When does dementia really begin

The main aggravation with treating Alzheimer’s has been that as many drugs as they’ve tested and approved, most do little if anything to attack the damage already done to the brain.

Researchers and Doctors have come to agree that the actual brain damage began many years before symptoms of memory loss ever present themselves. Many scientists think the problem may be that the drugs were given too late, when, as Dr. John C. Morris, an Alzheimer’s expert at Washington University in St. Louis, puts it, “there’s a heck of a lot of brain cell damage and we’re trying to treat a very damaged brain.”

Several of the research projects are expected to make new discoveries next year. They are working on the idea of finding the disease earlier and treating earlier. “We’re trying to go earlier and earlier in the course of the disease,” said Neil Buckholtz, chief of the Dementias of Aging branch at the National Institute on Aging. “The idea is to locate how people move through these stages and what indications there are of each stage.” If drugs could be given earlier, and created for specific changes or biomarkers in the brain, then treatment or even prevention might be more successful.

One of the current research projects involves a family in Colombia. This one involves the world’s largest family to experience Alzheimer’s disease, an extended clan of about 5,000 people in Colombia, many of whom have inherited a genetic mutation that guarantees they will develop dementia, usually in their 40s. So not only is it Alzheimer’s, but Early on-set Alzheimer’s as well.

The Colombian condition is virtually identical in its disease process to more common Alzheimer’s, which has unknown causes and afflicts millions of elderly people.

The New York Times reports, “A team of American and Colombian scientists plans to test treatments on Colombians in their late 30s and early 40s who are destined to get Alzheimer’s but have not yet developed symptoms to see if dementia can be prevented or significantly delayed. The treatment, to be chosen by an independent panel, will be a drug or vaccine that attacks beta-amyloid, the protein associated with plaques, deposits between nerve cells. A project leader, Dr. Eric Reiman, director of the Banner Alzheimer’s Institute in Phoenix, said testing on as many as 2,000 people, including about 750 with the mutation, is likely to begin late next year or early in 2012. “

The project has already received some interesting results as the youngest family members ages 18 to 26 have begun testings with brain scans spinal taps and memory tests. While Dr. Reiman said he could not discuss specific data yet, the tests showed enough evidence of Alzheimer’s-related biomarkers on people with the mutation that fMRI brain scans will be done on even younger family members, ages 8 to 17.

If the scans reveal children with the mutation have Alzheimer’s-like anomalies, like atrophy in the hippocampus, which is involved in forming new memories, that would suggest the brain begins transforming decades before symptoms appear.

Even now, it is believed that the earliest brain damage from Alzheimer’s begins 10-20 years before any symptoms occur. All the testing and research can only offer hope that the earliest accumulations of the sticky beta-amyloid plaques and tangles that clog the brain may eventually be discovered. Then medications can be created to stall or prevent Alzheimer’s many years before memory-loss begins.

For now, our goal as Caregivers is to keep the person with dementia stimulated and happy while they take part in as many activities as possible and enjoy their life to the fullest.

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