Diagnosing and Treating Alzheimer’s Disease [Digital Edition]

Where Does Normal Forgetfulness End and
Mild Cognitive Impairment Begin?

Diagnosing and Treating Alzheimer’s Disease

From Dr. Peter V. Rabins, acclaimed author and one of the nation’s leading experts on the care and management of patients with Alzheimer’s disease and other forms of dementia.

This Special Report provides the facts you need to make informed decisions if you have to confront Alzheimer’s disease-the most common cause of dementia.

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With the passage of time, most of us will notice changes in our memory or thinking. But while some degree of forgetfulness is a normal part of getting older, dementia-and Alzheimer’s disease specifically-is not.

Yet we all worry. And not without reason.

Today, one in ten people 65 and older has Alzheimer’s disease (AD)-more than 5 million of us-yet only half of these people have actually been diagnosed with the disease. The rest don’t even know they have it! And it’s estimated that by 2050 as many as 16 million of us will have Alzheimer’s.

We read these statistics and think, “When (not if) will it happen to me or someone in my family?”

If you’re concerned because you’ve experienced recurring “senior moments” … if you have any history of AD or related memory disorders in your family … if a loved one has been showing signs of memory loss that concern you … if you are caring for someone recently diagnosed with Alzheimer’s and are wondering about a new drug or therapy … Then it’s critically important to learn everything you can about this devastating disease now so you can make informed decisions about getting the correct diagnosis and treatment — so you can partner with your doctor effectively, ask the right questions, and understand the answers.

The GOOD NEWS is that for most people, Alzheimer’s progresses very slowly. Deterioration of thinking, memory, and judgment are gradual, often taking place over many years. So you have time to learn about Alzheimer’s, to make the best treatment choices, and to plan for the future.

To help you, we asked Peter V. Rabins, M.D., M.P.H., to share his wisdom and hands-on experience with Alzheimer’s patients in a new in-depth digital report, Diagnosing and Treating Alzheimer’s Disease to download on your computer. The founding director of the Division of Geriatric Psychiatry and Neuropsychiatry at the Johns Hopkins School of Medicine, where he is a Professor of Psychiatry, emeritus, Dr. Rabins is co-author of the bestselling guide, The 36-Hour Day.

In the 109 years since Dr. Alois Alzheimer first described the symptoms of the disease, much has happened in brain research-but not enough. We still don’t have an easy way to diagnose AD with complete accuracy, nor do we have a cure.

What do we know? In Diagnosing and Treating Alzheimer’s Disease, you’ll learn how AD is currently diagnosed … the existing drugs that are used to treat it … and various new therapies that may some day provide better treatment. You’ll learn answers to key questions, such as:

• What is the current thinking about the cause of Alzheimer’s disease?
• What is the amyloid hypothesis and why is it under attack?
• Are amyloid plaques and neurofibrillary tangles the cause of Alzheimer’s or a byproduct of some other cause?
• How does beta-secretase prevent the buildup of beta-amyloid?
• What’s the difference between having a genetic predisposition to Alzheimer’s and carrying a genetic mutation for Alzheimer’s disease?
• What’s the role of APOE in the formation of amyloid plaques?
• Does depression increase a person’s risk of developing Alzheimer’s? What about head injury?

Where Does Normal Forgetfulness End
and Mild Cognitive Impairment Begin?

Some experts think that mild cognitive impairment (MCI) is the earliest manifestation of Alzheimer’s. There is no definitive test for diagnosing AD (other than an autopsy)-but clinical information from the patient’s history and mental status exams are accurate about 90% of the time. In Diagnosing and Treating Alzheimer’s Disease, Dr. Rabins explains how the Mini-Mental State Exam (MMSE)-a 17-item test that assesses general cognitive function-and other tests are used to screen for Alzheimer’s.

• You will learn about laboratory tests that can aid in the diagnosis of AD, including: ADmark Assays and testing for APOE type.
• Additionally, Dr. Rabins clearly explains the use of MRI, fMRI, SPECT, PET, and CT-high tech brain scanning and imaging techniques that can help in detecting early AD.

Aricept, Razadyne, Exelon, Namenda-Do They Work?

After screening for Alzheimer’s, then what? Currently, we have four “symptomatic therapies” for Alzheimer’s disease-drugs that can improve symptoms better than a placebo, but cannot cure patients or reverse the disease. Researchers estimate about 10 to 15 percent of the time, it seems clear that the drug is helping. Why? Should you or your loved one take medication? What are the risks?

Diagnosing and Treating Alzheimer’s Disease gets to the heart of these questions: we explore in depth the arguments for and against these AD drugs, explain the benefits and common side effects of each drug, and answer frequently asked questions on the minds of many Alzheimer’s families:

• How do you determine which patient should be using an Alzheimer’s drug?
• How long do cholinesterase medications actually help?
• What happens if the patient does not respond to the medication?
• If one drug doesn’t work, should the patient try another?
• If the cholinesterase inhibitors are considered safe and efficacious, why are so many Alzheimer’s patients untreated or else taken off the drugs after just a short time?

There’s more to Diagnosing and Treating Alzheimer’s Disease, much more. In page after page of this comprehensive report, we hone in on your most serious concerns about living with or caring for a patient with Alzheimer’s.

For example, depression in Alzheimer’s patients is common. It doesn’t appear like you’d expect it to, but it tends to respond to treatment. Dr. Rabins offers in-depth guidance on this crucial topic.

• Is depression an early symptom of Alzheimer’s disease?
• Should you tell a patient that he or she has Alzheimer’s?
• How is depression diagnosed in the Alzheimer’s disease patient?
• When is the right time to introduce medications to treat depression?
• Could antidepressants aggravate Alzheimer’s disease?
• What effect do antidepressants have on the biology of Alzheimer’s disease?

To add special value to this report, Dr. Rabins answers dozens of real-life questions from family members asking about specific concerns, symptoms, and issues regarding memory loss and dementia-the same questions that are on YOUR mind now as you search for practical advice to guide you in making decisions.

University of California, Berkeley,
School of Public Health

Diagnosing and Treating Alzheimer’s Disease is published by the University of California, Berkeley, School of Public Health. This publication is part of an outgrowth of the School’s commitment to help improve the health and wellness of our community of readers by publishing expert advice on the prevention, diagnosis and treatment for a wide range of ailments and disorders. We provide trusted, authoritative health guidance from leading physicians and researchers at America’s top medical centers and hospitals.

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