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The Alzheimer's enigma.


Because Alzheimer's disease is a complicated disorder, with no known "cure" on the horizon, researchers have instead devoted much attention to not only halting the progressive loss of cognitive abilities that characterize this disease, but restoring those abilities as well. Several companies, including DuPont, have developed drugs for this purpose, but as yet these products are still being tested. Scientists have also identified the protein that plays an important factor in the disease's development--suggesting the possibility for a simple blood test to diagnose the disorder.

As increasing numbers of persons have succumbed to the devastating effects of Alzheimer's disease in this and other countries, scientists have hoped to identify a single genetic defect that would somehow lead to eventual control of the disease. Recent research has suggested that this might be the case in at least one group of patients--those acquiring the disease before age 65--but another study reported in the British journal Lancet seems to have at least temporarily put that possibility to rest. Some 48 families with a history of Alzheimer's were evaluated by an international team hoping to identify some defect in the particular chromosome thought to have been the guilty party. Most patients had no identifiable genetic defect, supporting the conclusion reached by other scientists that the disease is not a single entity but, instead, one with multiple causes. Nonetheless, says the study's co-author, Dr. Peter St. George-Hyslop, this is the "first really solid evidence that there is more than one cause, more than one way in which you can get Alzheimer's."

Although Alzheimer's has been known to strike persons as young as 35, symptoms do not usually appear until after age 65. Sometimes referred to as senile dementia, Alzheimer's usually comes on very slowly, often manifesting itself as nothing more than memory loss regarding recent events, something that everyone experiences to some extent with age. The patient may ask a question, be given an answer and, a few minutes later, repeat the same question. The same question may be repeated many times a day, to the exasperation of the person being asked. Eventually, other signs of mental deterioration occur until the patient regresses into an infantile state, with commensurate personality changes. Although other illness may intervene, the patient may experience little physical change and appear to be a normal, healthy adult ("a body without a brain," as one woman called her still-handsome husband of 40 years).

Nevertheless, Alzheimer's is a killer--this country's fourth-leading cause of death among adults after heart disease, cancer and stroke. More than 100,000 American lives are lost to Alzheimer's each year, usually as a result of the body's increasing inability to fight off infection. The disease, which affects about 4 million American adults, strikes men and women almost equally and drains our economy of more than $80 billion annually in terms of diagnosis, treatment, nursing home care, informal care (at home, where most Alzheimer's patients are treated), and lost wages. The average life span of the Alzheimer's patient after diagnosis is between 8 and 10 years, although the Chicago-based Alzheimer's Association reports that some people last as little as 3 years and as long as 20 years.
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Publication:Medical Update
Date:Nov 1, 1990
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