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Alzheimer's is a disease of the brain that causes a gradual but progressive loss of abilities in memory, thinking, reasoning, judgment, orientation, and speech. It causes an inability to recognize and identify objects and carry out motor activities. People with the disease are eventually unable to perform the most basic activities of daily living such as dressing, cooking, and bathing. Alzheimer's Disease (AD) is not the result of normal aging, but it does occur more frequently in those 65 years of age or older.

Alzheimer's disease is far more serious than the occasional forgetfulness experienced by the elderly. In its early stages, however, the disease may be difficult to distinguish from ordinary forgetfulness. Because the disease affects the brain gradually and persons ordinarily will compensate for the early symptoms, neither the person with AD nor those around her may suspect a real problem at first. The results of Alzheimer's slow but progressive damage to the brain may not be noticed until the person experiences greater than normal life stressors, major health problems, or a situation that stretches coping abilities to the breaking point; or until major behavior problems, a driving accident, unpaid bills, or significant changes in daily functioning make denial or avoidance of what is happening impossible.

Research has made considerable progress toward understanding the disease. Ongoing research is getting closer to unlocking the secrets of the disease. AD is not a simple disease with one obvious cause. It is a complicated disease that develops as the result of a complex cascade of events that occur over a period of time and affect the brain. Alzheimer's disease results from a combination of genetic and environmental factors, as well as from other factors that are being identified. Nongenetic factors such as the free radical damage linked with oxidative stress, disease-related brain inflammation, and damage associated with brain infarcts are believed to play a role in the development of the disease. The multiple genetic and nongenetic mechanisms through which the disease develops demonstrate the difficulties researchers face in identifying a clear-cut cause that points to one definite treatment. Preventing or delaying AD involves multiple approaches.

Alzheimer's (pronounced ALTS-hi-merz) disease was first identified in 1906 by a German neurologist, Alois Alzheimer. His subject was a 51-year-old woman who exhibited problems with memory and disorientation. Later, Alzheimer identified depression and hallucinations as additional symptoms. The woman's condition continued to deteriorate; a severe dementia was evident, and the woman eventually died at age 55 in a mental institution. An autopsy revealed that her brain had cortical atrophy and abnormalities in the cerebral cortex called neurofibrillary tangles and neuritic plaques. These changes in the brain were thought to have caused the impairment of the woman's memory, her disorientation, and her cognitive and emotional decline.

Beta-amyloid, an abnormal protein aggregating into plaques outside of neurons, is implicated as being a possible cause, or very close to the cause, of AD. The tau protein, aggregating into twisted tangles inside neurons, is thought by some researchers to have a causative role in the disease process. Normal tau protein helps bind and stabilize microtubules, which are part of the internal, skeleton-like structure of the cell. In AD, tau is chemically altered, which causes microtubules to fall apart. The collapse of microtubules disrupts connections over which cell communications are transported.

Genetic factors are certainly involved in the disease, but Alzheimer's is a genetically complex and heterogeneous disease. Only a small percentage of AD cases are actually caused by genetic defects. Research has also identified genetic links to the disease. These genetic factors do not cause the disease, but they are associated with an increased risk of getting Alzheimer's. Scientists are identifying other factors that might confer susceptibility for developing AD, for example, high-fat diets and high cholesterol levels. More research must be conducted before these and other findings can be considered conclusive. We do know that Alzheimer's is caused by a combination of multiple causative and risk factors. . . 

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