Alzheimer’s disease is a brain disorder in which memory, thought processes, and behavior become progressively impaired. It is named for Dr. Alois Alzheimer, the German neurologist who first described it in the early 1900s. He discovered during an autopsy of a woman who had died of progressive dementia that her brain was riddled with plaques and tangles of abnormal nerve cells, the hallmarks of the disease. What causes Alzheimer’s disease remains unknown, but studies have revealed the presence of an abnormal substance, called amyloid protein, among the plaques and tangles. Researchers are now trying to determine whether these abnormalities stem from an infection, or genetic trait, or perhaps are caused by an environmental toxin.
Diagnostic Studies and Procedures
Only an autopsy can reveal the brain irregularities of Alzheimer’s disease. Thus, diagnosis in a living person requires a process of elimination to rule out other possible causes of progressive mental deterioration. Family members and friends may be called upon to fill in the details about previous illnesses, accidents, medications, and personal habits, especially diet, alcohol use, and substance abuse. The physical examination is usually concentrated on neurological function, although a doctor may also look for circulatory or respiratory disorders. Special studies might include psychological tests, blood and urine analyses, skull X-rays, electroencephalography, and perhaps a CT brain scan or MRI.
Medical Treatments
Until recently, there was little that doctors could do to treat Alzheimer’s disease. This situation is changing with a drug called tacrine (Cognex), which was released in 1993. Long-term effects of the medication are unknown, but about 20 percent of the patients who received it in clinical trials experienced significant improvement in mental functioning. For an additional 20 percent, the disease’s progress was slowed down. Patients taking Cognex must undergo frequent blood tests to determine if there is any liver damage, the major adverse effect of the drug. Some of the more troubling symptoms of Alzheimer’s can be treated with older medications. For example, sedatives may be prescribed for sleep problems, antipsychotic drugs to calm psychosis and aggressiveness, and stimulants such as methylphenidate (Ritalin) to combat fatigue and improve mood. These drugs should be used only under regular medical monitoring, however, because they can also impair mental functioning.
Alternative Therapies
As with medical treatments, the goal of any alternative therapy for Alzheimer’s disease is to provide comfort.
Hydrotherapy
As an alternative to drugs, some nursing homes use warm baths to soothe agitated or anxious patients. A word of caution, however: To prevent accidental drowning, an elderly person with Alzheimer’s should never be left alone in a hot tub or bath.