Science and Research Questions

The link that you may have heard about recently involves a genetic variation near the gene involved in vitamin D metabolism in the brain. Vitamin D deficiency has been associated with memory problems, so people who cannot process vitamin D efficiently may be more susceptible to issues with memory. The recent study compared the DNA of nearly a thousand patients (492 with Alzheimer's disease, 498 without AD) and found there was a single variation in the DNA of Alzheimer's patients near this “vitamin D” gene. Doctors are still unsure of what the variation actually means, but theorize that it may have something to do with how these patients utilize vitamin D in the brain.

Your mother should be deeply thanked for her generosity, as she is making an invaluable contribution to science in general and Alzheimer's research in particular. You should first find out what donation programs are available at teaching hospitals, medical schools, or research institutions in your area. You can do this by searching online for local programs (type in something such as “body donation, Alzheimer's research” and your state or city in a search engine) or by calling the neurology department of medical universities in your area. Most donation programs will require that your mother’s wishes are specified in her will—you may want to consider speaking with her lawyer for this. The donation program director will inform you of any additional procedures, policies, forms or expenses required for the donation.

It is not uncommon for Alzheimer's patients to experience hallucinations. Reports indicate that just under half of patients diagnosed with Alzheimer's develop some hallucinations that are either visual and/or auditory in nature, and which generally occur in the later stages of the disease. If anything, the drug Abilify® should help to reduce the occurrence of hallucinations. Please talk to your father’s physician about these hallucinations to see if his medication needs to be adjusted or changed.

Brain trauma and brain injury (often called traumatic brain injury or TBI) have been linked to an increased risk of developing Alzheimer's disease. Studies indicate that injury to the brain can cause the deposition of amyloid-beta protein, which is one of the main proteins found in the characteristic brain plaques of Alzheimer's disease. So if a crash results in a head injury, then it could increase an individual's overall risk of developing Alzheimer's.

It is unlikely that the results of your blood test are indicative of Alzheimer's disease for two main reasons. The first reason is that doctors do not typically test for Alzheimer's disease in a routine examination unless they have some reason to suspect that a person has the disease, such as memory problems or uncharacteristic behaviors. Your doctor may have detected an abnormal level of a particular protein unrelated to Alzheimer's (or an abnormally high or low protein level in general)—but that is different from an abnormal protein. The two most commonly measured blood proteins are albumin and globulin, neither of which can tell you anything about Alzheimer's disease.

Second, the only real blood test currently available that can give some indication of a person’s risk of developing Alzheimer's disease is a genetic test that looks for specific genes or mutations in specific genes. The genetic tests examine DNA, not protein (proteins are what are produced from DNA). Because this test is not routine and can be expensive, your doctor would have informed you if this test had been performed.

Donepezil is an acetylcholinesterase inhibitor that can help to improve cognition in Alzheimer's disease patients. As such, it has been explored as a possible therapy for other disorders that affect memory and/or attention. For example, the effectiveness of donepezil has been investigated for the treatment of mild cognitive impairment (MCI), schizophrenia, vascular dementia, Parkinson's disease with dementia (PDD), dementia with Lewy bodies (DLB), autism, Down syndrome, attention deficit hyperactivity disorder (ADHD), Tourette's syndrome, traumatic brain injury, and the cognitive symptoms associated with multiple sclerosis. Donepezil has been found to be most effective in cases of MCI, vascular dementia, PDD, DLB, and multiple sclerosis. However, donepezil is currently only FDA-approved for the treatment of mild- to moderate-Alzheimer's disease.

Mild forgetfulness and memory delays often occur as part of the normal aging process. Older individuals simply need more time to learn a new fact or to remember an old one. We all have occasional difficulty remembering a word, someone's name, or where they placed their car keys. Memory loss—particularly of short-term memory—will increase with age and it is all quite normal. A 50 year old will simply not be able to remember things as quickly or well as a person half their age.

Despite this discouraging news, there is evidence to suggest that exercising your mind as well as your body can help to reduce memory loss. As an added benefit, healthy diet and exercise can also help to reduce your risk of developing Alzheimer's disease. You should strive for diet that is low in saturated and trans fats and high in antioxidants. Foods considered antioxidant-rich include blackberries, blueberries, spinach, strawberries, red bell peppers, walnuts, artichoke hearts, green tea, dark chocolate, red wine and tomatoes, among many others. You can mentally exercise your brain by doing puzzles, word games, learning a new language or technology—anything really that challenges your mind and really makes you think. But don't forget about your body. Physical exercise for your body is just as important because it can help to lower blood pressure, reduce your body weight (or maintain a healthy weight), and decrease stress levels. Reducing stress will not only act to aid your short-term memory, but can also improve your overall emotional well-being, which is good for your long-term cognitive health. Finally, be sure to get enough sleep. Most adults need at least 7-8 consecutive hours of sleep each night in order for their memory functioning to be at its best.

Shingles, also known as herpes zoster, is caused by the varicella-zoster virus, a relative of the herpes simplex virus that causes cold sores. It is an opportunistic virus that may lay dormant for decades before re-infecting an individual with painful skin rashes when the patient's host defenses are down. Varicella-zoster attacks the peripheral nerves, but can also infect the nerves' origin, such as in the spinal cord or brain, which can lead to a brain infection (called encephalitis).

Shingles dementia has been identified but its incidence is quite low. The symptoms are, as you mentioned, clinically identical to Alzheimer's disease (AD). Unlike Alzheimer's, however, the brains of patients having shingles dementia have no pathological lesions characteristic of AD. Instead, the pathological brain damage observed in shingles dementia cases is typical of viral meningoencephalitis (an infection of both the brain and meninges). It is likely that your friend's doctor has already given her an antiviral medication (such as acyclovir) and/or an anti-inflammatory such as corticosteroids, which are about the only treatments available for a varicella-zoster type encephalitis infection.