Number of Patients with Dementia on the Rise
Studies are underway to help understand Alzheimer's disease and offer more effective treatment
At 81, Alberta Sabin's mind is not as sharp as it used to be, and she knows it. She frequently misplaces common items, forgets names and appointments, some of the most frustrating aspects of memory loss, she says. "I had been looking for my cell phone for three days and would you believe I found it laying on the counter in plain sight?" Sabin says. "There it was and I thought, why didn’t I see it before?"
It is that frustration that motivated Sabin to participate in University of Michigan-sponsored research designed to better diagnose and treat dementia before it escalates.
Sabin is one of millions of Americans who experience memory loss and may eventually be diagnosed with dementia. "This is an explosive disease," says Sid Gilman, M.D., director of the Alzheimer's Disease Research Center at University of Michigan Health System, who conducts research with Sabin and others in her community. "It's a disease that robs people of their humanity. They forget their families and friends."
Number of Cases Predicted to Reach 30 Million By Mid-Century
Roughly 50 percent of people who reach 85 will develop dementia, according to studies conducted by investigators at Rush Medical Center in Chicago. By age 100, the number spikes to 60 percent. Of those who develop dementia, roughly 60 percent will prove to have Alzheimer's disease.
It's predicted that the current number of patients with Alzheimer's disease in the United States is roughly five million. By the year 2050, it will grow to about 30 million, presenting a significant financial burden to the healthcare system.
Gilman and other researchers at the Michigan Alzheimer's Disease Research Center (MADRC) have a keen interest in patients like Sabin. The center first received grant support from the National Institutes of Health in 1989 and has continued to receive funding since. The researchers have so far studied 80 patients in a project that has been going on for four years about the diagnosis of Alzheimer's at the earliest sign of cognitive dysfunction. Researchers would ultimately like to evaluate 120 patients.
Studies Try to Pinpoint Best Diagnostic Strategies
One of the goals of the research is to determine the best tool for the early diagnosis of Alzheimer's disease: PET scans or clinical evaluations. In addition to Alzheimer's disease, there are other possible diagnoses with early onset cognitive impairment, including multiple strokes, frontotemporal dementia, corticobasal degeneration, and the cognitive disorder associated with Parkinson's disease, which is termed dementia with Lewy bodies. Gilman affirms, "The earliest possible treatment for Alzheimer's disease would be to the patient's greatest advantage."
PET (or positron emission tomography) is an imaging technology that allows doctors to evaluate the use of certain substances by the brain. Normally, the brain uses glucose as a fuel. Using PET scans, doctors can image the amount of glucose used by the brain, to determine whether there's a difference in brain use by the frontal lobe, temporal lobe or the parietal lobe.
PET gives the ability to make predictions as to those individuals who will go on from mild impairment of memory to developing Alzheimer's disease. These patients may then qualify to participate in clinical trials for medications that treat Alzheimer's. Studies with glucose are being supplemented by PET scans that can image beta-amyloid, one of the abnormal proteins in the brain in Alzheimer's disease.
Sabin, whose mother and grandmother had dementia, is participating in research that will help researchers diagnose and treat the illness earlier in life. Sabin says, "I have trouble remembering names, and the most frustrating is when they are names of people I know really well, and I just can't bring the name to the surface."
Sabin adds, "I felt I needed to do this because with my family history, studies I was participating in would help other people so that they won’t have to go through what I did with my own relatives."
Source: University of Michigan Health Systems
Next month: Learn more about diagnosing Alzheimer's disease, and about conditions which mimic Alzheimer's but might be treatable. See "Confusion and Forgetfulness: the Right Diagnosis is Important" in the December 2009 Caring Right at Home.
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