Canadian Health Network

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In an interview with the Canadian Health Network, Dr. Jack Diamond, Scientific Director of the Alzheimer Society of Canada answers questions about Alzheimer Disease and brings us up to date on the latest research findings.

Canadian Health Network: What is Alzheimer Disease?
Dr. Jack Diamond: Alzheimer Disease is a progressive, degenerative disease in which brain cells shrink or disappear. This is caused by the appearance in the brain of a multitude of microscopic deposits made of a toxic protein. These are known as "amyloid plaques." In addition, thread-like tangles develop inside the brain cells and effectively choke them to death

Alzheimer Disease eventually affects all aspects of a person's life: how he or she thinks, feels and acts. And while it is difficult to predict the symptoms each person will have, Alzheimer Disease generally reduces a person's ability to understand, think, remember and communicate. Confusion and memory loss, initially for recent events and eventually for long-term events, will occur.

			Reducing risk of Alzheimer Disease
			According to the Alzheimer Society of Canada, there are several things you can do to reduce your risk of disease. They include: Keep physically active. Clinical trials show that getting regular exercise is good for keeping your mind fit as well as your body. In addition, regular physical activity has now been associated with lowering risk of Alzheimer Disease. Keep your heart healthy. By controlling high blood pressure and high cholesterol, you may reduce risk of having a stroke. In turn, this may delay or prevent Alzheimer Disease. The role of cholesterol-lowering agents such as statins is also being studied. Aim for moderation. Researchers are looking at what role wine, coffee and diet may play in reducing risk of Alzheimer Disease. Keep your mind active. Preliminary research shows that those who keep mentally active by reading, doing crossword puzzles, playing cards, etc., may reduce risk of Alzheimer Disease.

CHN: Is Alzheimer Disease the same as dementia?
Dr. Diamond: Alzheimer Disease is the most common form of dementia, which refers to a number of symptoms such as loss of memory, judgement and reasoning, and changes in mood and behaviour. Alzheimer Disease accounts for 64 per cent of all dementias.

CHN: What is the incidence of Alzheimer Disease in Canada?
Dr. Diamond: It is estimated that 364,000 Canadians over the age of 65 have Alzheimer Disease and related dementias. As a result of our aging population in Canada, it is expected that by the year 2031, the number of people with dementia will grow to more than three-quarters of a million.

CHN: What causes Alzheimer Disease?
Dr. Diamond: We know that all the things that are not good for health generally-such as high blood pressure, high cholesterol, overindulgence in alcohol, not getting enough exercise, eating poorly - can increase your risk for Alzheimer Disease. So if you maintain a healthy lifestyle, you reduce your overall risk of disease, including Alzheimer. There is one risk factor that none of us can escape, however, and that's age. In other words, the older you get, the greater your risk of many diseases, including Alzheimer, which tends to show up in people who are 65 years of age or older. People who are in their 40s or 50s have been known to get Alzheimer but this is quite rare and usually, there are special circumstances, as in the case of the person who has Down's syndrome or diabetes. There are also important genetic factors.

CHN: Can you tell us about the genetic factors?
Dr. Diamond: Yes. Some 5-7% of cases are known as "familial" Alzheimer which means that it runs in your family. It doesn't mean that there's a 100% certainty of getting Alzheimer, it just means that your risk is enormously increased. The other 95% of Alzheimer cases are what we call "sporadic" and there are genes that certainly contribute to this, especially the one known as Apoe4.

CHN: What if one or both of your parents has Alzheimer Disease? Does this mean your risk is greatly increased for developing it, too?
Dr. Diamond: Not necessarily. Unless one is dealing with familial Alzheimer Disease, in which case there are many members of your family who have the disease-sisters, brothers, grandparents, aunts, uncles, and so on-you will not inherit Alzheimer Disease. Not having the gene for familial Alzheimer doesn't mean that you won't get the disease, however; you could develop the far more common "sporadic" form of Alzheimer Disease.

CHN: Some people, especially in middle age, worry that short-term memory loss may be "the beginning of the end" and that forgetting the name of the film they saw last night could be an early sign of Alzheimer Disease. Should these people be worried?
Dr. Diamond: If it's simple memory loss, such as when you forget where you put your car in the parking lot, rest assured, we all get that sometimes. However, if you find yourself on the street and you don't know where you are, despite the fact that you're in familiar surroundings, you may have a problem.

CHN: How is Alzheimer Disease diagnosed?
Dr. Diamond: Alzheimer Disease cannot be diagnosed using everyday examples of memory loss. In Alzheimer or memory clinics, however, a battery of memory tests are applied and the results make it possible to distinguish very effectively between those who have the disease and those who do not.

CHN: Is there a cure? Are any treatments available?
Dr. Diamond: At this time, there is no cure for Alzheimer Disease. However, medication is available, especially in the earliest stages of disease, that can definitely delay the onset of some of the symptoms. In addition, support services, programs and learning more about the disease can help enhance the quality of life of both the person with the disease and the family.

CHN: How far away are we from preventing or curing Alzheimer Disease?
Dr. Diamond: This is one of the most exciting phases in the history of Alzheimer Disease research. Scientists are currently working on better vaccines that will be able to inhibit the development of amyloid plaques that I referred to earlier. The formation of these is almost certainly the initiating event in Alzheimer Disease.

CHN: How long will it take a vaccine to prevent Alzheimer Disease?
Dr. Diamond: My guess is that a new vaccine will be developed within the next three years. After that, it will take another three years to test it. So in all, we may have a vaccine in 6 or 7 years. Once the vaccine is developed, it will probably be first used in the earliest stages of disease. However, even if you have something that will stop the disease dead in its tracks, you're still left with the damage that's already been done. Fortunately, scientists are very actively identifying approaches that will help the brain repair itself and in particular, to re-establish the circuitry that was lost.