Science and Research Questions

Depending on the number and severity of the hearts attacks, your aunt’s heart may have suffered damage which would make her more prone to heart failure. A November 2008 study in the journal Neurology found that Alzheimer's disease patients who have diabetes or high blood pressure were twice as likely to die sooner than Alzheimer's disease patients without such conditions. Although the study did not specifically assess whether the occurrence of heart attacks increased mortality in Alzheimer's disease patients, in general it is known that high blood pressure is a risk factor for the development of a heart attack, which may have factored into the higher observed mortality rates. It is therefore possible that the repeated heart attacks your aunt has suffered have increased her likelihood of mortality. Your aunt’s doctor would be the best person to ask about how her heart condition may have affected her overall health and survival.

All of the behaviors you have mentioned could be symptoms of dementia, but they could also be symptoms of other medical conditions, so it is difficult to state whether or not your husband has Alzheimer's disease. As soon as possible, you should definitely take him to see a doctor, such as a neurologist, who can give him a thorough medical and psychological evaluation. As mentioned, there are other medical conditions that can cause cognitive impairments, hallucinations, mood swings, and other symptoms that can mimic dementia; these other conditions need to be ruled out before a diagnosis of dementia or Alzheimer's disease can be determined. For example, dementia can be caused by hypothyroidism, vitamin B12 deficiency, stroke, drug interactions, or brain injury. Some conditions are potentially reversible (such as dementia caused by hypothyroidism or B12 deficiency), and others (such as stroke, brain injury, and Alzheimer's disease) cause irreversible brain damage. However, even for conditions that fall into this latter category, there are often medical treatments available to help manage the symptoms.

If your husband should be diagnosed with dementia, please ask his doctor if there are any caregiver support groups he could recommend to you. Or you can search for an Alzheimer's support group in your community.

The ramifications of current global economic situation on Alzheimer's disease patients, caregivers and researchers in general could fill a book, and it may even be too early to determine what the lasting effects the global market collapse will be on the field of Alzheimer's disease. For example, relatives of Alzheimer's disease patients who have recently been faced with unemployment may now be no longer able to afford skilled nursing care for their loved ones. Medicare is already stretched tight, and more people may now require help from the government, which could translate into shortages for adequate care. Even people who are not worried about losing their jobs may now decide on less expensive options for care, or may decide to care for their loved ones themselves. How the economic crisis affects caregivers and their patients really just depends on the individual circumstances of the people involved.

In the U.S., as part of the stimulus spending package (officially called the American Recovery and Reinvestment Act (ARRA)), the National Institutes of Health (NIH) have been allotted $10.4 billion over the next two years to help promote medical and scientific research. Undoubtedly, some of this NIH funding will be devoted to Alzheimer's disease research. However, in the private sector, pharmaceutical and biotech research and development (R&D) may slow due to companies tightening their budgets as well as the increased reluctance of venture capitalists to invest in new biotech companies. Again, it is probably too early to tell how and to what extent Alzheimer's disease research will ultimately be affected.

Pittsburgh Compound B (PIB) is an imaging agent that binds to amyloid plaques. When it is attached to a tracer compound, it can be used in positron emission tomography (PET) neuroimaging to assess amyloid plaques in the brains of Alzheimer's disease patients. Scientists hope that this method will provide for a more accurate clinical means to diagnosing Alzheimer's disease.

The sedative effects of clonidine and some other antihypertensive drugs can lead to deficits in attention and mild cognition impairments, particularly in elderly individuals, but there does not appear to be any evidence in the medical literature suggesting that clonidine or other antihypertensive agents actually cause dementia. On the contrary, most studies indicate that the use of antihypertensive agents to lower blood pressure is associated with a lowered risk of developing cerebrovascular disease, such as stroke, vascular dementia or Alzheimer's disease.

Researchers are always seeking to find new methods capable of reliably diagnosing Alzheimer's disease in living patients. Part of this search has focused on finding suitable biomarkers of Alzheimer's disease, that is, biological molecules in the body that accurately correlate with the disease and which could be used clinically as part of standard diagnostic testing.

A recent study published in the Annals of Neurology by researchers at the University of Pennsylvania School of medicine reports that by measuring cerebrospinal (CSF) concentrations of two of Alzheimer's disease’s most prominent biomarkers—amyloid-beta42 peptide and tau protein—it may be possible to confirm or rule out an Alzheimer's disease diagnosis in a patient. The researchers found that changes in the CSF levels of these two biomarkers could detect Alzheimer's disease at its earliest stages, and could accurately predict whether a patient with mild cognitive impairment (MCI) would go on to develop Alzheimer's disease. For example, it was found that a CSF profile having high levels of tau protein and low levels of amyloid-beta42 significantly correlated with AD. Further, patients having the ApoE4 allele (a known genetic risk factor for Alzheimer's disease) had even lower levels of amyloid-beta42 peptide in their CSF. You can read more details about this study our news update section.

It should be noted that additional validation studies of this research test system are underway. Further work is needed to develop additional biomarkers, as well as identify more genetic risk factors that will help distinguish Alzheimer's from other neurodegenerative diseases characterized by cognitive impairments.

According to a study by researchers at the Pain and Palliative Care Center at Duke University, Alzheimer's disease patients can experience pain and unpleasant sensations just as acutely as individuals without this neurological disease. The difference, however, is that Alzheimer's disease patients are not always able to effectively communicate their pain to their caregivers. Therefore, as a caregiver it is important to try to anticipate when or if a patient may feel discomfort or pain. Sometimes subtle changes in his behavior—irritability, changes in appetite, etc.—can be indicative of discomfort related to pain. In your father’s situation, there may not have been any such indicators – as you said, he never even complained about his tooth. But now that you are aware that he may have difficulty communicating his discomfort, you can be on the lookout for potential pain indicators in the future.

To some extent, the statement is accurate in that Alzheimer's disease and type-2 diabetes mellitus (T2DM) do share some pathological and biochemical similarities. For example, both diseases are known as amyloidoses in that both are characterized by an abnormal deposition of amyloidogenic proteins—amylin deposition in pancreatic islets in T2DM, and amyloid-beta deposition in the form of plaques in Alzheimer's disease brains. Also, when deposited in and around cells, both types of proteins are toxic and cause cell death—pancreatic beta-cells in T2DM and neuronal brain cells in Alzheimer's disease. The similarities between the two diseases and their associated amyloidogenic proteins have lead researchers to question whether there are other shared cellular or molecular mechanisms underlying their pathologies, and how such findings might influence the development of effective therapies for each of these diseases.
In addition, epidemiological studies suggest that metabolic syndrome (characterized by the “deadly quartet” of factors including high blood pressure, dyslipidemia, central obesity and insulin resistance), which is predictive of T2DM, may also be predictive of and/or increase the risk of vascular dementia, stroke, and even Alzheimer's disease. Taken together with the above evidence, it is understandable how some people may therefore consider Alzheimer's disease to be a form of “diabetes of the brain.”