Alzheimer’s disease is a complex disease that affects the brain. Approximately 4 million Americans have this disease. Although many things about Alzheimer’s remain a mystery, research continues to bring us a better understanding of the disease, more accurate diagnoses, and more effective treatments.
Alzheimer’s disease is a progressive, ultimately fatal, disorder in which certain types of nerve cells in particular areas of the brain degenerate and die for unknown reasons. Vulnerable brain regions include the amygdala as well as the hippocampus and areas around the hippocampus, and affected cell populations include cortical pathways involved in catecholaminergic, seritonergic, and cholinergic transmission. Advancing pathology is believed to underlie the classic clinical presentation of memory deficits followed by gradual erosion of judgment, reasoning ability, verbal fluency, and other cognitive skills.
The two “hallmark” Alzheimer lesions observable at autopsy – first described by German neuropsychiatrist Alois Alzheimer in 1906 — are amyloid plaques and neurofibrillary tangles. Plaques are extra cellular deposits of abnormally processed amyloid precursor protein, and tangles are intracellular accumulations of the cytoskeletal protein tau.
Researchers now recognize that development of plaques and tangles may represent a fairly late stage in the disease process that may or may not reflect the fundamental biochemical disruptions at work in Alzheimer’s.
Although the “amyloid hypothesis,” which assigns a central causative role to abnormal amyloid processing, remains the most widely embraced theory, other active areas of research include tau, inflammation, disruptions of cell signaling pathways, and cardiovascular risk factors.
Key elements of disease management include timely diagnosis and effective use of available therapies to manage cognitive and behavioral symptoms. Other important considerations include identifying comorbid conditions and monitoring individuals for adequate nutrition, hydration, and pain management as well as signs of abuse. Drugs currently approved specifically to treat Alzheimer symptoms all act chiefly by inhibiting acetylcholinesterase, the main enzyme that breaks down acetylcholine. For about 50 percent of the individuals who take them, these drugs offer a modest, temporary delay in the worsening of cognitive symptoms. But cholinesterase inhibitors do not stop underlying neurodegeneration, and the disease inevitably progresses.
The New York City Chapter of the Alzheimer’s Association is a founding member of the Alzheimer’s Association which is the largest national voluntary health organization dedicated to advancing research for the causes, treatments, and prevention of Alzheimer’s disease. As baby boomers enter the age of greatest risk, Alzheimer’s disease is becoming the leading public health crisis of the 21st century.
The mission of the New York City Chapter of the Alzheimer’s Association is to create and promote comprehensive and humane care and treatment for persons with Alzheimer’s disease and related disorders, and to provide support for their family and professional caregivers. The Chapter meets this mission in the community through increasing public awareness, providing education, creating and encouraging replication of model programs, collaborating with research centers, and undertaking advocacy.