Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Dementia is significant loss of intellectual abilities such
as memory capacity,
severe enough to interfere with social or occupational functioning. Dementia
is reported in as many as 1% of adults 60 years of age. Moreover, it has been
estimated that the frequency of dementia doubles every five years after 60 years
of age. So, dementia is clearly related to aging.
Alzheimer's disease is the most common form of dementia. Among other causes
are medical conditions (thyroid disease, drug toxicity, thiamine deficiency with
alcoholism, and others),
brain injury, strokes, multiple sclerosis, infection of
the brain (such as meningitis and
syphilis),
HIV infection, hydrocephalus,
Pick's disease, and
brain tumors.
impairment in another area of thinking such as the ability to organize thoughts and reason, the ability to use language, or the ability to see accurately the visual world (not because of eye disease), and
these impairments are severe
enough to cause a decline in the patient's usual level of functioning.
Although
some kinds of memory loss are normal parts of aging, the changes due to aging
are not severe enough to interfere with the level of function. Many different
diseases can cause dementia, but Alzheimer's disease is by far the most common
cause for dementia in the United States and in most countries in the world.
What is Alzheimer's disease?
Alzheimer's disease (AD) is a slowly progressive disease of the brain that is
characterized by impairment of memory and eventually by disturbances in
reasoning, planning, language, and perception. Many scientists believe that
Alzheimer's disease
results from an increase in the production or accumulation of a specific protein
(beta-amyloid protein) in the brain that leads to nerve cell death.
The likelihood of having Alzheimer's disease increases substantially after the age of 70 and
may affect around 50% of persons over the age of 85. Nonetheless, Alzheimer's
disease is not a normal part of aging and is not something that inevitably
happens in later life. For example, many people live to over 100 years of age
and never develop Alzheimer's disease.
Who develops Alzheimer's disease?
The main risk factor for Alzheimer's disease is increased age. As a population ages, the
frequency of Alzheimer's disease continues to increase. Ten percent of people over 65
years of age and 50% of those over 85 years of age have Alzheimer's disease. Unless new treatments are developed to decrease
the likelihood of developing Alzheimer's disease, the number of individuals with
Alzheimer's disease in the United
States is expected to be 14 million by the year 2050.
There are also genetic risk factors for Alzheimer's disease. Most patients develop
Alzheimer's disease after
age 70. However, 2%-5% of patients develop the disease in the fourth or fifth decade of
life (40s or 50s). At least half
of these early onset patients have inherited gene mutations associated with
their Alzheimer's disease. Moreover, the children of a patient with early onset
Alzheimer's disease who has one of
these gene mutations has a 50% risk of developing Alzheimer's disease.
There is also a genetic risk for late onset cases. A relatively common form
of a gene located on chromosome 19 is associated with late onset Alzheimer's
disease. In the
majority of Alzheimer's disease cases, however, no specific genetic risks have yet been
identified.
Other risk factors for Alzheimer's disease include
high blood pressure
(hypertension), coronary artery disease, diabetes, and possibly elevated blood
cholesterol. Individuals who have completed less than eight years of education
also have an increased risk for Alzheimer's disease. These factors increase the
risk of Alzheimer's disease, but by no means do they mean that Alzheimer's
disease is inevitable in persons with
these factors.
All patients with Down syndrome will develop the brain changes of Alzheimer's
disease by 40 years of age. This fact was also a clue to the "amyloid hypothesis of Alzheimer's disease" (see
section later in this article).
Alzheimer's Disease - TreatmentsQuestion: What stage of Alzheimer's disease are you or your loved one currently experiencing, and have any treatments been effective?
Dementia is a significant loss of intellectual abilities such as memory capacity, severe enough to interfere with social or occupational functioning. There are different criteria classification schemes for dementias such as cortical, subcortical, progressive, primary, and secondary dementias. Other conditions and medication reactions can also cause dementia. Dementia is diagnosed based on a certain set of criteria. Treatment for dementia is generally focused on the symptoms of the disease.
Stress occurs when forces from the outside world impinge on the individual. Stress is a normal part of life. However, over-stress, can be harmful. There is now speculation, as well as some evidence, that points to the abnormal stress responses as being involved in causing various diseases or conditions.
Depression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. The principal types of depression are major depression, dysthymia, and bipolar disease (also called manic-depressive disease).
Dysphagia or difficulty in swallowing, swallowing problems. Dysphagia is due to problems in nerve or muscle control. It is common, for example, after a stroke. Dysphagia compromises nutrition and hydration and may lead to aspiration pneumonia and dehydration.
Amyloidosis is a group of diseases resulting from abnormal deposition of certain proteins (amyloids) in various bodily areas. The amyloid proteins may either be deposited in one particular area of the body (localized amyloidosis) or they may be deposited throughout the body (systemic amyloidosis). There are three types of systemic amyloidosis: primary (AL), secondary (AA), and familial (ATTR). Primary amyloidosis is not associated with any other diseases and is considered a disease entity of its own. Secondary amyloidosis occurs as a result of another illness. Familial Mediterranean Fever is a form of familial (inherited) amyloidosis. Amyloidosis treatment involves treating the underlying illness and correcting organ failure.
Hypothermia is having a body core temperature of less than 35 C or 95 F. Most causes of hypothermia are preventable. Risk factors for hypothermia include age, mental status, medical conditions, and medications. Symptoms of hypothermia generally depend upon the severity of the condition. Treatment depends upon the severity of hypothermia. If not treated early, hypothermia can lead to cardiac arrest, coma, or death.
Stress may be considered as any physical, chemical, or emotional factor that causes bodily or mental unrest and that may be a factor in disease causation. An important goal for those under stress is the management of stress in our lives. Elimination of stress is unrealistic, since stress is a part of normal life. We can however, learn to manage stress through techniques such as exercise, relaxation, meditation, time management, and support systems so that we have control over our stress and its effects on our physical and mental health.
There are many types of urinary incontinence (UI), which is the accidental leakage of urine. These types include stress incontinence, urge incontinence, and overflow incontinence. Urinary incontinence in men may be caused by prostate or nerve problems. Treatment depends upon the type and severity of the UI and the patient's lifestyle.
Amyotrophic lateral sclerosis (ALS, Lou Gehrig's disease) is a neurological disease that progresses rapidly. The disease attacks the nerve cells responsible for the control of voluntary muscles. Early symptoms include cramping, twitching, or stiffness of the muscles; slurred nasal speech; difficulty swallowing or chewing, and muscle weakness in an arm or leg. Currently, the cause of ALS is not known. ALS is a fatal disease. No cure has been found for ALS, however, the drug riluzole (Rilutek) is FDA approved, and this drug reduces the damage to motor neurons by decreasing the release of glutamate.
Brain lesions (lesions on the brain) are caused by trauma, inflammation, autoimmune diseases, cancers, other diseases, stroke, bleeding, pituitary adenomas, and cerebral palsy. Symptoms of brain lesions include headache, nausea, fever, neck pain and stiffness, affected vision and speech, weakness or paralysis to one side of the body. Diagnosis of brain lesions is generally with imaging studies like CT or MRI scans. Treatment and prognosis of brain lesions depends on the cause of the lesion.
The most common taste disorder is phantom taste perception; that is, a lingering, often unpleasant taste even though you have nothing in your mouth. We also can experience a reduced ability to taste sweet, sour, bitter, salty, and umami, a condition called hypogeusia. Some people cannot detect any tastes, which is called ageusia.
Advance directives are designed to outline a person's wishes and preferences in regard to medical treatments and interventions. Advance directives generally fall into three categories: living will, power of attorney, and health-care proxy.
Caring for a loved one or patient with Alzheimer's can become a difficult and overwhelming task at times. This guide helps caregivers of individual's with Alzheimer's deal with communicating, bathing, and dressing; as well as problem solving with incontinence, sleeping, wandering; and coping with difficulties Alzheimer's patients present.
Most often, caregivers take care of other adults who are ill or disabled. Less often, caregivers are grandparents raising their grandchildren. The majority of caregivers are middle-aged women. Caregiving can be very stressful, so it's important to recognize when it's putting to much strain on you and to take steps to prevent/relieve stress.
Reduction of the sense of smell is termed hyposmia. Total inability to detect odors is termed anosmia. Smell disorders have many causes. Most people who develop a smell disorder have recently experienced an illness or an injury.
Depression in the elderly is very common. That doesn't mean, though, it's normal. Treatment may involve antidepressants, psychotherapy, or electroconvulsive therapy.
Alzheimer's disease can be not only mentally devastating to an indivdiual and family, it can also be emotionally devastating. Preparing financially for someone with Alzheimer's disease is an important task to complete so that bills get paid and the best coverage is provided. Learn what Medicade and Medicare will provide for a patient.
The sense of smell is part of our
chemical sensing system, or the chemosenses. Sensory cells in our nose, mouth, and throat have a role in helping
us interpret smells, as well as taste flavors. Microscopic molecules released by
the substances around us (foods, flowers, etc.) stimulate these sensory cells.
Once the cells detect the molecules they send messages to our brains, where we
identify the smell.
Olfactory, or smell nerve cells, are stimulated by the
odors around us--the fragrance of a gardenia or the smell of bread baking. These
nerve cells are found in a small patch of tissue high inside the nose, and they connect directly
to the brain. Our sense of smell is also influenced by something called the
common chemical sense. This sense involves nerve endings in our eyes, nose,
mouth, and throat, especially those on moist surfaces. Beyond smell and taste,
these nerve endings help us sense the feelings...
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