Research into Alzheimer's disease:
Dr. Bill Simpson: Essentially, all of the treatment has been according to what they call the cholinergic hypothesis, that is that we don't have enough acetylcholine in our brains as we age, it decreases as we age, and so all the treatments thus far have been directed toward getting more of that around. The medicines that we have Aricept and Rivastigmine or Reminyl and those sorts of things have been designed to do that. The research also was looking at other ways to increase acetylcholine in the brain that have fewer side effects or more effective than what we have now. None of our medicines now are very effective. They help a little bit and in some people, not all the people. So we are looking for other medicines that will do a better job at preventing the development of these neurofibrillary tangles and plaques, the development of the amyloid deposits or other things that are changing the brains of Alzheimer's patients.
Question: Are there any known prevention measures for Alzheimer's disease?
Dr. Bill Simpson: Since we don't know the cause, it's very difficult to prevent something we don't know the cause of, but one thing that we do know is that mental activity as we said that there is a risk in people that have lower levels of education and don't read and don't do things with their minds that there is an increased rate of Alzheimer's disease in that population. So, in general, high levels of education, keeping educationally involved, reading, doing puzzles, doing sudoku, or whatever that square thing is, doing those sorts of things a lot seem to decrease either the age or increase the age at which Alzheimer's develops or decrease the actual onset of Alzheimer's disease.
Question: How can we distinguish normal aging from Alzheimer's disease?
Dr. Bill Simpson: Well, I'd like to say and I think most people agree with me that there is no normal loss of mental function as we age. Our mental ability goes down. We can't think quite as quickly as we want to. We can't make decisions as quickly and we can't get the answer quite as quickly but if we were given enough time, we can get to the answers. So it's a slowing down of the mental processes. I like to think of it as having lots of file drawers that we have to look for through to get to the answer. As we get older, we have more and more file drawers, more and more memories, more and more things that we know, so it takes us longer to get to those answers.
So, that's the change that happens in memory as we get older. But if we begin to not be able to remember things at all, not that we can't find the car in the parking lot where we lived, that's not a sort of normal though we sometimes have difficulty remembering where we parked the car but forgetting whether we drove or not. That's a substantial suggestion of a memory problem. Not being able to remember a person's name when you've not seen them for a couple of years but having difficulty remembering the name of someone that you see all the time, a family member or something like that, that's not normal aging.
So when people do those kinds of things, we are thinking that, that's the abnormal aging. But it's very difficult sometimes to tell the difference between what's just a little forgetfulness or early Alzheimer's disease, but I'd like to think of the senior moments people talk about when they don't remember the things that they think that they should have remembered. That's mostly a problem with attention. If we don't pay attention to the things that we're trying to remember, we don't register them in our heads. So, names and parties; if we're not careful to repeat the name two or three times when we first hear the name, we may not remember that name, that's not an indication of Alzheimer's disease. That's an indication of being too busy not paying attention and not keeping it in our head well enough to remember it.
Alzheimer's disease: Making the diagnosis.
Dr. Bill Simpson: First step will be the talk to your physician because there are reversible causes of dementia, loss of previously acquired mental function, that are not Alzheimer's that can be treated very easily. People that have depression sometimes look demented. People that have very low thyroid functions sometimes look like they have dementia.
So, there are a lot of things that can look like Alzheimer's disease but are not and can be treated very easily, whereas Alzheimer's is difficult to treat. I always recommend that anyone that's dealing with the person of Alzheimer's, get the book called 'The 36-Hour Day' by Peter Rabins and Peter Mace, that's best description of Alzheimer's disease and about the things to expect and how to deal with them that I know of.
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