Well
An Academic Research Center of Excellence
Alzheimer’s Disease:
november - december
2008
Wellness Mondays for Employees
• November 3, 10 & 17, 9 a.m.-3 p.m.
• December 1, 15 & 22, 9 a.m.-3 p.m.
320 Bayer Learning Center
Wellness Wednesdays
• November 12 and December 10, 1-3 p.m.
320 Bayer Learning Center
Blood Pressure Screening
• November 12 and December 10, 10 a.m.-noon
3rd Floor, Duquesne Union
Wellness Mondays/Wednesdays
To schedule an appointment, please call x5874.
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Flu Vaccine $25 available on Wellness Mondays
& Wednesdays 1:00 – 3:00 p.m. Please make an
appointment.
Tobacco Cessation
The Center for Pharmacy Care offers brief
intervention. Any employee or student interested
in information about quitting should call X 5874.
Center for Pharmacy Care Services
The Center offers the following complimentary
screenings and services Mondays and Wednesdays
by appointment: osteoporosis screening/bone
density, body composition analysis, facial skin
analysis, cholesterol screening, Serum glucose and
A1C testing for diabetes & Living My Life®, medication
therapy management, and health care coaching.
Please call 412-396-5874 for an appointment.
aware
More Than Just a Loss of Memory
S
ome say that memory loss is a normal
part of getting older, but, at some
point, it must be recognized as
more than a natural consequence of aging.
Alzheimer’s disease has become increasingly
recognized over the past few decades and
is now considered the most common cause
of dementia. It affects portions of the brain
that control thought, memory, and language.
As the disease progresses, patients appear
to be become more forgetful, have difficulty
in selecting the proper words for speech,
and may develop severe agitation and
depression. The condition is marked by a
steady decrease in memory.
Today, Alzheimer’s disease affects nearly
4 million Americans and continues to
increase in recognition and frequency. It
is estimated that by 2050, approximately
12 million citizens over 65 years of age
will be affected by the disease. The onset
of signs and symptoms normally occurs
around the age of 60, however, in rare cases,
it may develop as early as the age of 30.
Approximately 5% of men and women aged
60-74 have Alzheimer’s disease while up to
50% of those over 85 years may have some
characteristics of the condition.
Signs and Symptoms
Everyone occasionally forgets a name
or a few facts; however, in Alzheimer’s
disease, slight memory loss and confusion
can progress to permanent memory
impairment. There are some characteristics
that are shared by most people with this
disorder. They can be categorized into
groups based on disease severity and rated
as mild, moderate, and severe.
• Mild: Patients have trouble with simple
daily tasks such as managing money.
They ask repetitive questions and tend
to get lost when attempting to get to a
familiar location. These patients often lose
energy and seem uninterested in starting
new projects.
• Moderate: These individuals are likely to
wander and get lost and become a danger
to themselves if left alone. They often
forget their manners and frequently create
From: Wikimedia Commons
http://commons.wikimedia.org/wiki/Image:Brain-ALZH.png
(16 July 2008)
stories in order to fill gaps in their memory
of actual events.
• Severe: Patients speak incoherently or
become mute and frequently do not
recognize loved ones. They may groan or
scream randomly and often lose bowel and
bladder function. Those with this degree of
disease are unable to care for themselves
and require constant attention.
Possible Risk Factors
Alzheimer’s disease is a complex condition
and some factors increase the individual’s
risk of developing the disorder. These factors
include:
• Gender: Women are more likely to develop
Alzheimer’s than males. One reason for this
is their greater longevity.
• Age: The risk of the disease increases with
age.
• Lifestyle: Some of the same factors that
place the person at risk for developing
heart disease (e.g., poorly controlled
cholesterol or blood pressure) increase
their likelihood of developing Alzheimer’s.
• Education level: It appears that the
greater the level of education, the less likely
an individual will develop this condition.
This may be related to expansion of brain
capacity during study resulting in greater
reserves of brain activity later in life.
• Head injury: Serious trauma affecting the
brain may increase the risk of Alzheimer’s.
continued on back
Alzheimer’s Disease: More Than Just a Loss of Memory
Causes of Alzheimer’s Disease
Treatment
Prevention
The exact cause of this disease is unknown.
It progresses by destroying cells (neurons) in
certain areas of the brain and is accompanied
by a decrease in production of some
essential chemicals (neurotransmitters). This
decreases signaling and interferes with many
daily functions.
Drug treatment for Alzheimer’s is primarily
divided into two classes of therapy (see
accompanying table). Drugs known as
cholinesterase inhibitors prevent the
breakdown of acetylcholine, a major
neurotransmitter in the brain. Acetylcholine
contributes significantly toward maintaining
normal brain function including memory and
learning. Another drug, memantine, blocks
a site in the brain normally occupied by the
chemical glutamate. Excessive activity of this
compound may be responsible for many of
the characteristics of the disease. Each of the
drugs is approved to treat some or all of the
stages of Alzheimer’s. Adverse effects are not
uncommon and the drugs must occasionally
be discontinued and an alternative drug
prescribed. In addition to drug therapy,
proper living conditions are important in
maintaining patient safety and quality of life.
There are currently no methods to prevent
Alzheimer’s disease. Some non-drug
measures may help to slow or prevent
disease onset. A healthy lifestyle with
exercise and controlled diet may be
beneficial. Reducing any of the risk factors
addressed earlier may also be helpful.
There are two abnormalities found in the
brains of patients with Alzheimer’s disease
– plaques and tangles. Plaques are dense
deposits of protein and other material
located around neurons. In Alzheimer’s, large
plaques develop in areas of the brain that are
critical for memory and decision making. It
is unknown whether these plaques are the
cause or result of the disease. In addition,
certain proteins are chemically altered
and subsequently intertwine producing
tangles. This leads to a disruption of nerve
transmission and contributes to problems
with memory and function.
Diagnosis
The diagnosis of Alzheimer’s disease
consists of a combination of examinations
and tests. No single test can definitively be
used for diagnosis; however, a combination
of examinations can result in a diagnosis
with 80-90% accuracy. Doctors investigate
the patient’s history and conduct tests
to evaluate sight, hearing, memory, and
other mental functions. Brain scans may be
ordered by the physician to check for tumors
or other lesions of the brain.
Well
aware
A publication of:
Mylan School of Pharmacy
Center for Pharmacy Care
Pharmaceutical Information Center (PIC)
Additional information on newsletter topics:
Pharmaceutical Information Center
412-396-4600
[email protected]
Questions about screenings or programs:
Christine O’Neil, Pharm.D, B.C.P.S.
412-396-6417
Newsletter Contributors
John G. Lech, Pharm.D.
Kristen L. Ridge, Pharm.D. Candidate
John M. Van Damia, Pharm.D. Candidate
Non-steroidal antiinflammatory drugs
(NSAIDs) and statins have shown some
potential to decrease the risk of developing
Alzheimer’s. Dietary supplements, primarily
vitamin E and ginkgo, may be of some use;
however, their benefit is unproven.
Alzheimer’s disease is an ever increasing
problem that affects memory, learning, and
other thought processes. It has few effective
therapies. The condition has a dramatic
impact, not only on the patient, but on family
and friends as well.
Drugs Used to Treat Alzheimer’s Disease
Drug
(Generic/Brand
Degree of
Disease Severity*
Adverse
Effects
Headache, constipation,
restlessness, dizziness
memantine (Namenda)
Moderate to severe
donepezil (Aricept)
All stages
Nausea, vomiting, joint
pain, tiredness, irritability,
sleeping problems
galantamine (Razadyne)
Mild to moderate
Loss of appetite, weight
loss, depression, decreases
in urination, fatigue
rivastigmine (Exelon)
Mild to moderate
Anxiety, depression, weight
loss, decreased appetite,
fatigue
* based on FDA product labeling
www.pharmacy.duq.edu
For more information regarding Alzheimer’s disease, please visit the following
Web sites:
• http://www.mayoclinic.com/print/alzheimers-disease/DS00161/
DSECTION=all&METHOD=print
• http://www.nia.nih.gov/Alzheimers/Publications/UnravelingTheMystery/
UnravelingTheMystery.htm
• http://www.nia.nih.gov/NR/exeres/6739F4B3-C1A9-4564-8AC3-77DC1315974E.htm
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