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Vol. 3 & 4 9 / 2001 |
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Alzheimer’s
Disease
Alzheimer's is a disease of the central nervous system. The most
common of the dementing illnesses, it is a progressive, irreversible brain
disease, which results in severe intellectual impairment. It is said to be the
fourth leading cause of death among adults.
Dementia is a chronic loss of thinking ability severe enough to
interfere with normal living. Persons with dementia are disabled by the death
of brain cells; they are not suffering from a psychiatric disorder.
The symptoms of Alzheimer's disease is memory loss, confusion
and personality change are early symptoms. From an occasional absent-mindedness
and disorientation as to time and place, the malady worsens to a complete loss
of all remembered and learned procedures, facts and functions. Decline may be
rapid, but usually the disease process is slow and insidious.
As yet, no one knows the causes of Alzheimer’s disease. Scientists are investigating selective cell
death provoked by viral or environmental agents, excessive accumulation of
toxins, a genetic defect (or predisposition), or an age-related change in the
immune system.
It is often said that the most common risk factor is age. The
prevalence increases from 3% at age 65 to nearly 50% after age 85. The
incidence of new cases also increases from .5% at age 65 to 8% at age 85.
Familial forms of the disease in which multiple family members get the disease
at a young age are relatively rare. However, even among the elderly having a
family member with the disease may also increase one’s risk two- to four-fold.
Alzheimer’s disease particularly important to women because
women live longer than men they are more likely to get Alzheimer’s disease. For
the same reason, once they get the disease they are likely to live longer with
it. As a result, it is a very common cause of disability among elderly women.
In addition, women are twice as likely to be caregivers for patients with AD.
This includes women providing care to other women, such as mothers and sisters.
Caregivers of patients with Alzheimer’s disease spend 68-100 hours per week
providing care, and more than 50% of caregivers experience clinical depression.
Compared to controls, caregivers have more physician visits, are prescribed
more medicine, and are more likely to be hospitalized. Both as patients and as
caregivers, Alzheimer’s disease seriously compromises a women’s life.
At present we do not know how to prevent the disease. But there
are several observational studies, which hold promise for preventing
Alzheimer’s disease. One of these is estrogen. Many studies have shown that
women who took estrogen, mostly for the treatment of menopausal symptoms, have
a reduced risk of Alzheimer’s disease and a delay in the onset of the disease.
This does not mean that taking estrogen will prevent Alzheimer’s
disease. These studies suggest that estrogen may be helpful, but they
are only observational studies and they must be followed by a clinical trial to
determine if estrogens are truly effective and safe.