Try to remember: More targeted treatments and better disease identification aim to get at the root of Alzheimer's disease

January 22, 2007

The phone rings and it's the manager of the local supermarket. He asks whether you know a woman named Margaret. It's your mother. He informs you that she had been wandering the store aisles for more than two hours and then proceeded to get into her car and back into the side of the building. Although not injured, she seems disoriented, he says. On your way to her aid, you start thinking about all that hasn't been right with Mom for sometime. She's been so forgetful, her speech seems off, she repeats the same question multiple times, and she can't seem to find anything. You wonder if it could possibly be Alzheimer's disease.

The phone rings and it's the manager of the local supermarket. He asks whether you know a woman named Margaret. It's your mother. He informs you that she had been wandering the store aisles for more than two hours and then proceeded to get into her car and back into the side of the building. Although not injured, she seems disoriented, he says. On your way to her aid, you start thinking about all that hasn't been right with Mom for sometime. She's been so forgetful, her speech seems off, she repeats the same question multiple times, and she can't seem to find anything. You wonder if it could possibly be Alzheimer's disease.

A presentation like Margaret's is quite common in Alzheimer's disease (AD) and, although initial symptoms of AD can vary widely, often the first people who notice a problem with a loved one are family members. According to the Alzheimer's Association, an estimated 4.5 million Americans have AD and experts believe that as many as 1.8 million additional people could be undiagnosed in this country. Its well-known patients have included former President Ronald Reagan, who has since passed away, and actor Charlton Heston, who is said to be in the last stages of the disease.

What Margaret's daughter may or may not understand is that AD is a progressive brain disorder that gradually destroys a person's memory and ability to learn, communicate, make judgments, and reason. As her mother gets further along in the disease course, her personality and behavior will continue to change, and she may eventually end up needing help with the basic functions of life, including dressing and personal hygiene.

Magic markers

In December, researchers at Weill Cornell Medical College reported in an Annals of Neurology article that preliminary tests have identified 23 biomarkers in the cerebrospinal fluid (CSF) of patients with confirmed AD, providing a possible fingerprint for identifying the disease. According to Norman Relkin, M.D., Ph.D., associate professor of clinical neurology and neuroscience at Weill Cornell and one of the lead scientists working on the project, more work is necessary to confirm these findings; however, he believes we are entering an era where the uncertainty of AD diagnosis is coming to an end. Currently, a diagnosis of Alzheimer's is made based on a patient's symptoms and is sometimes confused with other types of dementia or normal aging.