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One sad statistic that continues to haunt us is the current certainty that almost half of the people who make it to age 85 will develop some form of cognitive disability affecting the brain. Alzheimer's Disease is perhaps the best known of these afflictions. The brain is an organ which function defines who we are. It utilizes enormous amounts of energy to function, but its weight shrinks only about 10 percent from our twenties to death. In my younger days, high school health lectures taught us that we would lose 10,000 brain cells with every drink of alcohol. This does not quite seem to be the case anymore! We now think that in fact you may gain a few brain cells with time. What brain cells we have need to be properly nourished and looked after or their long axons and complex connections would shrink.
Alzheimer's Disease is a form of Dementia. It is a progression of brain cell degeneration that profoundly affects the memory, the ability to think and communication skills. Early signs may include misplacing things, forgetting new concepts, fumbling for words or suddenly not knowing where you are. Sadly, those affected tend to transform from being productive societal members to requiring a great deal of care and supervision. It is turning into one of the most costly diseases within the health care system. Two types of abnormalities are frequently found in the brain. The first is a protein called tau that forms insoluble neurofibrillary tangles inside neuronal cells. The other abnormality is the build-up of plaques made of beta-amyloid which clog the space around neurons. Each neuron has thousands of synaptic connections with neighboring cells. When these kinds of cellular debris accumulate, those connections are lost and the neuron goes on to die. These abnormalities may not be the cause, but serve more as a marker that an unhealthy process is going on. Currently, the diagnosis is made by noting the deterioration in a patient's memory. There are, as yet, no adequate techniques to spot these plaques early. They are almost invisible to an MRI (Magnetic Resonance Imaging) in early stages. Medications do exist that attempt to promote neuronal functioning, but results tend to be guarded.
Alzheimer's Disease was only characterized about 100 years ago, which raises several questions. Perhaps it was not fully recognized before that, or people were not living long enough to see it. Alternately, changes in lifestyle, nutrition, and environment could be triggering genetic problems. There are at least two identified gene mutations associated with the disease. More recently, it has been suggested that strokes may be related to Alzheimer's Disease. Some people suffer large multiple strokes that leave areas of the brain damaged. They go on to develop some similarity in their deficits. In those cases we refer to them as suffering from Multi Infarct Dementia. At the other end of the spectrum, some scientists believe that almost undetectable mini-strokes cause minor damage and trigger local inflammation. This may go on to start a cascade of events that result in production of those abnormal protein levels. Insulin sensitivity seems to be a factor too, and diabetics are at a higher risk for developing Alzheimer's Disease.
Large studies have demonstrated that perhaps we can do something to help prevent this disease. Obesity, smoking and alcoholism have all been linked to Alzheimer's Disease. It also turns out that you can exercise the brain. Regular physical exercise is just as important as mental exercise such as reading, continuing learning and socializing. Low fat diets devoid of toxins and rich in natural anti-oxidants seem to have a protective role as well. You need to keep blood flowing to the brain just as it does to the heart. Keeping other diseases such as diabetes, elevated lipids and hypertension in check will help accomplish this task. Sadly, our primary care system is not configured to provide the in-depth care that Alzheimer families require. It is a disease that frustrates front line doctors, because the resources to detect, manager and help families to cope with it are severely lacking. Visit Alzheimer Society of Canada for more information.
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