Teena George
Neurology
Dr. Morgan
Final Paper
12-7-99


Alzheimer's Disease 

	Alzheimer's Disease (AD) is a progressive degenerative 
disorder of the brain.  It was first identified in 1906 and 
named after Dr. Alois Alzheimer in 1907.  There are many 
functions that are inhibited by the effects of AD.  The 
symptoms mask many other diseases and disorders making it 
difficult to diagnose.  Experimentee's and experimentor's 
all over the world are working diligently to find a cure for 
this devastating disease.  Reports are coming in all over 
the world about the race to find a drug to regenerate brain 
tissue, which has destroyed in this disease.  It is 
estimated that 4 million American people have this diagnosis 
in the progressive stages.  Currently the options of 
specified treatment for the disease continues to expand in 
its varieties.
 	Alzheimer's Disease effects the brain like no other 
disease.  There are insoluble balls of protein that develop 
in areas responsible for memory, emotions, and thinking 
called amyloid plaques.  Plaques have a protein called 
amyloid beta, a byproduct for a larger protein responsible 
for cell membrane function, it is secreted by the cells in 
large amounts.  In normal functioning people this byproduct 
is continuously cleaned out.  With this build up spaces are 
created in between the neurons that link to neuron 
breakdown.  Tangles are formed and die leaving a ghost 
tangle or tombstone tangle that clutters the brain.  Tangles 
are abnormal threadlike structures within the nerve cell.  
The brain becomes its own graveyard for senile plaques and 
neurofibrillary tangles making the brain its own victim.  
Its like land, once it is all used up there's no room to 
expand, it gets cluttered and dirty. Recently, scientist 
have discovered two enzymes, hypothetical enzymes beta 
secretase and gamma secretase, that are involved with the 
production of protein.  Blocking the enzymes could mean 
slowing the plaque formation down in the brain.  There is 
also a significant amount of data that refers to gender 
differences between males and females.  The testosterone and 
estrogen hormonal levels were reported as influences in the 
disease.  Males are less likely to get Alzheimer's Disease, 
but the males diagnosed were given the hormone estrogen to 
produce slower responses in the degenerative brain cells.  
Women on the other hand, are more likely to get Alzheimer's 
due to the postmenopausal loss of estrogen.  When given 
postmenopausal estrogen therapy to women it reduced the 
chances of getting sporadic Alzheimer's by 30% to 50%. 
(World Disease Weekly Plus, 8/30/99, p11)  At Yale 
University School of Medicine, researchers have also 
discovered that memory neurons can be restimulated by 
manipulating a brain mechanism called notch signaling. 
(Business Week, 11/99, p111)  They have strong research 
indicating that this is directly connected to the 
irreversible memory loss that plagues the Alzheimer's 
Community. Alzheimer's symptoms have been found in primates, 
pigs, and mice, which have been experimented on for years to 
obtain data. The first human trials are expected to take 
place in the year 2000.  GAMMA Eli Lilly/Scios Drug blocks 
an enzyme that causes plaque build-up and NEOTROFIN is a 
nerve growth factor that stimulates nerve growth in the 
brain.  This is exciting news for all medical professionals; 
especially those who have studied animal or petri dish 
experiments their whole lives. All of these are currently 
being ratified to improve the wellbeing of the mind.  We 
will see the results of these plans in the near future.  
There are several scientist and doctors that are positive 
about curing this disease in our coming millenium.    
	Alzheimer's Disease effects the geriatric population.  
Seniors after the age of 60 are more inclined to have some 
signs of dementia.  Rarely as it is there are a few people 
that develop this disease at younger ages.  Some of these 
people have Down Syndrome, hereditary genes, environmental 
factors like: aluminum deposits in the brain (a possible red 
herring), and/or some type of injury to the brain.  There 
has also been some resent data released about the 
relationship of Alzheimer's and the developmental stages of 
childhood.  There has been 20 years of study on these 
finding and they think they will have constant accurate data 
to finally prove this link.  The difficulty in proving the 
connection is because of the test and experiments, which 
were done on an adult level. Not taking into effect that the 
disease has a reversal type effect, mocking childlike 
stages.  Thus, the reformation of tests to support this 
thesis is still in the headway.
 	Diagnosis of this disease is difficult.  By examining 
the brain through biopsy, EEG (recording of brain wave 
patters), CT scans, MRI, and a series of medical testing 
involving the patients family history, physical examination, 
and mental acuity tests.  Changes in their short-term 
memory, the ability to remember little things not distant 
past events, those seem too embedded deep into the memory 
regions and are not effected till later in the disease.  
Other symptoms may include: Judgment and planning are 
effected by means of trying to do everyday task, solve 
problems, and follow directions properly.  Language skills 
become challenging because of the difficulty to follow 
conversations, thoughts, or use appropriate words and/or 
sentences.  The inability to control their mood swings, 
aggressiveness, emotions, and behavior is inevitable.  There 
is usually some type of violence prevalent to the behavior 
of Alzheimer's Disease that is in direct correlation with 
the onset of the disease.  Further symptoms include 
psychosis, such as hallucinations and paranoid delusions, 
incontinence, and lack of interest in personal hygiene 
becomes inevitable.   
Drugs used to delay the inevitable outcome are minimal.  
There is a product that has been out on the market for 
almost 3 years called Aricept (by Pfizer Inc).  Aricept is 
available in 5mg and 10mg tablets, whichever the doctor 
feels is appropriate.  This medicine helps delay some of the 
onsets of Alzheimer's Disease by 6 to 12 months.  Premarin 
usually accompanies it, which is a female hormone inducer.  
Fortunately, for the patients who have a combination of 
MediCal and Medicare (which is a large population of 
seniors) are fully covered for this treatment if you have 
been diagnosed within 180 days of documented onset.  Another 
restriction is a score of 10 to 26 on the MMSE, a mental 
acuity test, must be given to the Pharmacist periodically to 
continue the treatment.  This is definitely not the answer 
if your looking for a cure, but if your hoping something 
else may be invented to prevent and/or reverse the effects 
of Alzheimer's Disease while your taking this treatment at 
least its some form of hope.  Many researchers are on the 
brink of discovery of new insights into the disease. 
There are many issues a person with AD is forced to consider 
before it is literally to late.  Many people want to set 
funeral and burial plans themselves to lessen the burden on 
the family of the AD patient.  The person usually wants to 
make financial and medical arrangements as well.  The last 
request most frequently is that their family puts them into 
a home when the burden becomes too demanding and 
inconvenient.  There are many programs that assist with 
these processes.  There are also many local and global 
organizations related to Alzheimer's.  The internet is the 
best source to use when looking for these affiliations.  
Many families can have support groups, which is where a 
group of people that care for their AD loved ones, get 
together to vent frustrations or to be educated.  The city 
and state offer respite care to family members that take 
care of the seniors.  The chance of getting even one respite 
care visit a year is hard because of the unbalanced ratio 
between families and workers.  There is usually always a 
city day program for seniors with disabilities (physical or 
mental).  They have nurses, physical therapist, social 
workers, and bus drivers.  They entertain, feed, give 
medicines, exercise, involve them in community projects 
(limited), and they pick them up too.  They are the greatest 
help to a family struggling to take care of the seniors 
themselves.  
The effects of Alzheimer's disease is degenerative and 
linked to brain plaques that clutter the brain.  Many new 
preventive or reversal treatments and medicines are in the 
making.  The year 2000 has many new offerings in this field 
that will revolutionize the Alzheimer's Community and the 
medical field.  The sources available for assistance with 
this disorder are plentiful.  There are several options for 
patients and their families.  Always get a second opinion 
and keep up to date by means of the internet.  The internet 
has lots of ideas and suggestions for caregivers, patients, 
and family members.

* I take care of my grandmother; she was diagnosed with 
Alzheimer's Disease two years ago.  My husband and our two 
kids decided we wanted grandma to live with us instead of a 
convalescent home, a year and a half ago.  She has many of 
the behaviors I described.  She has tried the medicines 
listed above, but they made her more agitated, so we 
discontinued them.  It is a very difficult situation to 
handle for anyone.  Even with all my medical diplomas, work 
related experience, and college education I have a hard 
time, but there are ways of making it work effectively.  If 
you have any questions or would like more information please 
email me at: Dageorges@aol.com.  I have many personal and 
educational knowledge to help anyone going through this 
process, it took me over a year to get it right and 
understand.
  
References:
Trends in Neurosciences, 10/99, vol. 22, issue 10, p439
Newsweek, 11/1/99, vol. 134, issue 18, p76
Prevention, 12/99, vol. 51, issue 12, p169
American Family Physician, Aug99, vol. 60, issue 2, p379
Journal of the American chemical Society, 9/29/99, vol. 121, 
issue 38, p8698
Psychology Today, Sept/Oct99, vol. 32, issue 5, p21
Brown University GeroPsych Report, 11/99, vol. 3, issue 11, 
p3
                                                             
10/99, vol. 3, issue 10, p4
World Disease Weekly Plus, 8/30/99, p11
Business Week, Science & Technology, 11/8/99, issue 3654, 
p111
Henderson Center Pharmacy, Eureka, CA  95501
American Medical Association Encyclopedia of Medicine, 1996

Copyright © 1999, Dr. John M. Morgan, All rights reserved - This page last edited 13 - December, 1999
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