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 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.
My mother had been suffering from Alzheimer disease for six years. She started taking Exelon; then her doctor changed the medication to Aricept (donepezil), and finally Reminyl (galantamine) in combination with Ebixa (memantine). In addition to these drugs, she takes heart medicines, including Furosemide, Lanoxin, and Levothyroxine. Unfortunately, she died six month ago as a result of her ascites. In my opinion, the ascites occurred due to malfunctioning kidneys, as a result of the Alzheimer’s medications that she was taking. Your “Frequently Asked Questions” section of the website indicates that, on average, patients with Alzheimer`s disease live eight to ten years after diagnosis. How long does Alzheimer`s disease last, on average, for patients if they do not take the conventional treatments. Thank you in advance for your kind assistance. [ 08/30/13 ]
I am sorry for your loss, and many grieving individuals question whether medications prescribed during a terminal illness were more harmful than beneficial. The medications for Alzheimer's disease are not thought to either decrease or increase survival time; however, quality of life is modestly improved for some affected people and their caregivers. Ascites is more typically caused by liver failure than by malfunctioning kidneys, and it is more often the case that malfunctioning kidneys alter the effects of medications rather than vice versa.
What kind of information should I bring to my first visit to the doctor? [ 08/30/13 ]
If you visit a new doctor, bring your medical records; for any doctor, bring a list of over the counter and prescription medicines you are currently taking. 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. Also make a list of current medical problems. It's a good idea to show the doctor a list of symptoms, behaviors and any problems carrying out routine activities (for example, paying bills) in yourself or your loved one that concern you.
What are the stages of Alzheimer's disease? [ 08/30/13 ]
The following stages represent the general course the disease follows, but moving from one stage to another may not be perceptable due to the fact that the symptoms are on a gradual continuum of severity.
Physical conditions connected to Alzheimer’s disease exist in a person’s body long before symptoms are evident. These conditions are normally defined through the use of “biomarker” tests, like those searching for beta-amyloid and tau proteins in blood and cerebrospinal fluid, and specialized PET and MRI scans. Currently, this stage is only defined in research settings and clinical trials and is unlikely to be given as an official clinical diagnosis by a health professional.
Mild Cognitive Impairment (MCI) Due To Alzheimer’s Disease/Prodromal Stage:
Recently, scientists have identified a condition between normal age-related memory loss and dementia called mild cognitive impairment (MCI). Individuals with MCI have persistent memory problems (for example, difficulty remembering names and following conversations and marked forgetfulness) but are able to perform routine activities without more than usual assistance. MCI often leads to Alzheimer’s, but while all those who progress to some form of dementia go through a period of MCI, not all patients exhibiting MCI will develop Alzheimer’s disease. An official clinical diagnosis of MCI can be given by a health professional.
Dementia Due To Alzheimer’s Disease (Mild, Moderate, Severe Stages):
Mild (Stage 1)
Early in the illness, people with Alzheimer’s tend to lose energy and spontaneity, though often no one notices anything unusual. They exhibit minor memory loss and mood swings and are slow to learn and react. After a while they start to shy away from anything new and prefer the familiar. In this stage, Alzheimer’s patients can still perform basic tasks independently but may need assistance with more complicated activities. Speech and understanding become slower, and patients often lose their train of thought in midsentence. They may also get lost while traveling or forget to pay bills. As they become aware of this loss of control, they may become depressed, fearful, irritable, and restless.
Moderate (Stage 2)
Eventually, people with the illness begin to be disabled by it. Though the distant past may be recalled, recent events become difficult to remember. Advancing Alzheimer’s affects the ability to comprehend location, the day, and the time. Caregivers must give clear instructions and repeat them often. As Alzheimer’s patients’ minds continue to slip away, they may invent words and not recognize formerly familiar faces.
Severe (Stage 3)
During the final stage, patients become more and more unresponsive. Memory becomes so poor that no one is recognizable. Patients lose bowel and bladder control and eventually need constant care. They lose the ability to chew and swallow and become bedridden and vulnerable to pneumonia, infection, and other illnesses. Respiratory problems worsen, particularly when the patient becomes bedridden. This terminal stage eventually leads to coma and death.
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 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.