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Incidence of Alzheimer's Increases; Cause Remains Elusive

Alzheimer's is a progressive brain disorder that gradually destroys a person's memory and ability to communicate. It affects approximately 27 million people worldwide. In the United States alone, 5 million people are living with the disease, a number that the Alzheimer's Association predicts will rise to over 13 million within the next 50 years. With an ever-growing number of cases, researchers are still working to understand the causes of this debilitating disease.

While death rates from heart disease and some forms of cancer are on the decline, Alzheimer's-related deaths have continued to skyrocket. Stephen McConnell of the Alzheimer's Association believes that these trends are not unrelated. According to McConnell, the cruel irony is that as we cure these other diseases, "people are now living longer, only to face this terrible disease of Alzheimer's."

Two years ago, Patty Smith noticed that she was missing appointments, and forgetting things in a way she never had before. "I knew something was wrong, I just didn't know what it was." At only 51 years of age, she was diagnosed with Alzheimer's disease. Early onset Alzheimer's, like Patty's, is still relatively uncommon, representing only 20% of all U.S. Alzheimer's cases. Most people are over 65 when they develop the disease.

Although Alzheimer's attacks the part of the brain that is required for thinking, and not the part that regulates essential organs like the heart and lungs, it is still fatal.

Sam Gandy is an Alzheimer's specialist and the director of the Farber Institute for Neurosciences. In the later stages of the disease, says Gandy, people lose all contact with their environment. They become bedridden and susceptible to developing an infectious illness, such as pneumonia, a urinary infection, or even a bedsore. It is that infection, Gandy explains, that is the actual cause of death.

But what causes someone to develop Alzheimer's, in the first place? In 3 percent of cases, the disease is due entirely to genetic mutations, but no one has yet been able to determine exactly how the disease starts for the other 97 percent.

Most research to date has focused on beta-amyloid plaques, sticky deposits that develop in the brains of people with Alzheimer's. An alternative theory blames a protein, tau, which is found in their tangled brain nerve fibers.

While the search continues for the root causes of Alzheimer's, intensive work is being done to develop drugs that can better treat the disease. Most of the existing drugs treat only the symptoms of Alzheimer's, rather than the underlying causes of the disease. But Peter Davies, biochemist at the Feinstein Institute for Medical Research, is optimistic. "It's a very exciting time in this research," he says, explaining that real progress is being made in understanding the basic disease process, and that new drugs are being developed that will interfere directly with the biochemistry of Azheimer's.

Although drugs may help to control the symptoms of Alzheimer's, other evidence suggests that eating well, and maintaining an active physical, social, and mental lifestyle, are critical to fighting the disease.

Even without a known cure, Stephen McConnell of the Alzheimer's Association stresses the importance of seeking a diagnosis: "If a phsycian refuses to diagnose, or families avoid it, it is just tragic, because there are things that can help." McConnell add, "There may be other causes of memory loss that could be treated."

It's also important for people to have time to plan for the future, for themselves and their families. As the disease progresses, McConnell explains, Alzheimer's patients lose the ability to make decisions related to finances and other family matters, so it is important to do that early on.

Alzheimer's patient, Patty Smith, encourages people not to be afraid of seeking a diagnosis. She says that she herself would rather know, than not know: "when you have knowledge of something, you can confront it, I think it helps you deal with it much better."

More information about Alzheimer's, including the benefits of early diagnosis, available treatment options, and other resources for people living with the disease, are available on the Alzheimer's Association website.

The interview excerpts used in this feature are from the Diane Rehm Show, which is produced by Washington DC radio station WAMU.