimer's disease is inherited and develops in people between the ages of 30 and 60. If even one of three gene mutations that causes the disease is inherited from a parent, the child will almost certainly develop Alzheimer's disease. However, less than five percent of patients have early-onset Alzheimer's disease.

Late-onset is usually developed after age 60; this is the most common form of the disease. Its cause is not known and no pattern of inheritance has yet been discovered, although clusters of cases are seen in some families. One particular gene carried by about 25 percent of the American population increases the risk of developing Alzheimer's disease, while another carried by a small proportion of the population substantially protects against the disease. Scientists have identified other genes that may influence the risk of contracting the disease, and further research is ongoing.

Since genetic risk factors are not enough to cause late-onset Alzheimer's disease, researchers are also studying education, diet, and other factors to see if they play a role in developing the disease.

A patient in the final stages of Alzheimer's disease is unlikely to be aware of her state, and therefore is not suffering emotionally. Sometimes occasional moments of lucidity can occur in such a patient, though this is rare. If your loved one does ever become lucid enough to become aware of her condition, she most likely would also be able to communicate with you that time.