About Alzheimer's
Definition of Alzheimer's
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Alzheimer's disease is a progressive, degenerative disorder that attacks the brain's nerve cells, or
neurons, resulting in loss of memory, thinking and language skills, and behavioral changes.
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These neurons, which produce the brain chemical, or neurotransmitter, acetylcholine, break connections
with other nerve cells and ultimately die. For example, short-term memory fails when Alzheimer's disease first
destroys nerve cells in the hippocampus, and language skills and judgment decline when neurons die in the
cerebral cortex.
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Two types of abnormal lesions clog the brains of individuals with Alzheimer's disease: Beta-amyloid
plaques—sticky clumps of protein fragments and cellular material that form outside and around neurons; and
neurofibrillary tangles—insoluble twisted fibers composed largely of the protein tau that build up inside nerve
cells. Although these structures are hallmarks of the disease, scientists are unclear whether they cause it or a
byproduct of it.
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Alzheimer's disease is the most common cause of dementia, or loss of intellectual function, among people
aged 65 and older.
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Alzheimer's disease is not a normal part of aging.
Origin of the term Alzheimer's disease dates back to 1906 when Dr. Alois Alzheimer, a German physician,
presented a case history before a medical meeting of a 51-year-old woman who suffered from a rare brain
disorder. A brain autopsy identified the plaques and tangles that today characterize Alzheimer's disease.
The Facts on Alzheimer's Disease

Alzheimer’s disease is an irreversible degeneration of the brain that causes disruptions in memory, cognition,
personality, and other functions that eventually leads to death from complete brain failure.
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Over 5 million (5.4 million) Americans age 65 and older are thought to have Alzheimer’s disease. By 2050, the
number of Americans with this disease could increase to over 15 million.

The national cost of Alzheimer’s disease (in people over 65 years old) was $183 billion in 2011, and by 2050 it will
be $1.1 trillion.
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One person in the United States is diagnosed with Alzheimer's disease approximately every 69 seconds.
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It is estimated that almost 500,000 new cases of Alzheimer's disease will be diagnosed this year.
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According to data from the CDC, in 2010, more than 82,000 deaths were recorded as being caused by Alzheimer’s
disease.
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Alzheimer's disease is the 6th leading cause of death in the United States.

Worldwide, nearly 36 million people are believed to be living with with Alzheimer's disease or dementia. That
number is projected to increase to 65.7 million by 2030 and 115.4 million by 2050.
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Alzheimer’s disease is the most common form of dementia.

By 2048, 1 in 45 people may be living with Alzheimer’s disease.
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Alzheimer’s disease usually begins after age 60 and risk increases with age. Younger people in their 30s, 40s and
50s may get Alzheimer’s disease, but it is rare.

Approximately 5 percent of all cases of Alzheimer’s disease are believed to be familial (hereditary). In familial
cases, often called early-onset Alzheimer’s disease, symptoms typically appear within the age range of 30 - 60 years.
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It is estimated that more than one in three Americans 85 years and older have Alzheimer's disease.

The lifetime risk of Alzheimer’s disease among those who reached the age of 65 is approximately 1 in 5 for women
and 1 in 10 among men.

People with poor vision that did not visit an ophthalmologist for treatments had a 9.5 fold increased risk of dementia
when followed over an 8.5 year period.
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Death from Alzheimer’s disease is often underreported or misdiagnosed.
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Alzheimer’s disease represents around 70% of all cases of dementia. Making it the most common cause of dementia.

Approximately 5.1 million Americans are age 85 years or older, and this age group is one of the fastest growing
segments of the population. It is also the group with the highest risk of Alzheimer’s disease. It is estimated that at
least 19 million people will be age 85 and older by the year 2050.

Common symptoms include: disturbances in memory, attention, and orientation, changes in personality, language
difficulties, and impairments in gait and movement.

On average, patients with Alzheimer’s disease live for 8 to 10 years after diagnosis, but this fatal disease can last as
long as 20 years, or as little as 3 to 4 years if the patient is over 80 years old when diagnosed.

Currently, the only way to definitively diagnose Alzheimer’s disease is to physically examine the brain through
autopsy.
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Approximately 70% of Alzheimer’s disease patients receive care at home.

In terms of health care expenses and lost wages of both patients and their caregivers, the cost of Alzheimer's disease
nationwide is estimated at $100 billion per year.

Nearly half of all nursing home residents have Alzheimer’s disease or a related disorder.

The average hourly service cost for home health aides is $21 per hour.
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The average annual cost for an assisted living facility is $37,572.
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For a person with Alzheimer’s disease, the annual cost of a room in an Alzheimer’s special care unit is estimated in
the range of $214 and $239 per day or $77,998 and $87,362 per year, for a semi-private or private room,
respectively.
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For a person with Alzheimer's disease, the annual cost of home care is estimated at $76,000, including medical
expenses and indirect costs such as a caregiver's time and lost wages.
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The care of an Alzheimer’s patient, viewed as custodial care, is not covered by Medicare and most health insurance
plans.
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In the absence of disease, the human brain often can function well into the 10th decade of life.
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58% of people with dementia worldwide live in low or middle income countries.
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One third of those whose lives have been touched by Alzheimer’s disease provide support to their loved ones.
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Of those providing financial support to someone with Alzheimer’s, the average amount is $200 per month. Those
providing caregiving support give the average amount of 16 hours a month.
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Among those who do not personally have Alzheimer’s disease, one third worry about getting Alzheimer’s. Those
who have a parent or parent in law with the disease are even more concerned.
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Roughly half of all caregivers are between the ages of 18 and 49, with the average age of the typical caregiver being
48.
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Nearly 2 in 10 Americans believe they know someone with Alzheimer’s disease who has not sought
diagnosis/treatment.
Brain With Alzheimer's Disease
© 2000 - 2012 American Health Assistance Foundation
These images represent a cross-section of the brain as seen from the front. The cross-section on the left
represents a normal brain and the one on the right represents a brain with Alzheimer's disease.
In Alzheimer's disease, there is an overall shrinkage of brain tissue. The grooves or furrows in the brain,
called sulci (plural of sulcus), are noticeably widened and there is shrinkage of the gyri (plural of gyrus),
the well-developed folds of the brain's outer layer. In addition, the ventricles, or chambers within the
brain that contain cerebrospinal fluid, are noticeably enlarged. In the early stages of Alzheimer's disease,
short-term memory begins to fade (see box labeled ‘memory') when the cells in the hippocampus, which
is part of the limbic system, degenerate. The ability to perform routine tasks also declines. As
Alzheimer's disease spreads through the cerebral cortex (the outer layer of the brain), judgment declines,
emotional outbursts may occur and language is impaired. As the disease progresses, more nerve cells
die, leading to changes in behavior, such as wandering and agitation. In the final stages of the disease,
people may lose the ability to recognize faces and communicate; they normally cannot control bodily
functions and require constant care. On average, the disease lasts for 8 to 10 years, but individuals with
Alzheimer’s can live for up to 20 years.
How the Brain and Nerve Cells
Change During Alzheimer's Disease
Illustration by Bob Morreale, provided courtesy of the American Health Assistance Foundation.
One of the hallmarks of Alzheimer's disease is the accumulation of amyloid plaques between nerve cells
(neurons) in the brain. Amyloid is a general term for protein fragments that the body produces normally.
Beta amyloid is a fragment of a protein snipped from another protein called amyloid precursor protein
(APP). In a healthy brain, these protein fragments would break down and be eliminated. In Alzheimer's
disease, the fragments accumulate to form hard, insoluble plaques.
Neurofibrillary tangles are insoluble twisted fibers found inside the brain's nerve cells. They primarily
consist of a protein called tau, which forms part of a structure called a microtubule. The microtubule
helps transport nutrients and other important substances from one part of the nerve cell to another.
Axons are long threadlike extensions that conduct nerve impulses away from the nerve cell; dendrites
are short branched threadlike extensions that conduct nerve impulses towards the nerve cell body. In
Alzheimer's disease the tau protein is abnormal and the microtubule structures collapse.
As Alzheimer’s disease progresses, brain tissue shrinks. However, the ventricles, chambers within the
brain that contain cerebrospinal fluid, are noticeably enlarged. In the early stages of Alzheimer's disease,
short-term memory begins to decline when the cells in the hippocampus degenerate. Those with the
disease lose the ability to perform routine tasks. As Alzheimer's disease spreads through the cerebral
cortex (the outer layer of the brain), judgment worsens, emotional outbursts may occur and language is
impaired. Advancement of the disease leads to the death of more nerve cells and subsequent changes in
behavior, such as wandering and agitation. In the final stages, people may lose the ability to feed
themselves, speak, recognize people and control bodily functions. Memory worsens and may become
almost non-existent. Constant care is typically necessary. On average, those with Alzheimer’s live for 8
to 10 years after diagnosis, but this terminal disease can last for as long as 20 years.
Plaques and Tangles
© 2000 - 2012 American Health Assistance Foundation
The formation of amyloid plaques and neurofibrillary tangles are thought to contribute to the
degradation of the neurons (nerve cells) in the brain and the subsequent symptoms of Alzheimer's
disease
Amyloid Plaques
One of the hallmarks of Alzheimer's disease is the accumulation of amyloid plaques between nerve
cells (neurons) in the brain. Amyloid is a general term for protein fragments that the body produces
normally. Beta amyloid is a protein fragment snipped from an amyloid precursor protein (APP). In a
healthy brain, these protein fragments are broken down and eliminated. In Alzheimer's disease, the
fragments accumulate to form hard, insoluble plaques.
Neurofibrillary Tangles
Neurofibrillary tangles are insoluble twisted fibers found inside the brain's cells. These tangles consist
primarily of a protein called tau, which forms part of a structure called a microtubule. The microtubule
helps transport nutrients and other important substances from one part of the nerve cell to another. In
Alzheimer's disease, however, the tau protein is abnormal and the microtubule structures collapse.
Homework
1. Use the world-wide web to find the five approved methods of treatment for Alzheimer’s Disease.
Explain the logic of the acetylcholine esterase inhibitor therapy.
2. Use the world-wide web to find one or two proposed/plausible treatments that may be used in the
future. Explain how these treatments would help the patient.