Alzheimer Disease

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What is Alzheimer disease?

Alzheimer disease is a degenerative disease of the brain that causes dementia, which is a gradual loss of memory, judgment, and ability to function. This disorder usually appears in people older than age 65, but less common forms of the disease appear earlier in adulthood.

Memory loss is the most common sign of Alzheimer disease. Forgetfulness may be subtle at first, but the loss of memory worsens over time until it interferes with most aspects of daily living. Even in familiar settings, a person with Alzheimer disease may get lost or become confused. Routine tasks such as preparing meals, doing laundry, and performing other household chores can be challenging. Additionally, it may become difficult to recognize people and name objects. Affected people may increasingly require help with dressing, eating, and personal care.

As the disorder progresses, some people with Alzheimer disease experience personality and behavioral changes and have trouble interacting in a socially appropriate manner. Other common symptoms include agitation, restlessness, withdrawal, and problems with speech. People with this disease usually require comprehensive care during the advanced stages of the disease. After the appearance of symptoms, affected individuals usually survive 8 to 10 years, but the course of the disease can range from 1 to 25 years. Death usually results from pneumonia, malnutrition, or general body wasting (inanition).

Four major types of familial Alzheimer disease have been identified. Types 1, 3, and 4 are classified as early-onset Alzheimer disease because their signs and symptoms appear before age 65. Type 2 is classified as late-onset Alzheimer disease because its signs and symptoms appear after age 65.

How common is Alzheimer disease?

Alzheimer disease currently affects an estimated 4.2 million to 5.8 million Americans. Because more people are living longer, the number of people with this disease is expected to more than triple by 2050.

What genes are related to Alzheimer disease?

Mutations in the APP, PSEN1, and PSEN2 genes cause Alzheimer disease.

Variations of the APOE gene increase the risk of developing Alzheimer disease.

About 75 percent of Alzheimer disease cases are classified as sporadic, which means they occur in people with no history of the disorder in their family. Although the cause of these cases is unknown, genetic changes are likely to play a role. Virtually all sporadic Alzheimer disease begins after age 65, and the risk of developing this condition increases as a person gets older.

The remaining cases of Alzheimer disease are familial, which means they are found in multiple members of a family. Familial Alzheimer disease can be divided into early-onset disease (symptoms begin before age 65) and late-onset disease (symptoms begin after age 65).

The early-onset forms of Alzheimer disease are caused by gene mutations that can be passed from parent to child. Researchers have identified three genes that cause these forms of the disorder. Mutations in the APP gene cause Alzheimer disease type 1. Changes in the PSEN1 gene are responsible for Alzheimer disease type 3, while PSEN2 mutations lead to Alzheimer disease type 4. As a result of mutations in any of these genes, large amounts of a toxic protein fragment called amyloid beta peptide are produced in the brain. This toxic peptide can build up in the brain to form clumps called amyloid plaques, which are characteristic of Alzheimer disease. Amyloid plaques may lead to the death of nerve cells and the progressive signs and symptoms of this disorder.

Some evidence indicates that people with Down syndrome have an increased risk of developing type 1 Alzheimer disease. Down syndrome, a condition characterized by mental retardation and other health problems, occurs when a person is born with an extra copy of chromosome 21 in each cell. As a result, people with Down syndrome have three copies of many genes in each cell, including the APP gene, instead of the usual two copies. Although the connection between Down syndrome and Alzheimer disease is unclear, the production of more amyloid beta peptide in cells may account for the increased risk. People with Down syndrome account for fewer than 1 percent of all cases of Alzheimer disease.

The genetic causes of late-onset (type 2) familial Alzheimer disease are less clear. This disorder is probably related to mutations in one or more risk factor genes in combination with lifestyle and environmental factors. A gene called APOE has been studied extensively as a risk factor for the disease. In particular, a variant of this gene called the epsilon 4 (e4) allele seems to increase an individual's risk for developing type 2 Alzheimer disease.

How do people inherit Alzheimer disease?

The early-onset familial forms of Alzheimer disease (types 1, 3, and 4) are inherited in an autosomal dominant pattern, which means one copy of the altered gene in each cell is sufficient to cause the disorder. In most cases, an affected person inherits the altered gene from one affected parent.

The inheritance pattern of late-onset (type 2) familial Alzheimer disease is uncertain. People who inherit one copy of the APOE e4 allele have an increased chance of developing the disease; those who inherit two copies of the allele are at even greater risk. It is important to note that people with the APOE e4 allele inherit an increased risk of developing Alzheimer disease, not the disease itself. Not all people with Alzheimer disease have the e4 allele, and not all people who have the e4 allele will develop the disease.

Source: National Institutes of Health

Penn Treaty Launches Wellness Program to Support Healthy, Independent Living

Highlighting the wellness services is the Brain Fitness Program(TM), a computer-based mental exercise program that guides users through a series of exercises designed to help improve memory, strengthen communication, and sharpen thinking skills-with the ultimate goal of delaying the onset of dementia and Alzheimer's disease.

Hailed as one of the "medical breakthroughs of the year" by CNBC, the program was developed by Posit Science (www.positscience.com) and is the first of its kind in the long-term care insurance industry.

"We're eager to offer wellness tools that may help policyholders take control of their health and address concerns they may have about developing dementia as they age," said Stephen LaPierre, executive vice president of Penn Treaty. "I believe that insurers have the responsibility to help policyholders move toward healthy, independent living well into their retirement years."

In recently published studies, Posit Science reported that participants using the Brain Fitness Program(TM) showed statistically and clinically significant gains on standard cognitive batteries, while participants in control groups showed minimal or no gains. The gains are equivalent to 10 or more years of improved cognitive function, such as the ability to remember and with faster processing speed, among populations over age 60.

Tailored exclusively for Penn Treaty long-term care insurance policyholders, the Wellness Privileges Program will be rolled out over the next year and will be available to policyholders for free or at a discount.

In addition to the Brain Fitness Program(TM), the Wellness Privileges Program will offer lifestyle coaching, which is focused upon the policyholder's specific health conditions and risks; an emergency response service that provides nationwide medical alerts and medical alarm systems; and critical disease screening, which includes heart, aorta, carotid artery scans and osteoporosis screenings for early detection of these problems.

Designed exclusively for Penn Treaty long-term care insurance policyholders, the Wellness Privileges Program will be rolled out over the next year. The various offerings under the Wellness Privileges Program will be available to policyholders for free or at a discounted rate.

"Penn Treaty has been a pioneer and innovator in providing long-term care insurance solutions for over 35 years. We are dedicated to improving the quality of life of the nation's seniors," LaPierre said. "We're leading the way again with a new wellness program that sets an example for the industry."

Keywords: Alzheimer Disease, Central Nervous System Disease, Dementia, Wellness, Penn Treaty American Corporation.

This article was prepared by Pain & Central Nervous System Week editors from staff and other reports. Copyright 2007, Pain & Central Nervous System Week via NewsRx.com.