As the world's population continues to age and which is happening at a rapid pace the number of people who will be diagnosed with Dementia will grow dramatically The numbers will rise from 35 million today to 65 million by the year 2030 In the United States alone it is estimated that 1 in 9 people over the age of 65 are diagnosed with AD As a result of these rising numbers in AD diagnosis many patients families and society as a whole will be affected It is of extreme importance for physicians to have a deep understanding of the disease in order to provide patients their families and society with the tools needed to cope with the increasing number of people who are diagnosed with AD Dr Alois Alzheimer a psychiatrist and neuropathologist was the first to describe the symptoms and conditions which today has become known as Alzheimer's disease His first case study was that of a 51 year old woman who showed many symptoms such as language and memory impairment disorientation and behavioral impairments to name a few Surprisingly many of the findings described by
Dr Alois Alzheimer over a century ago are those observations that are critical to our understanding of AD in today's medical world AD is described as a gradual loss of cortical neurons specifically the pyramidal cells which are found in areas such as the cerebral cortex the hippocampus and the amygdala These areas are associated with higher brain functions The most reliable way to diagnose AD is by completing a pathological evaluation during autopsy The evaluation is based on the presence and distribution of amyloid plaques and neurofibrillary tangles in the brain When diagnosing AD physicians mainly rely on medical history physical and neurological exams and Velez 2 neuropsychological evaluations They also rely on excluding other medical conditions which could possibly cause some of the symptoms presented during the diagnosis process The accuracy is 70 to 90 compared to the pathological evaluation during an autopsy There is no cure for AD today research is still ongoing Through way of research some medications for the treatment of AD have been approved but these medications only help control the symptoms of patients with AD These medications do not help control the progression of the disease Research is still ongoing the modification of some of these drugs have been used to evaluate patients in clinical trials and others continue to be evaluated in ongoing trials At the time of the submission of this article three trials were completed using different amyloid lowering drugs
These drugs failed to be effective in the treatment of AD Some reasons as to why these trials failed were presented These trials were conducted with patients who demonstrated to be at a mild to moderate stage of dementia at which the damage to brain functions is too high to reverse using drugs or for the drugs to have any effects on the subject AD can begin many years preceding the beginning of dementia For this reason early diagnosis and intervention is crucial As the result of previous failed trials trials are now being performed with populations who have no dementia but are at higher risk for developing AD Populations such as those experiencing mild cognitive impairment MCI Neuroimaging and other measures such as other diseases and environmental exposures are used to study AD and MCI These measures provide a better way in the selection of subjects for clinical trials They are also used to identify those subjects who are at a higher risk of developing AD thus providing them with treatment at the early stages of the disease to observe Velez 3 the progression of the disease and whether or not the subject is responsive to the treatment provided during the trial MRI s fMRI s and PET s are used to study the structure of the brain An MRI measures the energy released by gray matter white matter and cerebrospinal fluid An fMRI determines brain function by measuring hemodynamic the blood oxygen level And lastly a
PET measures regional brain metabolism Studies of large populations in the United States and Europe have predicted the prevalence of mild cognitive impairment MCI among adults age 65 or older to be 24 Patients who experience mild cognitive impairment show an annual rate of progression toward dementia of 15 These rates were higher in specialty clinic based trials compared to those communities based trials The progression of MCI to dementia increased above the 2 rate which was found with the general older population Research in the control of diseases state that mild cognitive impairment is effective because it describes symptoms related to the early stages of AD A lot of progress has been made since the first case of AD was described by Dr Alois Alzheimer There is a better understanding of etiology and diagnosis of the disease There have been considerable advances made in identifying the early stages of AD such as mild cognitive impairment There have also been improvements in options for diagnosing and treating the symptoms of AD There is still lots of work to be done to find the cure for AD More studies need to be done to get a better understanding of what causes the cellular and molecular processes to go bad
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