At what stage is Namenda no longer effective? [ 04/25/12 ]
It would be great to know the answer to this question, since nobody wants to give Alzheimer's patients medications that aren't helping them; however, there is not a great deal of scientific information to guide physicians. Studies have shown that Namenda (memantine) improves cognition and some behavioral measures in "severe" Alzheimer's disease patients, and one study published in the Journal of the American Medical Directors Association in 2004 reported that nursing home residents who discontinued Namenda showed, as a group, worse changes in cognition and mood than a comparison group who remained on Namenda. This study also reminds us that Namenda's benefits (though they may be modest) extend beyond measures of cognition.
Is BPSD (Behavioral and Psychological Symptoms of Dementia) considered to be an Alzheimer's disease diagnosis? [ 04/24/12 ]
Current diagnostic criteria for Alzheimer's disease assess rely on the presence of cognitive but not behavioral and psychological symptoms of dementia. From the standpoint of a caregiver or clinician, though, these behavioral symptoms may create more distress than loss of memory. BPSD are usually the factors that determine when a person with dementia must move into institutional care, because it is so challenging to care at home for someone who, for example, is aggressive or tends to wander. These BPSD, incidentally, do not occur only in Alzheimer's disease—they are found in other types of dementia and in conditions other than dementia—but the majority of Alzheimer's disease patients will show them at some point in the course of the illness.
Is it possible to replace the neurons that have been destroyed by plaques and tangles? If not, then seeking a cure for Alzheimer's disease in terms of returning the person to his/her normal state of health is not possible. Once the brain cells are dead they cannot be replaced. Thus, research should focus on early identification, diagnosis, prevention, and slowing the progress of the disease. Are my comments accurate? [ 04/23/12 ]
I think you could look at this problem a little differently. Although current approaches do not "cure" Alzheimer's disease by reviving neurons, they have some symptom-alleviating effects. They could be considered palliative. But in the future, perhaps there will be therapies that allow stimulation of new brain cell growth or at least growth of new synaptic connections that compensate for the loss of destroyed neurons. I certainly agree with your view that current research should pay a lot of attention to prevention and early recognition as well as finding additional ways to reduce symptoms and, if possible, affect the course of the disease.
I have been reading that new stem cell therapies have been created specifically for Alzheimer’s disease. I was wondering if this was true and if so, which hospitals offer this treatment. [ 03/26/12 ]
Stem cell research holds great promise for learning about the mechanisms of Alzheimer's disease, and scientists have hope that stem cells may help us learn new ways to understand and fight this terrible disease. As of yet, however, there are no stem cell therapies available and patients cannot obtain stem cells as a treatment for Alzheimer's disease. To learn more about stem cell therapies, please visit the website of the International Society for Stem Cell Research.
My mother has Alzheimer's disease and has the ApoE4 gene. Does Namenda or the patch work just as well in people who have the ApoE4 gene? [ 03/26/12 ]
There is some research to suggest that there are less favorable responses to conventional cognitive enhancers in Alzheimer's disease patients who have the ApoE4 gene.
My dad is 76 years old and my mother is his primary care taker. He no longer wants to leave the house for any reason. He will go to certain doctor appointments only if forced. Otherwise, he just wants to sit on the couch all day and stay home. Is this common? [ 03/26/12 ]
It is increasingly stressful and challenging for patients with dementia to go out into the world, where they may have to face uncomfortable and overwhelming stimulation. Readiness to go out requires encouragement, regular practice, and activities that are not over-stimulating.
My dad is 78 years old and is in the early stages of Alzheimer’s disease. He sleeps most of the day, and says that he has pressure on his head, is unable to think clearly, and cannot pick his head up off the pillow. Are these common symptoms of this disease? [ 03/26/12 ]
Headaches, including migraines, are reported by patients with Alzheimer's disease but whether the rate is greater than among patients who do not have this neurological disorder has not been determined. Although the accepted answer to this question is that there is no established connection between Alzheimer's and headaches, some researchers have found increased headache prevalence among people who have a particular familial Alzheimer's disease gene, called PSEN1.
Possible explanations for headaches in Alzheimer's patients include cerebral inflammation, issues with blood pressure, vision problems, and medication side effects, each of which can be treatable causes of headaches.
How can you tell if someone is showing early signs of Alzheimer’s disease? [ 02/13/12 ]
The earliest stages of Alzheimer's disease, according to the National Institute on Aging, are characterized by brain accumulation of beta amyloid without obvious behavioral or cognitive changes. The earliest cognitive changes, detectable only on careful neuropsychological testing, may be subtle changes in memory storage. When Alzheimer's disease produces actual cognitive changes, some of the first ones are non-diagnostic (that is, they could just be signs of normal aging). The affected person feels like he or she is not remembering things as well as as they used to, but nobody else notices. The next stage in progression toward Alzheimer's, is “mild cognitive impairment,” and at that point the memory difficulties start to attract others' attention. The affected person has trouble recalling words or names, performing complex tasks, remembering what he or she has read, or planning and organizing things. This usually, but not always, progresses to Alzheimer's disease, which in its mild phase is noticeable to friends and family and even to people who did not previously know the patient. Early-stage Alzheimer's disease includes more obvious cognitive changes including forgetting significant recent events, and having greater difficulty with complex tasks such as calculating the tip in a restaurant or balancing the checkbook and paying bills. Emotional changes such as those seen in depression may also be more apparent at this stage.