Alzheimer's Disease
And Related forms of Dementias
Dementia affects over 15% of those over the age of 65. Dementia disorders are a group of brain disorders that involve "loss of intellectual functions (such as thinking, remembering and reasoning) of sufficient severity to interfere with daily functioning." Alzheimer's accounts for over 50% of the cases of Dementia among seniors. More than 70% of Alzheimer's sufferers live at home. It is distinguished from other forms of Dementia: (1) irreversibility, (2) characteristic patterns of progressive degeneration, and (3) the types of changes in the brain, including plaques and tangles. The risk of Alzheimer's rises exponentially with age, doubling each decade after age 65. Almost half of those over 85 have this disease. It affects both men and women; however, it has a disproportional impact on women because they live longer than men. Some studies have found that the disease occurs more often among people who suffered traumatic head injuries earlier in life. Educational attainment levels may also be associated with Alzheimer's disease in that the more years of formal education a person has the less likely they are to develop the disease.
According to projects by the National Institute on Aging, Alzheimer's disease may affect as many as 14 million people in the U.S. in the next 50 years, unless a cure or preventative measures are found.
Doctors can now diagnose Alzheimer's disease with 80-90% accuracy, however, there are still concerns about the frequency of misdiagnosis. According to NIH studies, Alzheimer's remains the most "overdiagnosed and misdiagnosed disorder of mental functioning in adults."
In the U.S., an estimated $100 billion is spent annually, including the cost of diagnosis, treatment, paid care in community settings, and nursing home costs. Neither Medicare nor private health insurance covers the type of long term care most patients need. The federal government pays 4.4 billion of these costs, states cover another $4.1 billion and most of the rest is paid by individuals with Alzheimer's disease or their families. Over the course of a lifetime, the average cost of Alzheimer's disease is $174,000 per patient.
Although there have been promising advances over the past 20 years, research efforts are still focused on identifying the cause, prevention strategies and treatment options. The long range goals are prevention of the disease. Two powerful statistics dramatically illustrate why Alzheimer's disease has become a topic of huge concern. First, the fastest growing segment of the population are those over the age of 85 (the growth rate for this population from 1990 to 1994 was 274%). Second, as previously stated, 50% of those over the age of 85 have Alzheimer's disease. Take together, the convergence of these two points mean enormous implications for our society in the future. Some have labeled Alzheimer's disease as a disease of epidemic proportions.
It is important to remember that developing Dementia is not part of the normal aging process. Everyone experiences forgetfulness from time to time; this by itself is not an indication of Dementia. Memory loss is one of the most commonly recognized features, but not the only change in intellectual function. Decline in memory is generally accompanied by dysfunction in one or more of the following areas: (1) language, (2) recognition of spatial relationships, (3) other areas of thinking such as calculating numbers or abstract thinking, (4) executive functions such as planning, and (5) change in personality. Additionally, the amount of intellectual loss is generally severe enough to interfere with daily functioning. The rate of progression varies with the type of Dementia and also differ from person to person.
Treatment of Alzheimer's disease includes an emphasis on maximizing the functional abilities and quality of life for those afflicted. One unfortunate reality is that medical conditions that can be improved may not be adequately identified and treated in patients with Dementia. Depression, Alcohol, and Normal-Pressure Hydrocephalus (condition caused by increase of fluid pressure inside the brain), are examples of reversible dementias that may have symptoms that mimic Dementia.
The Alzheimer's Association headquarters is located at 225 North Michigan Ave., Suite 1700, Chicago, IL 60601-7633. Phone: (800) 272-3900 or (312) 335-8700. Fax: (312) 335-1110. The can put you in touch with a chapter near you. Email them at: info@alz.org
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