Better understanding of Alzheimer's raises hopes of cure


Researchers believe they are closer than ever to finding a cure for one of the biggest health problems affecting older Americans -- Alzheimer's disease.

"I think there will be drugs that will slow down the dementia within 10 years," said Warren J. Strittmatter, associate professor of Baylor College of Medicine's neurology and biochemistry departments. "There's just been an explosion of research in the last five years. We have more understanding of Alzheimer's disease than ever before."

Alzheimer's disease, an organic brain disease characterized by deterioration of mental functions, is the fourth most common cause of death among the elderly. More than 2 million people now have Alzheimer's, and with the aging of the baby boom population, that number is expected to grow.

Dr. Strittmatter said researchers are hard at work developing medical treatments to slow down the progression of the dementia, which includes memory loss and deterioration of the patient's feelings and conduct. Baylor's medical school is involved in three experimental drug trials to help find a treatment, Dr. Strittmatter said. He said clinical trials are under way.

"It won't reverse the disease but it might slow down the progression of it," he said.

"I think we've got to look at that with measured hope," said Howard Gruetzner, director of elder care services at the Heart of Texas Mental Health Mental Retardation agency. "Most drug research assumes the disorder is totally the result of a deficiency of neurotransmitters in the brain. It may be a multifaceted-caused disorder."

He said a problem with many of the proposed Alzheimer's treatments is "it seems all the stuff that works seems to work early on" and may be ineffective for someone who has had the disease several years.

But because of research, doctors are getting better at detecting Alzheimer's.

In past years, Dr. Strittmatter said, doctors could not be sure a patient had Alzheimer's until the patient died, because only an autopsy could accurately confirm whether the condition was present.

"In 1985, the biochemistry of Alzheimer's disease was opened up," Dr. Strittmatter said. That year, scientists were able to characterize the lesions of Alzheimer's found in the brains of patients.

This has resulted in an explosion of research, he said.

Scientists have found an accumulation of analoid protein, an abnormal protein, around blood vessels in the brains of Alzheimer's patients.

The accumulation builds up to ball-like structures outside the nerve cells of the brain, Dr. Strittmatter said. It is thought that such buildups cause the memory loss, he added.

Armed with such knowledge, Dr. Strittmatter said physicians now can clinically diagnose Alzheimer's disease 90 percent of the time if patients undergo a complete clinical evaluation. Clinical tests include blood tests, magnetic resonance imaging or computerized tomograph scans along with medical histories and physical examinations.

Unfortunately, such thorough examinations are not being done consistently, said Dr. Gruetzner. "If you're giving a diagnosis only with superficial evaluation, it's possible there is a treatable condition rather than Alzheimer's."

Patients should get a complete medical evaluation to rule out other causes of dementia, Dr. Strittmatter said. Often, if the dementia is caused by something other than Alzheimer's disease, it can be successfully treated.

Dr. Gruetzner said patients who appear to suffer from dementia instead may be suffering from depression.

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