Alzheimer's Disease Decoded

The following sections are included:

• Dedication
• Contents
• About the Authors
• Building a Community
• Foreword
• Preface
• Quick Reference Guide

The human brain is the most impressive structure Mother Nature has created. In fact, it is the most complex structure in the observable universe. It is capable of producing emotion, malleable enough to dynamically modify itself, and more powerful than any computer ever created. Despite these amazing feats, it consumes only 20 watts of energy (similar to a light bulb), is extraordinarily compact, and has mystified the greatest scientists in the history of humanity…

The spectacular ability of the brain to remember, synthesize, and manipulate information makes it essential to the health and well-being of an individual. Yet amidst this spectacle, there are unfortunate opacities that illustrate just how the brain can malfunction, and how delicately beautiful it really is. Unfortunately, there are many different things that can harm the brain, ranging from environmental insults such as alcohol, to trauma and neurodegenerative disorders such as Alzheimer’s or Parkinson’s disease (PD)…

The following sections are included:

• Is Alzheimer’s Disease a Normal Part of Aging?
• Where did the Term “Senility” Come From and Why is it Ubiquitously Associated with Aging?
• Cognitive Reserve
• References

Dementia can be dissected into the prefix de-, which means “to depart” and -mens, which stands for mind. Literally, dementia means “to depart from one’s mind.” It is a general term to describe a wide range of symptoms that lead to overall mental decline that is severe enough to interfere with everyday life.

Alzheimer’s disease has begun to attract the attention of national leaders around the world. As a disease that primarily affects elderly adults, it is growing in importance as the world’s population ages. In fact, as life expectancy increases on a yearly basis and as baby boomers begin entering their sixth decade of life, Alzheimer’s disease has evolved into a public health crisis. Alzheimer’s has acquired national attention in recent years, and has been acted upon by President Barack Obama, who in 2011 signed into existence the National Alzheimer’s Project Act, or NAPA for short. This piece of legislation established a national strategic plan focused on containing the growing issue of Alzheimer’s disease. It sought to increase funding to researchers focused on treatments for Alzheimer’s disease, as well as increasing funding and resources to Alzheimer’s disease national organizations and the families of patients afflicted by the disease…

Alzheimer’s disease is extremely prevalent and pervasive within our society. It truly is a disease that almost every individual in the country is aware of, and one that has personally affected millions of Americans. However, in order to ensure that all readers are up-to-date on the epidemiology of Alzheimer’s disease, let us walk through some important points related to Alzheimer’s disease…

The following sections are included:

• The Characterization of the Disease by Dr. Alzheimer in the Early 1900s
• The Development of the Diagnostic Tools
• The Development of Medications
• Clinical Trials Overview
• Solanezumab
• References

The following sections are included:

• Human Brain: Evolution
• Three Types of Alzheimer’s Disease
• Trisomy 21 (Down Syndrome)
• The Interesting Role of Sleep in Alzheimer’s Disease
• References

This chapter of the book on surgical treatments will begin not with a particular surgical solution, but rather a question. The question arose from a surgical proposal from the 1970s for an 84-year-old dementia- stricken man. This man’s incessant yelling caused him to be unmanageable in all settings, whether it was in his private home with his aged wife or in a hospital facility. The proposal suggested removing one of the nerves supplying the patient’s vocal cords, changing his voice to “a very acceptable soft tone.” At the time, the proposal was suggested and unanimously endorsed by an ad hoc advisory committee consisting of psychiatrists, internal medicine physicians, Ear, Nose and Throat (ENT) surgeons, and other staff members at the hospital where the patient was admitted. Although conflicted, the patient’s wife maintained that her husband himself would have wanted the surgery. Ultimately, the hospital’s Department of Surgery did not allow the surgery on the terms that it involved some risk and was a non-medical operation. Dr. George Robertson, from the Department of Anaesthetics at the Royal Infirmary in Scotland, brings a different perspective on why this surgical proposal was to be rejected. He asked whether a treatment such as the one proposed above would effectively help improve the patient’s general condition. He related this treatment to the treatment of the recurrent pneumonias that an Alzheimer’s patient is very likely to contract. How many recurrent pneumonia infections do you treat when an Alzheimer’s patient is likely to contract it again? Should there be a limit?…

A common question that arises is whether or not traumatic brain injury (TBI) or concussion can lead to Alzheimer’s disease. Indeed, there has been much recent coverage in the press regarding the effect of repetitive concussions on the brain. First, to clarify, a TBI includes any type of injury to the head. This may be severe with hemorrhages (bleeds) and coma, or it may be mild. Mild TBIs are very common and include concussions, which are defined as any transient change in sensorium after an impact to the body. Sensorium refers to the perception of the body’s senses, and includes the sensation of consciousness. The impact does not necessarily have to hit the head, and there does not have to be a loss of consciousness. Patients sometimes describe a mild TBI, or concussion, as “stars before their eyes” or a being in a “daze” after the injury. Conservative estimates place the number of emergency room visits for TBI to be in excess of 2.1 million per year in the United States. The majority of these are for mild TBI or concussions. There has been a great deal of interest in concussion in young athletes. The fastestgrowing category of TBI in the civilian population, however, is occurring in the population over the age of 65. These patients may suffer a mild TBI from a ground-level fall. This presents a particular problem to the medical field, as these folks often have comorbidities and a diminished reserve for tolerating a TBI…

The following sections are included:

• Vitamin E
• Medications in the Pipeline
• Diagnosis
• Biomarkers and the Alzheimer’s Disease Neuroimaging Initiative Study
• Studying the Disease
• References

The following sections are included:

• Stem Cells
• Lifestyle Modifications
• Genetic Modification and Personalized Medicine
• Low-Level Light Therapy
• Marijuana (THC)
• THC and Neurogenesis
• THC and Inflammation
• Music Therapy
• References

In order to adequately address the problem of Alzheimer’s disease, we must attack it on several fronts, just like in cardiovascular disease, in which if an individual is at risk of developing a heart attack, they are given many tools to ward off this possibility. One of the most important tools that has lessened the burden of cardiovascular disease on our population has been early screening measures such as blood test-derived biological markers, or biomarkers. Before biomarkers were utilized, an individual’s risk was mainly determined by their family history, blood pressure, lipid profile, and other clinical signs or symptomatic manifestations of cardiovascular disease. This allowed doctors to estimate an individual’s risk of developing cardiovascular disease. However, this was not enough. Before the discovery of the first cardiac biomarkers in 1954,¹ the morbidity and mortality of cardiovascular disease was higher simply because the disease could not be detected until late into its progression. However, we must at the same time keep in mind that before the advent of fast food and widely prevalent sedentary lifestyles, individuals generally were at a lower risk of developing cardiovascular disease than they are now…

Although change occurs quite slowly in the scientific world, it seems as if change occurs even more slowly in the political world. Unfortunately, there is an interesting dichotomous link between science and politics. Science relies on the funding programs that are governed by political bodies, yet it wants to be relatively independent from political influences in terms of what is being studied and how it is being studied. Science, ranging from basic science to clinical research, undoubtedly benefits society. It is within the public interest to promote and encourage scientific discovery from economic, humanitarian, and public health standpoints. Fortunately, there are several government, non-profit, and for-profit programs that seek to further the goals of Alzheimer’s disease research, ranging from groundbreaking discoveries made in the laboratory to bringing the latest therapies to patients at the bedside.

The following sections are included:

• Acknowledgements
• Note to Readers
• Glossary/Abbreviations
• Index