From: hound23x@gmail.com   
      
   Alzheimer's experts: disease is a public health crisis   
      
   Jen Rini, The News Journal   
   1 day ago   
      
   From the movie, STILL ALICE. Left to right: Kristen Stewart as Lydia and   
   Julianne Moore as Alice Photo by Jojo Whilden, Courtesy of Sony Pictures   
   Classics   
   Age never mattered much to Shirley Gitcho.   
      
   At 70 years old the vibrant redhead biked to work every day, swam laps and   
   elegantly practiced ballroom dancing.   
   In a mere four years, however, her bright-eyed face and zest for life were   
   barely recognizable to family and friends. Her mind had been taken hostage by   
   Alzheimer's disease, a type of dementia that causes progressively worsening   
   problems with memory,    
   thinking and behavior.   
   "She was really an amazing lady," reflected her son Michael Gitcho, a research   
   professor with Delaware State University. At the time she was diagnosed in   
   2000, Gitcho was immersed in studying the brain development of fruit flies.   
   But as her disease    
   progressed, Gitcho swapped flies for Alzheimer's research.   
   "It made me want to understand more. I had a personal stake in it," he said.   
   For the last two years Gitcho and a team of graduate and undergraduate   
   students at DSU have been studying the basic function of TDP-43, a protein   
   found in the brain that is present in about 50 percent of sporadic Alzheimer's   
   cases   
   Most Alzheimer's research focuses on the buildup of two proteins called   
   beta-amyloid and tau. Genetics may also play a role in developing the disease,   
   but it is too soon for scientists to definitively say. Scientists suspect that   
   the increased presence    
   of tau and beta-amyloid destroy nerve cells in the brain, which causes memory   
   loss and personality changes. But increases in TDP-43 can also cause deficits,   
   Gitcho said.   
   "When those neurons are gone, they are gone. It's not a normal process. It's   
   not normal aging. It would be a huge benefit to detect that early," he said.   
   "To understand its normal function we can look at how it (TDP-43) relates to   
   the disease and    
   collaborates with targets."   
   People with this protein abnormality are 10 times more likely to show memory   
   deficits at the time of death, Gitcho explained. When the protein accumulates,   
   neuron cells in the brain die off. His team is studying the protein in virtual   
   3-D models as well    
   as experimenting with mice to see how the protein deteriorates the brain.   
   He expects the group to submit their research findings at the Alzheimer's   
   Association international conference in Washington, D.C., this July.   
   "Our job is to be able to understand this," he said.   
   Growing problem   
   Alzheimer's is the sixth leading cause of death in the country.   
   The Alzheimer's Association estimates that by 2050, nearly 16 million   
   Americans will have Alzheimer's disease. Currently, 26,000 Delawareans live   
   with it. About 200,000 Americans under the age of 65 live with early-onset   
   Alzheimer's. Julianne Moore won    
   an Oscar for best actress on Feb. 22 for playing a woman with early-onset   
   Alzheimer's, and that has thrust the disease back into the spotlight.   
   The absolute diagnosis is made by studying brain tissue, says Dr. Gerard   
   Gallucci, medical director for the Delaware Department of Health and Social   
   Services, but physicians can make a diagnosis based on clinical symptoms.   
   Either a psychiatrist or    
   neurologist can make the diagnosis.   
   There are pencil and paper tests that evaluate a person's memory, language,   
   attention, problem-solving and concentration.   
   "Alzheimer's tends to be of gradual onset and of gradual decline," Gallucci   
   said.   
   Warning signs include the inability to maintain a budget, losing track of the   
   date or season, having difficulty holding a conversation and misplacing things   
   and not being able to retrace your steps to find them. Age is the greatest   
   risk factor.   
   Many Alzheimer's patients suffer from depression, psychosis, hallucination and   
   paranoia, which can be very distressing and disturbing for the patient and   
   their family members, Gallucci said.   
   Unfortunately, there are no "magic bullets" for controlling those symptoms and   
   the worsening course, he said.   
   "Psychotropic medications can be helpful. There are some risks with those   
   medications particularly with the elderly population. Because the individual   
   has cognitive deficits, adding any medications can present a risk for the   
   development of delirium,    
   which can be superimposed on the dementia and worsen the symptoms," Gallucci   
   said.   
   It is not uncommon for people with the disease to be angry and defiant, he   
   said. Often they are frustrated that they can no longer remember how to do   
   basic tasks. Those symptoms might worsen at night, a condition Gallucci calls   
   "sundowning."   
      
   DELAWAREONLINE   
   March is nutrition month, and start of annual challenge   
      
   Identifying supports   
   Alzheimer's does not discriminate, but some populations are disproportionately   
   affected, said Katie Macklin, director of Delawarean's Alzheimer's Association.   
   Caucasians are more likely to have Alzheimer's diagnosis, but Af   
   ican-Americans and Hispanics are nearly two times more likely to live with   
   Alzheimer's and other dementias without getting an official diagnosis. Certain   
   risk factors within those    
   communities such as high blood pressure and heart disease could contribute to   
   the risk for developing dementia, she said.   
   Women are a "gender under siege" by Alzheimer's, she added. Not only are they   
   diagnosed at a higher rate, but two-thirds of caregivers are women, Macklin   
   said.   
   "We see Alzheimer's not as an aging issue, but as an overall health crisis,"   
   she said. "Alzheimer's is a heartbreaking and devastating disease. There is no   
   treatment, prevention and cure, but that is what we are working toward."   
   The state's Alzheimer's strategic plan serves as a blueprint to mobilize   
   community members with the goal of preventing and curing the disease by 2025.   
   There are five focal points, including improving the quality of services   
   available for patients,    
   awareness, increasing data collection, educating medical professionals on   
   warning signs and enhancing caregiver support.   
   Education of the disease is key for caregivers, Macklin said. Caring for   
   someone with Alzheimer's is similar to running a marathon, not a sprint, she   
   said.   
   "We aim to equip caregivers. They don't want to get burned out in the very   
   beginning," she said. "I think it's important for them to see what is out   
   there and explore those systems of support. Often times caregivers may feel   
   isolated."   
      
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