Decade of the
What Is Alzheimer's?
"Alzheimer's disease" is the term used to describe a
dementing disorder marked by certain brain changes,
regardless of the age of onset. Alzheimer's disease is
not a normal part of aging--it is not something that
inevitably happens in later life. Rather, it is one of
the dementing disorders, a group of brain diseases that
lead to the loss of mental and physical functions. The
disorder, whose cause is unknown, affects a small but
significant percentage of older Americans. A very small
minority of Alzheimer's patients are under 50 years of
age. Most are over 65.
Alzheimer's disease is the exception, rather than the
rule, in old age. Only 5 to 6 percent of older people
are afflicted by Alzheimer's disease or a related
dementia--but this means approximately 3 to 4 million
Americans have one of these debilitating disorders.
Research indicates that 1 percent of the population aged
65-74 has severe dementia, increasing to 7 percent of
those aged 75-84 and to 25 percent of those 85 or older.
At least half the people in U.S. nursing homes have
Alzheimer's disease or a related disorder; in 1985, the
annual cost of caring for individuals with Alzheimer's
disease and related dementias in institutional and
community settings was estimated between $24 billion and
$48 billion for direct costs alone and is probably
higher today. As our population ages and the number of
Alzheimer's patients increases, costs of care will rise
Although Alzheimer's disease is not curable or
reversible, there are ways to alleviate symptoms and
suffering and to assist families. Not every person with
this illness must necessarily move to a nursing home.
Many thousands of patients--especially those in the
early stages of the disease--are cared for by their
families in the community. Indeed, one of the most
important aspects of medical management is family
education and family support services. When, or whether,
to transfer a patient to a nursing home is a decision to
be carefully considered by the family.
Who Gets Alzheimer's Disease?
The main risk factor for Alzheimer's disease is
increased age. The rates of the disease increase
markedly with advancing age, with 25 percent of people
over 85 suffering from Alzheimer's or other severe
Some investigators, describing a family pattern of
Alzheimer's disease, suggest that in some cases heredity
may influence its development. A genetic basis has been
identified through the discovery of several genetic
markers on chromosomes 21 and 14 for a small subgroup of
families in which the disease has frequently occurred at
relatively early ages (beginning before age 50). Some
evidence points to chromosome 19 as implicated in
certain other families that have frequently had the
disease develop at later ages.
At the same time, data indicate that the likelihood that
a close relative (sibling, child, or parent) of an
afflicted individual will develop Alzheimer's disease is
low. In most cases, such an individual's risk is only
slightly higher than that of someone in the general
population, where the lifetime risk is below 1 percent.
And, of course, many disorders have a genetic potential
that is never expressed--that is, despite being at risk
for a certain illness, one might go through life without
ever developing any symptom of the disease.
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