About
Alzheimers
Alzheimers
is a progressive, neurodegenerative disease
characterized in the brain by abnormal clumps (amyloid plaques)
and tangled bundles of fibers (neurofibrillary tangles)
composed of misplaced proteins.
Age is the
most important risk factor for Alzheimers; the number of people
with the disease doubles every 5 years beyond age
65.
Three
genes have been discovered that cause early onset (familial)
Alzheimers. Other genetic mutations that cause excessive
accumulation of amyloid protein are associated with age-related
(sporadic) Alzheimers.
Symptoms
of Alzheimers include memory loss, language deterioration,
impaired ability to mentally manipulate visual information,
poor judgment, confusion, restlessness, and mood
swings.
Eventually
Alzheimers destroys cognition, personality, and the ability to
function. The early symptoms of Alzheimers, which include
forgetfulness and loss of concentration, are often missed
because they resemble natural signs of aging.
Treatment
There is
no cure for Alzheimers and no way to slow the progression of
the disease. For some people in the early or middle stages of
Alzheimers, medication such as tacrine (Cognex) may alleviate
some cognitive symptoms.
Donepezil
(Aricept), rivastigmine (Exelon), and galantamine (Reminyl) may
keep some symptoms from becoming worse for a limited time. A
fifth drug, memantine (Namenda), was recently approved for use
in the United States.
Combining
memantine with other Alzheimers drugs may be more effective
than any single therapy. One controlled clinical trial found
that patients receiving donepezil plus memantine had better
cognition and other functions than patients receiving donepezil
alone.
Also,
other medications may help control behavioral symptoms such as
sleeplessness, agitation, wandering, anxiety, and
depression.
Prognosis
Alzheimers
is a progressive disease, but its course can vary from 5 to 20
years. The most common cause of death in Alzheimers patients is
infection
Research
Several
clinical trials have found that acetyl-L-carnitine
supplementation delays the progression of Alzheimers,improves
memory, and enhances overall performance in some people with
Alzheimers.
However,
in one double-blind trial, people who received
acetyl-L-carnitine (1 gram three times per day) deteriorated at
the same rate as those given a placebo.
Overall,
however, most short-term studies have shown clinical benefits,
and most long-term studies (one year) have shown a reduction in
the rate of deterioration. A typical supplemental amount is 1
gram taken three times per day.
Reference for
Alzheimers Article
Pettegrew JW, Klunk
WE, Panchalingam K, et al. Clinical and neurochemical
effects of acetyl-L-carnitine in Alzheimer’s disease.
Neurobiol Aging 1995;16:1–4.
Salvioli G, Neri M.
L-acetylcarnitine treatment of mental decline in the
elderly. Drugs Exp Clin Res
1994;20:169–76.
Rai G, Wright G,
Scott L, et al. Double-blind, placebo controlled study of
acetyl-l-carnitine in patients with Alzheimer’s dementia.
Curr Med Res Opin 1990;11:638–47.
Sano M, Bell K,
Cote L, et al. Double-blind parallel design pilot study
of acetyl levocarnitine in patients with Alzheimer’s
disease. Arch Neurol 1992;49:1137–41.
Cucinotta D et al.
Multicenter clinical placebo-controlled study with
acetyl-L-carnitine (LAC) in the treatment of mildly
demented elderly patients. Drug Development Res
1988;14:213–6.
Bonavita E. Study
of the efficacy and tolerability of L-acetylcarnitine
therapy in the senile brain. Int J Clin Pharmacol Ther
Toxicol 1986;24:511–6.
Thal LJ, Carta A,
Clarke WR, et al. A 1-year multi-center
placebo-controlled study of aceyl-L-carnitine in patients
with Alzheimer’s disease. Neurology
1996;47:705–11.
Calvani M, Carta A,
Caruso G, et al. Action of acetyl-L-carnitine in
neurodegeneration and Alzheimer’s disease. Ann NY Acad
Sci 1992;663:483–6.
National Institutes
of Health
Health
Related Websites
The National Cancer
Institute
The National Eye
Institute
The National Heart, Lung,
and Blood Institute
National Institute on
Aging
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Allergy and Infectious Diseases
National Institute of
Arthritis and Musculoskeletal and Skin Diseases
National Institute of
Diabetes and Digestive and Kidney Diseases
National Institute on Drug
Abuse
National Institute of Mental
Health
National Institute of
Neurological Disorders and Stroke
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