Memory Alzheimer Disease
“Memory is the cabinet of imagination, the treasury of reason, the registry of conscience and the council chamber of thought.” Saint Basil the Great 330-379, Greek Churchman.
In 1901, a German doctor named Alois Alzheimer was presented with a fifty one year old female with several symptoms of disorientation, aphasia, paranoia, unpredictable behavior and psychosocial impairment. (2) Dr. Alzheimer cared for her until her death in 1906. He preformed an autopsy of the women's brain after her death and discovered changes in the brain tissue with signs of abnormal clumps and tangled bundles of fibers. (2) These signs of abnormality are now considered signs of Alzheimer's disease, bearing the name of the doctor who may have been the first to discover the puzzling disease that effects so many of our loved ones today.
Alzheimer's disease is a progressive, irreversible brain disorder with no one specific cause or cure. It is a puzzling disease that steals the minds of its victims. Symptoms of the disease include memory loss, confusion, impaired judgment, personality changes, disorientation, and loss of language skills. Alzheimer's disease is the most common form of dementia. More than 4.5 million Americans are believed to suffer from Alzheimer's disease. (4) Ten percent of U.S. adults by the age of sixty five and thirty percent of adults eighty five and over are affected by the disease. (6)
The area of the brain that is affected by Alzheimer's disease is the frontal lobe, hippocampus and the forebrain. Their functions include, processing thoughts, reasoning, sensation, thinking and memory. A particularly vulnerable region of the brain is the hippocampus, located in the medial temporal lobe of the brain. The hippocampus plays a vital role in learning and in processing information such as long term memory. (3)
The frontal lobe and the medial temporal lobe receive input from acetylcholine releasing neurons in the basal forebrain. The release of the neurotransmitter acetylcholine within these structures is thought to be the key to the formation of memory. Without the appropriate release of acetylcholine, the formation of memories and the ability to make new ones are disrupted. (3)
Alzheimer's disease is the result of the destruction and degeneration of neurons. Nerve signals travel across synapses, with the help of the chemical neurotransmitter, acetylcholine. The nerve cells are destroyed by a reduction of acetylcholine from the nucleus basalis in the basal forebrain. The nucleus basalis consists of gray matter that is made up mostly of cholinergic neurons. This disruption of cholinergic input inhibits memory formation and recovery. The nucleus basalis has the important job of neuronal release of acetylcholine. Without the release of acetylcholine, transmission of nerve signals cannot be executed, therefore missing the connection that possesses memory. (3,5)
Acetylcholine is thought to play a vital role in the neurons functional responsibility for memory, thinking, and judgment. In Alzheimer's disease, acetylcholine is broken down more quickly than usual. The levels of acetylcholine are decreased, affecting the cerebral cortex, basal forebrain and hippocampus ability to process thought. (3, 5) The brain as a whole begins to shrink as the disease advances. This is due to the reduction of acetylcholine, (3, 5) the formation of plaques and tangles at the ends of neurons which cause the death of neuron cells.
Protein deposits known as beta amyloid plaques and neurofibrillary tangles invade the brain tissue. The beta amyloid plaques are sticky, abnormal, fiber clusters. They are found in the spaces between the neurons, and they disrupt the pathways that carry impulses from one neuron to the other in the brain. Tangles are also made up of a protein called tau. Tangles are found inside the neurons and can clog them and keep them from functioning normally. When neurons are clogged with tangles, and the spaces between neurons are clogged with plaques, nerve impulses cannot be sent from one neuron to the next in the normal transmission of a signal. As a result, the brain has trouble performing mental functions, such as remembering and thinking. (1, 4)
There are progressive stages of the signs and symptoms of the Alzheimer's disease. Early in the illness, individuals tend to experience fatigue. They may show signs of some memory loss, experience mood swings, and may be slower to learn and react in daily activities. As the disease progresses, Alzheimer's victims may still be able to perform some daily tasks independently, but may need assistance with more complicated activities. Comprehension and verbal communication become slower and individuals often lose their train of thought in the middle of their sentences. As Alzheimer's victims become aware of this loss of control, they may become depressed and confused as to why they can't communicate or recall something that just happened. Memories may be recalled, while recent events are difficult to remember. (1)
During the final stages of Alzheimer's the individuals no longer have the ability to comprehend where they are, the date and or the time. Many victims lose the ability to chew and swallow, may experience loss of bowel and bladder control, and most eventually need twenty four hour care. They become vulnerable to infections and illnesses, particularly because the individual has become bedridden.(1) Memory is now irretrievable. The final stage of Alzheimer's disease eventually leads to death.
Diagnosing Alzheimer's is complicated due the fact that brain tissue can only be examined in depth by performing an autopsy. Therefore, doctors can only make probable diagnosis in the patient while they are living. (3) However, doctors can use other methods to help diagnose the disease such as, (3) asking questions about general health, medical problems from the past, ability to perform and carry out daily activities, memory tests, problem solving, attention, counting and language. Other tests include blood that might determine a thyroid problems, urine, spinal fluid and performing brain scans. (3) These tests can help the doctor diagnose the symptoms that the disease could be causing and help to make the patient more comfortable in dealing with the incurable disease.
There is no cure for Alzheimer's disease. Today's treatments can only slow the progress of the disease and help temporarily. None of the drugs that currently treat Alzheimer's can prevent the deterioration of brain cells. (5) Prescription medications are the most common method of treatment such as Cholinesterase inhibitors. They are designed to prevent the breakdown of acetylcholine, vital to memory and other cognitive functions, and keep levels high even when the cells that produce it degenerate or die. (4) Other methods of treatment, for reducing the formation of neurofibrillary tangles and beta amyloid plaque, are still being explored by researchers. In most cases medication is used to treat behavioral problems such as sleeplessness, anxiety and depression. Since there is no known cure, trying to treat the symptoms can make the patient more comfortable for the duration of the disease.
Some research suggests the treatment with antioxidant nutrients, such as vitamin A and C can limit free radical attack which damage DNA, cell membranes and proteins in people with Alzheimer's. Studies suggest that with antioxidant treatment, it cold delay or even prevent the disease. Minerals that have been evident in triggering free radical attack are iron, zinc, copper and aluminum. (6) Early scientific studies suggested that the extract from the leaves of ginkgo bilboa trees may be helpful in treating Alzheimer's patients. Researchers have yet been able to support this evidence but are trying to test this possibility in clinical trials. (1)
For now, medications, routine physical examinations, a well balanced diet and assisted care are the only treatments available for the disease. The cure is still a puzzle being pieced together by researchers. However, researchers are closing in on the exact cause of Alzheimer's disease. (6)
Scientists are finding that parts of the brain involving memory, such as the hippocampus, is sometimes viewable on brain scans before the symptoms of Alzheimer's occur. Neuroimaging technology is widely being studied to determine whether or not magnetic resonance and positron emission tomography can see or detect early changes in Alzheimer's disease, or measure the disease progression. (1)
Scientists still need to learn more about factors that could influence the disease such as genetics, the environment, diet, exercise and the role these factors play in over all brain health. Until they can find strong enough evidence to pin point the nature of the disease, Alzheimer's remains a puzzling disease that steals the minds of its victims, every 71 seconds. (1)
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