Introduction

Less than 30 years ago, the prevailing medical wisdom declared that "senility" was the result of either normal aging or hardening of the arteries. Today we are getting closer to truly understanding the causes of the major neurological disease of old age, the aging brain, for which one of the many symptoms is failing memory. As the brain ages, mental and physical functions are impaired. The most extreme form of this process can lead to death.

While the rest of our body reaches its prime around age 30, starting its natural progression of declining health soon thereafter, our brain does not start loosing its major functions until our 60s. The indicator of an aging brain is loss of brain tissue with men losing brain tissue almost three times faster than women, according to a study conducted at the University of Pennsylvania in 1999.

Four million Americans suffer from dementia, the hallmark of Alzheimer's Disease (AD). This number is expected to swell fourfold by the year 2040. 12% of people aged 60 and above, and 50% of those over 80 years of age, suffer from dementia, and the main cause is AD. Dementia is the fourth leading cause of death in those over 60. AD alone kills 100,000 people per year in the U.S.A. Onset of symptoms can start as young as 40 and continue for about 20 years before severe symptoms - such as loss of memory, inability to carry out normal work and being irritable and suspicious - show. 

Current treatment of dementia and AD include drugs (medications such as Aricept, anti-inflammatory drugs such as ibuprofen), hormones (DHEA, estrogen), nutritional supplementation (membrane stabilizers such as Phosphatidylserine, herbs such as Gingko Biloba, Butcher's Broom, Cat's Claw, amino acids such as L-Glutamine and Tyrosine, antioxidants such as Vitamin A, C, E and Selenium) and brain exercises such as mental stimulation exercises.


Pathophysiology of Dementia and AD

AD is a degenerative disease characterized by progressive mental deterioration, memory loss, and dementia. Memory and abstract thought processes are impaired. Symptoms include depression, disorientation of space and time, inability to concentrate and communicate, loss of bladder and bowel control, memory loss, personality change, and severe mood swings. Death usually occurs within 5 to10 years as the individual becomes totally incapacitated. Nerve fibers surrounding the hippocampus, the brain's memory headquarters, become tangled and shrunken. Information cannot be properly transmitted, new memory cannot be formed, and old memories cannot be retrieved. Characteristic plaques of beta-amyloid protein build up and damage nerve cells.


Diagnosis

There are no reliable and accurate markers, in the form of blood tests, of dementia and AD. A brain scan is helpful in marking the progression of the disease by indicating the brain's glucose metabolism rate. A test measuring electrical activity in the brain can be helpful, but not definitive. The measurement of the amount of beta-amyloid found in spinal fluid is not a definitive diagnostic tool either. Diagnosis of AD is not straightforward and rests largely on a combination of clinical findings, confirmed by a specific set of physiological changes in the brain.