Haley Fitzpatrick
Dementia: a word of growing prevalence in modern lexicon that has strayed progressively farther from its original definition. Today, the term is commonly used to refer to an elderly person’s “senility,” including forgetfulness and declining mental acuity. This lenient use of the word illustrates the widespread belief that mental decline is a standard symptom of aging. Dementia, however, is actually a “term for decline in mental ability severe enough to interfere with daily life”.1 It is a grave condition that serves as the overarching category for a list of serious mental diseases such as Huntington’s disease, Parkinson’s disease dementia, and Alzheimer’s. The symptoms associated with dementia, which include memory, communication, focus, reasoning, and/or visual perception impairments, are often minimized by the commonplace use of the word.1 Changing the rhetoric surrounding dementia and aging will give proper recognition to the debilitating mental conditions that are becoming more prevalent with the increasing life expectancy of the American population.
Alzheimer’s disease is a well-studied and well-known example of dementia. It is the most common form of dementia, accounting for about 60-80% of all of cases2. In the United States, 5.2 million Americans aged 65 and over currently have Alzheimer’s, representing one in eight seniors.2 Based on the 2012 Alzheimer’s disease Facts and Figures Report released by the Alzheimer’s Association, the population of citizens with Alzheimer’s is expected to increase by 30 percent by 2025 and triple by 2050. Alzheimer’s disease is already the 6th leading cause of death in the United States, making the projected figures particularly alarming.
The concern surrounding Alzheimer’s is further exacerbated due to a lack of conclusive information regarding the cause of the disease. The most promising research on Alzheimer’s has focused on finding a treatment for the early biological effects of the pathology. Physiological effects are found in the brain where neurons begin to die, particularly in areas of the brain related to memory including the hippocampus. The neuronal cell death ultimately causes progressive deterioration of cognitive function.
Research has proven that the death of nerve cells in the brain is caused by the formation of two different types of toxic protein aggregates called tangles and plaques; tangles are twisted fibers of a protein called tau that build up inside neuronal cell bodies, while plaques are deposits of protein fragments called beta-amyloid that aggregate between neuronal cells.2 In recent years, research has focused therapeutic treatments to reduce toxic protein aggregation.3 Despite the preliminary success of agents that reduce toxic protein formation, the drugs largely failed in clinical trials.4 Currently, there are limited approved treatments that temporarily improve symptoms, but do not change the course of the terminal disease.2 As such, Alzheimer’s disease currently has no known cause, cure, or effective treatment.
Research regarding old age must no longer solely address physical well being, but must also include mental health. A Special Studies Report5 conducted by the U.S. Census Bureau found that the number of Americans surviving into old-age, particularly into their 80s and 90s, is expected to grow dramatically due to advances in medicine, medical technology, and social and environmental conditions. Dementia affects an increasing number of individuals due to this increasing life expectancy, which in part explains the observable gender disparity in those suffering from Alzheimer’s disease. Women make up more than two-thirds of Americans aged 65 and older with Alzheimer’s disease, which reflects the longer life expectancy for women than men.2
Alzheimer’s not only touches the elderly, but also affects American society in a larger sense. Research shows that family members, relatives, and friends frequently care for individuals with Alzheimer’s. In 2011, these unpaid caregivers provided an estimated 17.4 billion hours of care, which represents approximately $210 billion dollars.2 Additionally, taking care of a person with Alzheimer’s can be emotionally difficult. Family caregivers of Alzheimer’s patients experience stress on both family relationships and financial situations.
Alzheimer’s disease and generalized dementia are not commonplace conditions that come with aging, but rather cause severe consequences for the individual, loved ones, and society in general. However, in the face of a growing elderly population, future research looks promising as President Obama signed the National Alzheimer’s Project Act in January 2011, calling for a coordinated national plan to aggressively move toward a cure.6
References
1. Alzheimer’s Association. alz.org. http://www.alz.org/. Accessed March 3, 2013.
2. 2012 Alzheimer’s disease facts and figures. Alzheimer’s and Dementia: The Journal of the Alzheimer’s Association. 2012; 8;131–168. http://www.alz.org/downloads/facts_figures_2012.pdf. Accessed March 5, 2013.
3. Wilcock, DM, Colton CA. Anti-amyloid-beta immunotherapy in Alzheimer’s disease: relevance of transgenic mouse studies to clinical trials. The Journal of Alzheimer’s Disease. 2008; 15; 555-569. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2615484/.
4. Nussinov, R et al. Alzheimer’s disease: which type of amyloid –preventing agents to employ? Journal of Physical Chemistry Chemical Principles. 2013. http://www.ncbi.nlm.nih.gov/pubmed/23450150.
5. He W, Sengupta M, Velkoff VA, DeBarros KA. 65+ in the United States: 2005. Current Population Reports. 2005. https://www.census.gov/prod/2006pubs/p23-209.pdf.
6. U.S. Department of Health and Human Services. “Focus on…We Can’t Wait: Presidential Initiative Stimulates Alzheimer’s Research.” National Institute on Aging. http://www.nia.nih.gov/alzheimers/publication/2011-2012-alzheimers-disease-progress-report/focus-we-cant-wait-presidential. Accessed March 2, 2013.