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Alzheimer's disease: epidemic or misdiagnosis?

Alzheimer's Disease: Epidemic or Misdiagnosis?

For those who are skeptical of statistics, recent news reporting Alzheimer's disease to be higher than previously estimated will probably seem to be confirming evidence.

Others, especially critics in the medical community, have long suspected that improper diagnosis has often confused the conditions of dementia, senility, pseudosenility and Alzheimer's disease.

The following reports are based on questions posed to experts in gerontology and scientific research in brain failure. Documented reports from medical textbooks and case histories comprise much of the inquiry.

Q: How is dementia defined? What are its symptoms? A: Dementia implies general impairment of mental functions,

including language, the inability to think abstractly, loss of sense

of time and place, emotional instability, and difficulty in taking

care of oneself.

Q: Is dementia an inevitable part of aging? A: Old age is not synonymous with loss of intellectual functioning.

We know that many people live into their eighties, nineties and

even beyond without a measurable decline compared to youth or

middle age.

Conversely, some individuals suffer from decline in their

forties, fifties and sixties. It should also be noted that when these

brain function changes take place in younger people they are not

accompanied by physical changes characterized as old age. Nor

is weakness a manifestation of middle-age brain failure (presenile


Q: This "infirmity of the mind" termed dementia, how does

it differ from Alzheimer's disease? A: Dementia is the general term for brain failure and it covers many

conditions, some of which are reversible with good prospects for

recovery; actual brain damage usually has not taken place.

Alzheimer's disease is one particular condition in which the brain's

cells are dying and plaque formations have begun to accumulate,

impairing functions. Recovery from Alzheimer's disease has

occurred infrequently. It is usually incurable.

Q: Since the symptoms of Alzheimer's disease often mimic the

other dementias, what are the chances of misdiagnosis? A: There are many disorders that cause dementia or simulate the

condition. Because Alzheimer's disease is not readily understood

by many in the medical profession, the chances of misdiagnosis

are widespread.

Psychiatric disorders, such as depression, are often mistaken

for dementia. Drugs and medications can cause personality

changes mistakenly identified. Nutritional disorders are

frequently implicated. The list is long and the probability of error

great. A discussion of these conditions follows in this report.

Q: Does hardening of the arteries contribute to Alzheimer's

disease? A: The hardening of the arteries theory (arteriosclerosis) has been

abandoned in the case of Alzheimer's disease. Autopsies of

individuals who suffered from various forms of dementia other

than Alzheimer's disease usually did not show arteriosclerotic

causes, whereas the plaques and neurofibrillary tangles of

Alzheimer's disease were evident.

Q: Do these plaques appear in the brain of older people who

have not suffered from any form of dementia? A: Some neurological diseases produce neurofibrillary tangles.

Parkinson's disease victims have plaques and tangles, according

to autopsies, but they do not affect the brain to the extent that

Alzheimer's disease does. The reason could be attributed to the

locale of the tangles and how they affect brain function.

Q: What are the known causes of Alzheimer's disease? A: No one seems to know for certain. Among the theories are viral

factors, toxic contamination, poor nutrition, aluminum deposits,

hereditary factors, drugs, alcohol, and possibly tobacco.

Practically all information about the disease can be gleaned

only from autopsies, so the researchers are stymied. Test animals

are spared in this particular research because there is no evidence

that the problem is found in other forms of life other than in


Q: What do autopsies of normal elderly people show in brain

structure? A: In cases of advanced Alzheimer's dementia, autopsies show brain

decay. Among the elderly where there were no signs of the disease,

neither brain cell destruction nor decay was found.

Significantly, where the decay was localized, in the temporal

lobes, there appeared to be selective destruction of the neurons

which secrete acetylcholine. Can we increase the acetylcholine in

the brain by eating foods rich in lecithin and taking food

supplements containing lecithin-containing choline?

Q: If hardening of the arteries is not a major cause of dementia,

what other problems are implicated? A: A principal cause of senility and eventually dementia is "cerebral

softening," the product of a series of strokes that accumulate over

a period of time. The condition is known as "multi-infarct

dementia" (M.I.D.), resulting from heart attacks, angina pectoris,

hypertension, vascular disease of the extremities (coldness,

tingling, numbness, pain and other abnormal sensations in the

arms and legs), obesity, out-of-control diabetes, and cigarette


Q: Does M.I.D. differ greatly from Alzheimer's disease? A: Males seem to be more susceptible than females. Also, M.I.D.

progresses slowly as the risk factors of the contributing diseases

exact their toll. Dementia caused by multi-infarction is usually

curable if the contributing ailments are brought under control.

Q: How can we differentiate between faulty memory caused by

anxiety and a failing memory observed in early senility? A: It has been scientifically proven that anxiety causes changes in

body chemistry and in brain chemistry. Also known is the fact

that in senility a decrease in acetylcholine in certain areas of

the brain takes place. Can this coincidence guide us to understand

brain destruction in people who live their lives in high anxiety?

Specific tests that differentiate can be ordered by the attending


Q: How can depression be distinguished from dementia? A: In depression the onset of memory loss is sudden and of relatively

short duration. The mood is constant. When asked a question,

the depressed individual tends to answer with "don't know" rather

than to make a response that is usually faulty as in senility.

Symptoms of dementia accumulate slowly, and, unlike depression,

the lethargy deepens.

Q: Can growing deafness produce dementia symptoms? A: Hearing impairment can produce paranoic behavior and delusions.

Hypochondria in the elderly may produce behavior symptoms like


Q: How prevalent is Alzheimer's disease and other dementias

in the elderly population? A: Several European studies, recently conducted, indicate that only

five to eight percent of noninstitutionalized individuals suffer from

Alzheimer's disease. Those with milder dementia impairments

range from six to fifteen percent of the elderly population.

Q: What about the recent report that Alzheimer's disease is more

prevalent than previously reported? A: Although the study was conducted by highly regarded scientists

and appeared in the Journal of the American Medical Association

(11/10/89) there are reasons to be skeptical of the results. First,

the total sample consisted of 487 persons who underwent

neurological, neuropsychological, and laboratory examination.

Some critics consider the size of the sample too small. Nothing

is mentioned in the report about checking for nutritional

deficiencies, habitual use of medications by the people examined

and the clear evidence of Alzheimer's disease in contrast to severe


No one doubts that the incidence of Alzheimer's disease and

senile dementia is rising. But the lack of precise diagnosis is a

factor that calls for investigation on a larger scale with meticulous

attention devoted to pseudosenility factors.

Q: How many forms of Alzheimer's disease are there? A: Two forms are considered. The presenile form has an onset around

the age of 40. Victims have a life span of about seven years after

the beginning of the disease. The senile form begins after the

age of 60 and may cause death in about three years.

Q: Since plaque formation is the physical cause of brain failure

in dementia, and deficiency in the chemical acetylcholine

is implicated as a possible cause of the disease, are there

other chemicals that could cause malfunction? A: Another transmitter system, between neurons, has been

implicated in Alzheimer's disease. It uses glutamate, which can

have toxic effects at elevated levels. The effect that ingestion of

monosodium glutamate, a popular food flavoring, has in sensitive

individuals been known to mimic dementia states. No proof exists

that monosodium glutamate can contribute to Alzheimer's disease.
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Author:Williamson, Francis
Publication:Nutrition Health Review
Date:Jan 1, 1990
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