Alzheimer's is the most common cause of dementia. Five million people in the United States have Alzheimer's Disease, and it is the nation's sixth leading cause of death.

The costs are already enormous, $148 billion a year and rapidly increasing as our population ages. Among people 85 and older, about 40 percent develop Alzheimer's ultimately becoming incontinent, mute, bedridden become completely dependent on others.

But currently, the diagnosis is not made until symptoms develop, but changes can be found in the brain 10-15 years before this, and by the time of clinical diagnosis, much of the damage is permanent. Drugs now in use can modify the disease with some improvement and slowing progression, but at best keep those suffering of the condition out of nursing homes for less than a year compared to those that are untreated.

There are risk factors that can be addressed in earlier years to limit the chances of suffering from this condition. These include diet, brain exercises, and supplements. Genetic testing and biomarkers detectable in the spinal fluid can help identify those at risk or with damage developing before memory loss is apparent. New imaging studies are becoming available that may make the diagnosis more certain and not be confused with other conditions that cause memory loss that would need other treatments. There are two classes of prescription medications that may help this condition. Acetylcholinesterase inhibitors (Aricept, donepezil, galantamine, and Exelon) help reduce the breakdown of the main memory neurotransmitter. They are often used "off label" for other conditions with memory loss such as traumatic brain injury, vascular dementia, and multiple sclerosis memory loss. Overall, 1/3 of people improve and as a group the progression of the condition may slow by up to 50%. The ongoing damage to the brain continues, and the end may be delayed but not prevented. Namenda is another class of drug that helps to block excessive glutamine that can be damaging to the brain. It is approved for moderate Alzheimer's and can decrease irritability and irascibility.

A promising new area of treatment involves the histamine H3 receptor. It is different from the H1 receptor active in allergies, and H2 receptor involved with gastric acid secretion. It is found in multiple areas of the brain, especially in memory areas like the hippocampus and hypothalamus. H3R antagonists have been shown to help memory and learning ability in animal and human studies. NervePro is presently participating in a clinical trial to test a medication of this type in a larger group of patients. Side effects are low, diminished drowsiness and sometimes insomnia can be experienced, cataract formation is being looked into, but little else has been noted. This is a new way to address the problem of memory loss, call NervePro to learn more.

Being a research subject may have advantages, according to one person in a study.

"We're the first ones in line," she said. "If I am genetically predisposed, and they have a preventive medication, they'll tell me right away."


Alzheimer's Beginnings

Some forgetfulness is normal. Distraction, fatigue and medications can contribute to difficulties remembering. A joking rule of thumb about Alzheimer's is actually close to the truth: it's O.K. to forget where you put your car keys, as long as you remember what a key is for. But worsening forgetfulness is a cause for concern. When occasional forgetting of names, recent events, and daily activities is the main problem, this is called Mild Cognitive Impairment. People with this often are slower and more distractable, but can still live without assistance. If more "executive tasks" become difficult such as following through on paying bills, making appropriate financial decisions, remembering the season, being able to drive safely or keep up a household, then one has dementia.

The specific cause of dementia is determined by imaging (CT or MRI) studies, lab tests and sometimes additional procedures such as PET scan or spinal fluid analysis. Once the type of dementia can be determined, the best combination of treatments can be used. Also, different complications develop in different dementias, and the common medications for Alzheimer's can make some other dementias worse.

No one knows whether the disease affects thinking, mood or personality before memory fails. Researchers think that the brain, like other vital organs, has a huge reserve capacity that can, at least for a time, hide the fact that a disease is steadily destroying it. There may be a very long phase where people are not themselves.