Guest column | Dr. Rao Musunuru

Steps forward on Alzheimer's disease

Go ahead, be honest and admit it. You have said to yourself many times that you are losing it — the mind that is. Your mind is beginning to play tricks on you.

You are not sure whether you closed the garage door when you left home. A brilliant idea came to you while driving, but it flew away in a fleeting moment. You cannot understand, how you forgot that important meeting in the afternoon. You purposefully walked into the study only to stand there and scratch your head, wondering why you were there. You cannot recall what you did with your keys. Good grief, the morning medications are still in the pill box.

You are sure you are developing Alzheimer's. Maybe not, if all of these did not happen to you on the same day or if some of these don't happen every single day. That is the good news. The bad news is, these may be early warning signs.

It is natural for people to start noticing a slip in memory, at age 50 (because of shrinking brain size). However, significant memory loss is a symptom of serious illness, at any age.

Alzheimer's disease represents about 60 percent of all dementia. In 2009, 5.3 million people are estimated to be living with Alzheimer's in the United States, a vast majority of them older than 65. It is now the sixth leading cause of death in the United States.

The exact cause of this irreversible disease (named after the German physician who described it) is not known. Alzheimer's progressively destroys brain nerve cells, causing memory changes, erratic behavior and ultimately loss of body functions.

Increasing age is the greatest known risk factor for Alzheimer's. After age 85, the risk reaches nearly 50 percent. Certain genes protect while certain others promote the disease.

Family history plays a role, but enough is not known at this time to recommend routine genetic testing. Head injury, heart disease, alcohol abuse, lack of exercise — physical and mental — smoking and social isolation are some of the risk factors that promote development of Alzheimer's.

Even though a definitive diagnosis of Alzheimer's can be made only at autopsy, advanced brain scans like MRI or PET can help in a vast majority of cases to establish the diagnosis.

Medications currently approved by the FDA for treatment only temporarily slow the worsening of symptoms for about half the patients. Also, none of the alternative medicine and supplements is yet proven to be of any substantial benefit in spite of anecdotal success stories.

Physicians can identify and correct other treatable conditions that may cause similar symptoms like thyroid problems, vitamin deficiency, depression and reaction to other medications, just to name a few.

Early detection by simple cognitive screening for memory dysfunction helps immensely to get counseling and education, to review family and community resources, to join support groups and to address legal and financial matters in a timely manner, which also helps to avoid caregiver burnout.

Prevention, to the extent possible, is the only option as there is no cure available for Alzheimer's yet, even though extensive research is in progress.

To prevent or postpone Alzheimer's: Keep moving (at least 30 minutes of aerobic exercise daily); eat well (colorful vegetables and fruits, fish, low calories, less fat and low salt); stay slim; stop smoking; avoid alcohol abuse; watch blood pressure; lower bad cholesterol; and control diabetes (with medications, if necessary).

You are right that you have heard it all before. Because, these are exactly the same suggestions to prevent heart disease, many cancers and stroke. Physical exercise is the most important of all. Mental training, ranging from crossword puzzles to expensive computer-based brain fitness programs, may also help.

You are not going to forget all this now, are you? Your heart and brain are in your hands.

Dr. Rao Musunuru, a practicing cardiologist at Regional Medical Center Bayonet Point, is a current member of National Leadership Committee of Clinical Cardiology Council of American Heart Association.

Steps forward on Alzheimer's disease 07/21/10 [Last modified: Wednesday, July 21, 2010 8:06pm]

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