Health Zone: Dr Miriam Stoppard's Health Focus: TALKING TO A STRANGER : ALZHEIMER'S DISEASE, PART 1

Article excerpt

Byline: Miriam Stoppard

ALZHEIMER'S disease is now the fourth most common cause of death in the Western world.

While most cases develop later in life, there are still some in the under-65 age group where the risk is one in 1,000. By the age of 80 it's one in five.

In the first of a two-part series, Miriam investigates the causes and consequences of this distressing condition.IN Alzheimer's disease, brain cells die slowly and inexorably. People gradually lose their memory, judgment and ability to find their way around their neighbourhoods or even their own houses.

Alzheimer's disease is the most common form of dementia, affecting nearly 500,000 people in the UK and nearly 18million people worldwide.

Dementia is a progressive disease of the brain and leads to personality changes and eventually severe disability.

Although age is the biggest risk factor for Alzheimer's disease, the youngest known person with Alzheimer's is in their thirties.

Some early warning signs are often memory loss, mood swings and difficulty finding words or places. We're all familiar with these signs from time to time, but in Alzheimer's the pattern can be seen to get suddenly worse or deteriorate steeply in a matter of months.The tragic tollAS Alzheimer's progresses a person will:

ROUTINELY forget recent events, appointments, names and faces and have difficulty in understanding what's being said.

BECOME confused when handling money, driving a car or, for example, using a washing machine.

UNDERGO personality changes, appear no longer to care about those around them, become irritable or apathetic, sometimes uncharacteristically rude.

SUFFER mood swings and burst into tears for no apparent reason, or become convinced that someone is trying to harm them.

In advanced cases people may also:

GET up in the middle of the night, wander off from their home and become lost.

LOSE their inhibitions and sense of suitable behaviour, undressing in public or making inappropriate sexual advances.

Finally:

THE personality disintegrates and the person becomes totally dependent or bed-bound. Relatives have described this experience as like living with a stranger.What brings about symptoms?

ALZHEIMER'S is a physical disease which attacks brain cells (where we store memory) and brain nerves and transmitters (which carry instructions around the brain).

Production of a chemical messenger acetylcholine is disrupted, nerve ends are attacked and cells die. The brain shrinks and gaps develop in the parts of the brain that receive and store new information. The ability to remember, speak, think and make decisions is disrupted.

What causes the disease?

THE short answer is we don't know. It may be a combination of factors, some we're born with, some in our environment and some which happen to us. Things that make Alzheimer's disease more likely are called risk factors - and they include:

A family condition SOME people are born at risk because of the genes they inherited. Alzheimer's runs in a small number of families where up to half the members are at risk.

In these families, faulty genes have been found on chromosomes 21, 14 and 1. If you have three or more close relatives who developed Alzheimer's at an early age, your doctor can counsel you about genetic testing.

Early onset

ABOUT 17,000 people in the UK are affected below the age of 65, sometimes as young as 35. Alzheimer's disease in younger people often progresses more rapidly. A number of rare genetic faults make the disease more likely at a young age. …