The aging brain and Alzheimer's disease

by Andrea J. Peterson

Betty often wanders out of her home at night. Her daughter and primary caregiver, Sue, has to go look for her in the neighborhood and bring her home. Esther likes to take the bus downtown to do her banking and shopping, but once she couldn't remember how to get home. Fortunately, a kind stranger helped her find the right bus. Fred's wife, Ellen, provides round-the-clock care for her husband. She loves him dearly, but the exhausting care schedule wears her out. A social worker helps her find an adult day-care program that gives her respite three days a week.

These are just a few examples of the serious challenges that Alzheimer's patients and their families face on a daily basis. The most common of dementing disorders, Alzheimer's currently affects an estimated 4.5 million Americans. The Alzheimer's Association projects that by the year 2050, between 11 and 16 million Americans could have the disease unless a cure is found.

The personal toll

Alzheimer's disease can have an unusually long course, up to 20 years from the time of diagnosis, with an average duration of 8 years. During this time, patients experience the gradual impairment of memory, thinking, and behavior. Eventually, 24-hour care is required, including assistance with daily activities such as eating, grooming, and using the toilet.

Families struggle with role reversal, with children assuming the parenting role. Maintaining the patient's dignity and individuality must be balanced with insuring their safety inside and outside the home. For many families, relinquishing the car keys is an especially painful turning point.

Medication mismanagement is an even greater issue. Patients often want to continue managing their multiple medications, and families may hesitate to step in and make sure all medications are being taken appropriately. Unfortunately, due to short-term memory problems, patients may forget that they've taken their medications and take them again — or forget to take them altogether. Since many Alzheimer's patients suffer from other serious conditions, such errors can be extremely dangerous.

The economic impact

According to the Alzheimer's Association, the average lifetime cost of Alzheimer's care for an individual is $170,000. The total national direct and indirect costs of caring for individuals with Alzheimer's add up to at least $100 billion per year — an amount that is expected to increase as the baby-boomer generation ages.

Early diagnosis and treatment is key to managing and eventually preventing Alzheimer's disease. Basic science researchers at the University of Minne-sota are hard at work investigating possible molecular causes of Alzheimer's, while clinical researchers are exploring the efficacy of known and approved medications as well as the accuracy of various diagnostic methods.

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