Alzheimer Disease

Diagnosis of the disease often results from an awareness of a change in behavior or memory by an individual or his/her physician. A definitive diagnosis requires the observation of plaques and tangled fibers in samples of brain tissue. However, such a tissue examination is possible only after death. So, in practical terms, only a "possible" or "probable" diagnosis of Alzheimer's is possible prior to death.

The pharmaceutical industry is developing drugs for a variety of therapeutic approaches to treating Alzheimer disease. These include drugs that will inhibit the inflammatory response the brain appears to mount against plaques. In this approach, it is assumed that the inflammatory response contributes to cell death. By inhibiting it, the researchers hope to decrease the loss of brain cells in Alzheimer disease.

Another tact is the development of drugs that increase the amounts of acetylcholine in the brains of patients with Alzheimer disease. By preventing the breakdown of remaining acetylcholine, researchers hope to alleviate some of the symptoms of the disease. The drug called Tacrine stops the destruction of acetylcholine that occurs normally, allowing acetylcholine to persist longer in the brain. Tacrine, which is currently one of a few drugs that has Food and Drug Administration (FDA) approval for the treatment of Alzheimer disease, appears to be helpful only in the early to middle stages of Alzheimer disease. Other drugs that exhibit similar effects include donepezil, rivastigmine, and galantamine.

Other efforts at preventing the onset of Alzheimer disease are focusing on the effects of hormones such as estrogen, drugs that reduce the inflammatory response (which might contribute to brain damage), drugs that decrease the oxidation of chemicals in the body, natural "remedies" such as gingko biloba, and increasing attention to the careful control of hypertension (specifically using calcium channel blockers).