What is Alzheimer's Disease?
Alzheimer's Disease occurs when a protein called amyloid accumulates in the brain. The brain cells (neurons) are damaged when this protein reacts with the metals copper and iron which are abundant in the brain. This chemical reaction is similar to rusting and the affected neurons no longer transmit information properly.

Alzheimer's Disease is not a natural part of ageing. It is a degenerative disorder of the brain that causes impaired mental functions affecting memory, personality and intellect.

Currently Alzheimer's Disease is the fourth largest cause of death in Australia and affects one in four people over 85 years of age.

Alzheimer's disease is also becoming increasingly common in many countries, including Australia, where life expectancy is increasing.

The emotional cost to the community outside of carers and friends of Alzheimer victims is too great to measure.

As many as 100,000 Australians suffer from Alzheimer's disease and it is a problem that countries like Australia face as the population ages. It is an unfortunate irony that more people are suffering from the disease as a result of improved health and increased length of life. One in eight people over the age of 65 will develop Alzheimer's and at 84 years of age, the incidence is one in four.

Early warning signs
Alzheimer's disease is difficult to diagnose in its early stages because the symptoms - forgetfulness, confusion and changes is personality, mood or behaviour - develop gradually and could be due to other causes, such as stress and depression. As the disease progresses, however, these symptoms show themselves more frequently and become more pronounced.

Some of the following symptoms are possible warning signs of the disease. The person may be unable to remember the names of those closest to them, their spouse, children, and grandchildren. They may become disoriented in familiar surroundings, such as their home or on their own street. They may have difficulty in constructing sentences, using inappropriate words or being unable to remember the right ones. They may not dress properly, wearing several shirts at once.

If you are concerned that you or a relative may have Alzheimer's disease, it is important to see a doctor. As yet, there is no single conclusive test, but it is possible to determine whether memory loss and confusion are due to other causes.

Support for carers
The discovery that a relative has Alzheimer's can be devastating. Perhaps the most difficult thing to deal with is the realisation that the person does not recognise you any more. For example, as spouse becomes stranger, the patient may refuse to sleep in the same room. These types of experiences mean that caring for a patient with Alzheimer's can be physically exhausting.

Alzheimer's alters relationships permanently and in some cases, the stress that this causes will be compounded by additional responsibilities that the carer must take on, such as managing the household or taking care of financial matters. For this reason, it is important that carers and their families accept counselling when problems of an emotional or practical nature arise.

The carer may have a number of ambivalent feelings towards the patient. As the situation takes its toll, it is not unusual for the carer to secretly wish for the patient's death and to feel guilty for such thoughts. It is important, then, that the carer take the opportunity to talk through these feelings with a counsellor. It is vitally important that carers have regular periods of time to themselves. Respite care can be arranged where a patient is looked after elsewhere for a specified time.

The Alzheimer's Association has a number of services to help those caring for a person with the disease.

How to deal with Alzheimer's Disease
The early stages of Alzheimer's Disease can be frightening, distressing and frustrating for the individual concerned. Along with memory loss, the person may develop changes in mood and behaviour, ranging from hostility and fearfulness, to depression and apathy. There is currently no cure for Alzheimer's disease, but there are things that can be done to help the person cope.

For people in the later stages of the disease, hospitalisation is usually necessary. Under the supervision of trained medical staff, prescribed medication may help relieve the patient's feelings of distress or agitation. Relatives may feel uncertain or unhappy about this option, but these days medication can be used to calm the person, while leaving them still alert and able to function.

There is no right way to deal with a person who has Alzheimer's, and any approach will change, depending on the stage of the disease. In the early days it may be possible to continue gently orienting the person toward the reality of the world around them. The time may come, however, where they may be comforted more if the carer plays along, or it is no longer possible to care for the person at home, and hospitalisation is necessary.

At first the person with Alzheimer's disease may cope best in their own home, and relatives may prefer to care for them as long as possible in this environment. The Royal District Nursing Service or your local hospital in rural areas can organise nursing care in the patient's home, and give advice to carers. Local councils can also offer assistance through services such as meals on wheels, home care and home maintenance.

The time will come when hospitalisation must be considered. Carers may feel inadequate because they are no longer able to cope with the situation. They may feel guilty because they feel they are abandoning the person.

It is important to remember that by the time hospitalisation is necessary, the patient may no longer recognise the house as their home.

Practical Considerations
There are several matters that need to be considered in the early stages of the disease. As Alzheimer's progresses, the patient is no longer able to manage his or her own affairs. It may make things easier for the carer if he or she has power of attorney. Otherwise it will be necessary to work through the Guardian Administration Board. If carers wish to avoid this, it is important to gain the patient's power of attorney in the early stages of the disease as it cannot be granted once the person is deemed not to be of sound mind.

The second issue concerns safety of the patient while he or she is being cared for. Deterioration of memory means that Alzheimer's patients live in the past. As a result they may become disoriented in their present surroundings and try to 'go home' - even if home is many miles away, or does not exist any more. It is difficult, if not impossible, to ensure that the patient is supervised at all times, so there may be instances where they get lost in the locality. One way to combat this is to buy an identity bracelet with the patient's name and the phone numbers of people to be contacted if the person is found lost in the street.

Research
Before a cure for Alzheimer's disease can be found, scientists need to uncover its causes.

The Mental Health Research Institute has an internationally recognised team of researchers - The Alzheimer's Disease Division - which is the major research team in Australia working toward this goal. Research at the Mental Health Research Institute focuses on how we can stop the 'rusting' from occurring. The research in the Alzheimer's Disease Division of MHRI explores the underlying causes of the disease. If the toxic reaction can be halted, this should give the brain time to stop the amyloid from accumulating. The effects of Alzheimer's disease may be slowed, stopped or even reversed. Professor Colin Masters of the Mental Health Research Institute says 'It's like washing the rust out of the brain.'

The disease not only has a devastating affect on the sufferers and their families but the cost to the community is tremendous. It is estimated that in the next fifty years the growth in the age group most susceptible to Alzheimer's disease will outstrip the growth of those who will have to support them.
In the past year, the Alzheimer's Disease Division has been increasing its understanding of how the amyloid protein damages brain cells and has developed a chemical which halts the toxic reaction.
This drug has been successfully used to slow down the accumulation of the amyloid protein in laboratory mice.

Forty human volunteers completed a trial of the drug, the results of which were published in April 2002.

A long term goal is to develop a blood test which can be used to diagnose Alzheimer's disease.