Alzheimer's Disease - Dementia
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Alzheimer's Disease - Dementia
NIH - Medical Encyclopedia Alzheimer's Disease
"Alzheimer's disease (AD), one form of dementia, is a progressive, degenerative brain disease. It affects memory, thinking, and behavior. Memory impairment is a necessary feature for the diagnosis of this or any type of dementia. Change in one of the following areas must also be present: language, decision-making ability, judgment, attention, and other areas of mental function and personality. The rate of progression is different for each person. If AD develops rapidly, it is likely to continue to progress rapidly. If it has been slow to progress, it will likely continue on a slow course. There are two types of AD -- early onset and late onset. In early onset AD, symptoms first appear before age 60. Early onset AD is much less common, accounting for only 5-10% of cases. However, it tends to progress rapidly. The brain tissue shows "neurofibrillary tangles" (twisted fragments of protein within nerve cells that clog up the cell), "neuritic plaques" (abnormal clusters of dead and dying nerve cells, other brain cells, and protein), and "senile plaques" (areas where products of dying nerve cells have accumulated around protein). Although these changes occur to some extent in all brains with age, there are many more of them in the brains of people with AD."
Highlighted Articles
Education and Alzheimer disease without dementia: support for the cognitive reserve hypothesis. (Neurology. 2007)
"CONCLUSIONS: Regardless of the neuropathologic criteria used, education is predictive of dementia status among individuals with neuropathologic Alzheimer disease. These results support the theory that individuals with greater cognitive reserve, as reflected in years of education, are better able to cope with AD brain pathology without observable deficits in cognition."
Nutritional factors, cognitive decline, and dementia. (Brain Res Bull. 2006)
"Nutritional factors and nutritional deficiencies have been repeatedly associated with cognitive impairment. … Deficiencies of several B vitamins have been associated with cognitive dysfunction in many observational studies. More recently, deficiencies of folate (B(9)) and cobalamine (B(12)) have been studied in relation to hyperhomocysteinemia as potential determinants of cognitive impairment, dementia, and Alzheimer's disease (AD). A small number of studies assessed the association between intake of macronutrients and cognitive function or dementia. Among the others, the intake of fatty acids and cholesterol has received particular attention. Although the results are not always consistent, most studies have reported a protective role of dietary intakes of poly- and mono-unsaturated fatty acids against cognitive decline and AD."
Exercise Is Associated with Reduced Risk for Incident Dementia among Persons 65 Years of Age and Older (Annals of Internal Medicine 2006)
"Conclusion: These results suggest that regular exercise is associated with a delay in onset of dementia and Alzheimer disease, further supporting its value for elderly persons."
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Notes
The 2007 Treatment Guidelines section will contain the 2007 published guidelines. To view Guidelines from previous years, view year 2006 Treatment Guidelines and 2005 InfoMedlinks (Articles section) or our Monthly Online Newsletter (under the Guidelines section).
Alzheimer's Disease - Dementia
Daily Treatment Report
Cognitive Therapy-CBT-Psychotherapy
Device Therapy
Drug Side-Effects and Interactions
[Delirium induced by drug treatment.] (Ther Umsch. 2011) “Anticholinergic activity is the mode of action by which drugs cause delirium. Antipsychotic drugs, antidepressants, antihistamines, and of course anticholinergic drugs themselves are the major anticholinergic classes of drugs. In addition some opioids have anticholinergic effects. Other drugs may induce delirium by dehydration (loop diuretics like furosemide) or sedation (benzodiazapines like lorazepam). Elderly people are at especially high risk to develop delirium, because of the multitude of drugs often prescribed to them, because they tend to drink to little, and because their brain is more sensitive to psychoactive drugs.”
Anti-Delirium Drug May Harm Critically Ill Patients “The anti-delirium drug rivastigmine (brand name Exelon) does not appear to control delirium in critically ill hospital patients, new Dutch research indicates. When given to critically ill patients, it may even be linked to a more severe type of delirium, a longer intensive care stay and increased mortality, the new study suggests. The findings could influence treatment protocols for the most severely ill Alzheimer's and Parkinson's disease patients for whom Exelon is a standard treatment. In a news release, the Dutch team, led by Dr. Maarten M J van Eijk and Dr. Arjen J.C. Slooter of the University Medical Centre in Utrecht, concludes that "since (the) findings of our study show that rivastigmine does not decrease duration of delirium and might increase mortality in critically ill patients, we do not recommend treatment of delirium with rivastigmine for patients in intensive care." “
Are All Commonly Prescribed Antipsychotics Associated with Greater Mortality in Elderly Male Veterans with Dementia? (Journal of the American Geriatrics Society 2010)
Drugs
Aspirin in Alzheimer’s Disease (Stroke. 2010)
Lipid-Lowering Treatment Is Related to Decreased Risk of Dementia: A Population-Based Study (FINRISK). (Neurodegener Dis. 2010)
Hormone Therapy Helpful in Women With Alzheimer's “Hormone treatment appears to improve mood and reduce cognitive decline in female Alzheimer's disease patients without an apolipoprotein E e4 (ApoE) allele, Norwegian researchers report. As lead author Dr. Arnhild Valen-Sendstad told Reuters Health by email, "Elderly women with Alzheimer's disease and with no contraindicative factors, and especially those without a genotype apolipoprotein E e4, will profit from hormone therapy with estradiol/norethisterone."”
Benefit of Memantine in Treating Alzheimer's Disease Not Proven, Study Finds “There is no scientific proof that patients with moderate or severe Alzheimer's disease benefit from drugs containing the agent memantine. This is the conclusion in the final report that the Institute for Quality and Efficiency in Health Care (IQWiG) published in September 2009.”
Exercise
General Information
What do cognitively intact older people think about the use of electronic tracking devices for people with dementia? A preliminary analysis. (J.Int Psychogeriatr. 2010)
Are You Being Served? Prescribing Practices For Demented Patients
Study: Popular Autism Diet No HelpPolypharmacy and Potentially Inappropriate Medication Use Among Community-dwelling Elders With Dementia (Alzheimer Disease & Associated Disorders 2010)
Systematic review of statins for the prevention of vascular dementia or dementia. (Geriatr Gerontol Int. 2010) “Conclusion: Study design differences among the studies and methodological shortcomings may have resulted in different outcomes. On the basis of these conflicting results, statins could not be recommended as a preventative treatment for dementia.”
Cognitive Stimulation Therapy (CST): effects on different areas of cognitive function for people with dementia. (Int J Geriatr Psychiatry. 2010)
Guidelines
NGC - Management of Alzheimer's Disease and Related Dementias (2009)
Immunotherapy
Internet Sites
Treatment Information
Drug-Food-Supplement Information
DrugDigest (drug interactions)
FDA - Drug Interactions: What You Should Know
NIH - Botanical Dietary Supplements: Background Information
NIH - Drug, Supplements, and Herbal Information
NIH - Herbal Supplements: Consider Safety, Too
NIH - Vitamin and Mineral Supplement Fact Sheets
Nutrition
Healthy Diet Could Slow Or Reverse Early Effects Of Alzheimer's Disease “Pratico also emphasized that the researchers believe that in addition to switching to a healthy diet, patients diagnosed with MCI or Alzheimer's also need a regiment of physical as well as mental exercises.”
Oxidative stress and Alzheimer's disease: dietary polyphenols as potential therapeutic agents. (Expert Rev Neurother. 2010)
Apple Juice Improved Behavioral But Not Cognitive Symptoms in Moderate-to-Late Stage Alzheimer’s Disease in an Open-Label Pilot Study (American Journal of Alzheimer's Disease and Other Dementias 2010)
Other
Other Treatments
Experimental
Grape Derived Polyphenols Attenuate Tau Neuropathology in a Mouse Model of Alzheimer's Disease. (J Alzheimers Dis. 2010)
Radiotherapy
Supplements-Vitamins-CAM
Effectiveness of melatonin treatment on circadian rhythm disturbances in dementia. Are there implications for delirium? A systematic review. (Int J Geriatr Psychiatry. 2010)
Effect of Folic Acid, with or without Other B Vitamins, on Cognitive Decline: Meta-Analysis of Randomized Trials (American Journal of Medicine 2010) “Randomized trials show no effect of folic acid, with or without other B vitamins, on cognitive function within 3 years of the start of treatment. Trials of longer duration, recording the incidence of dementia, as well as cognitive decline, are needed.”
Omega-3 fatty acids: potential role in the management of early Alzheimer’s disease (Clinical Interventions in Aging 2010)
Surgery
Transplantation
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