There are lots of reason for older people becoming confused and forgetful, but the one dreaded the most is Alzheimer’s disease.

Some of the reasons for Dementia include strokes and ministrokes (from hardening of the arteries/cholesterol, and from high blood pressure). We also see it after brain injury (i.e. boxers), and from other diseases such as Pernicious Anemia, where the B12 level is too low, and hypothyroidism. Syphillis and HIV can also cause dementia, as can viral infections of the brain, which are usually in younger age groups, and certain toxic substances, the most common of which is good old fashioned alcohol.

Depression in the elderly can mimic Alzheimers, but a good mental status test can tell the difference….and depression is treatable.

But Alzheimer’s disase is worse, because although there are treatments, the expensive treatment only slows the disease in most patients, it doesn’t cure it. And no one is sure what causes Alzheimer’s disease, or why it runs in some families and why people with Down’s syndrome get Alzheimers at a much earlier age than others.

Examination of the brain show shrunken brains with abnormal protein, placques and tangles.
Normal people have all these things, but not as bad.

Indeed, you make the diagnosis by doing a mini mental status test and by “ruling out” (doing tests for) other diseases.

A lot of people are looking for treatment and prevention.
Ignore the “stem cell” hype: it’s not a disease that putting in a few younger cells will do much for (maybe they might work for stroke or Parkinsons disease, but not for a disease caused by a toxin that would kill the new cells).

Right now docs are working on changing an enzyme that might not work well and allow the abnormal protein to pile up. LINK.

Research is early, so it may be ten years before scientists develop these things.

But the NYTimes reports that people on medicine to lower cholesterol had a smaller amount of Alzheimer changes in their brain at autopsy. (“Statin” drugs like Zocor, Mevacor, Lipetor, etc.)
Two problems with the study: One,  there was no clinical difference in people taking the medicine or not taking it.
Two: the people were taking the cholesterol medicine on an average of five years, so it might have been too soon to see a change.

A third problem: it’s not something one can do a “double blind” study to see if it works. Too many people need the cholesterol medicine to lower their cholesterol, and all these medicines have side effects (liver damage and muscle pain).
However, these medicines have been around for about twenty years, and in the last 10 years we use them more often and in higher doses.

So just like we have seen the heart disease and stroke rates go down after forty years of treating blood pressure, if the doctors are correct in thinking the “statin” medicines stop something that causes the tangles/protein of Alzheimers disease, we might start seeing a slight decrease in Alzheimer’s disease over the next twenty years.

As Drudge would say: developing….

Nancy Reyes is a retired physician living in the rural Philippines. Her website is Finest Kind Clinic and Fishmarket. She writes medical essays at Hey Doc Xanga Blog. 

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