ALZHEIMER'S DISEASE Introduction Alzheimer's

Alzheimer's disease (AD) is thought to be the fourth leading cause of death in the United States, with approximately 4.5 million Alzheimer's disease victims. This represents a major public health problem that results in an annual expense of over $100 billion. The problem is expected to grow as the baby boomer generation reaches ages of maximum prevalence of Alzheimer's disease (expected over 9 million by the year 2030). Most cases of AD occur after the age of 65 years and are sporadic rather than familial. AD is still considered to be poorly understood by family members and many health care workers. Antecedents may vary and include genetic factors, factors related to aging, and environmental factors (Brumback & Leech, 1994; Sobel, Davanipour, Sulkava, Erkinjuntti, Wikstrom, Henderson, Buckwalter, Bowman, and Lee, 1995). AD symptoms, mechanisms, treatment, consequences, and implications are also considered.

Risk factors in Alzheimer's disease (AD) have been confirmed as advanced age, a family history of dementia, and Down's syndrome. Some evidence concludes that head trauma is also a risk factor. Additional environmental antecedents are considered; some believe that AD is a disorder stemming from damage to the brain that is subclinical for decades, making those affected particularly prone to the consequences of neuronal attrition. With this view, environmental damage compounds effects of age-related neuronal losses

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d may have deficits in short-term memory. AD patients with amnesic syndromes have defects in learning and long-term memory, with intact short-term memory. Other AD patients may have normal long-term memory with deficiencies in problem-solving, cognitive resource allocation, rapid information processing, and shifting and maintaining central sets. Cognitive impairment in AD patients is found to change over time; changing patterns are consistent with the idea that multiple independent systems are deteriorating (Becker, Bajulaiye, & Smith, 1992). AD Mechanisms Brumback and Leech (1994) report regarding dementia mechanisms. Dementia is viewed as a progressive loss of intellectual or cognitive abilities which result in impaired social and work performance. These deficits may result in memory loss, impaired abstract thinking, decreased problem solving ability, impaired judgment, language disturbance (aphasia), apraxia, agnosia, constructional difficulties, and personality disturbances. Deficits are presumed as resulting from a loss of normal interconnections of cerebral neurons. AD results in marked reduction in numbers of synapses connecting neurons, a consequence of massive death of cerebral cortical neurons. Hallmarks o

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