Relationship Between Alzheimer's and Stroke

Alzheimer's Association
Tuesday, 11 March 1997

Studies Address Scope of Alzheimer's Disease

The brain damage caused by strokes may play a role in determining the onset and severity of Alzheimer's disease symptoms, according to new research.

"This study provides some hope that treatments and prevention strategies currently used for stroke and other cerebrovascular disease, such as atherosclerosis, may prove helpful in treating some people with Alzheimer's disease," said Zaven Khachaturian, Ph.D., director of the Association's Ronald and Nancy Reagan Research Institute. "This is very encouraging news."

According to Khachaturian, previous research pointed to a relationship between the brain's blood supply and dementia. He says more research is needed to clarify the relationship between problems with the blood vessels in the brain and Alzheimer's disease.

The study, by David Snowdon, Ph.D., of the Sanders-Brown Center on Aging at the University of Kentucky, Lexington, Ky., and colleagues, was presented at "Alzheimer's Disease: Help for the Patient and the Caregiver," a media briefing held March 11, 1997, sponsored by the American Medical Association in New York City.

For "Brain Infarction and the Clinical Expression of Alzheimer's Disease: Findings from the Nun Study," the researchers studied 102 college educated women age 67 and older who are participants in the Nun Study, a multi-year study of aging and Alzheimer's disease. On autopsy, 61 of the women were found to have brain lesions characteristic of Alzheimer's disease. Nearly half of those with Alzheimer's also had one or more areas of brain damage, known as infarcts, caused by strokes. Those who had infarcts and Alzheimer lesions had more dementia and did significantly worse on tests of mental functioning, than those who did not have infarcts.

The researchers suggest that having these infarcts in certain key areas of the brain may produce dementia symptoms in those people made susceptible by the brain cell damage caused by their Alzheimer's disease.

The goal of the Reagan Institute is to delay the onset of, and eventually prevent, Alzheimer's disease. Pushing back symptoms by five years could reduce by 50 percent the number of people with Alzheimer's, adding years of improved quality of life and saving this country as much as $50 billion in healthcare dollars, according to the Association.

Two additional research studies from the same issue of the Journal of the American Medical Association (JAMA) also were presented at the meeting.

Dementia Often Unrecognized and Untreated

In "Frequency and Characteristics of Silent Dementia Among Elderly Japanese-American Men: the Honolulu-Asia Aging Study," G. Webster Ross, M.D., of the Department of Veterans Affairs, Honolulu, Hawaii, found that, of 191 Japanese-American men with dementia, 21 percent had adult family members who did not recognize their condition. Of those whose family did recognize the problem, 53 percent failed to receive any medical attention.

"As the baby boomers near retirement age, more and more of the population will be at risk for Alzheimer's," said Edward Truschke, Association president and CEO. "The public needs to become aware of the symptoms and warning signs of diseases that cause dementia, because some are treatable or reversible, and there is much that can be done to help manage the disease for the benefit of both patient and caregiver."

According to Truschke, for those who do have Alzheimer's, early recognition and diagnosis allows them to participate in planning for their and their family's futures. Plus, they will be eligible for new treatments, as they become available.

Predicting the Course of Alzheimer's

Yaakov Stern, Ph.D., of the Gertrude H. Sergievsky Center at Columbia University in New York, and colleagues are working to address the desire of people with Alzheimer's and their family members for accurate prognosis about the course of the disease.

In "Algorithms for Predicting Time to Nursing Home Care and Death in Individual Patients with Alzheimer's Disease," the researchers report formulas for calculating, within a certain range, the amount of time it will take persons with Alzheimer's to reach two key stages in the disease: need for care equivalent to nursing home placement and death.

"This is an interesting early study, and may prove a useful tool to guide future research," said Steven DeKosky, M.D., director of the Alzheimer's Disease Research Center at the University of Pittsburgh and vice chair of the Association's Medical and Scientific Advisory Board. "At this point, the formulas are not ready to help a doctor make accurate predictions for an individual patient or family."

"People with Alzheimer's and their families look to their doctors for guidance on understanding and managing the disease over its entire course. The Association supports efforts to provide physicians the tools they need to properly advise Alzheimer families," DeKosky said.

For more information, or to contact Alzheimer's Association, see their website at: www.alz.org

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