Alzheimer's Disease: Everything You Need to Know (Your Personal Health)

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9781552977378: Alzheimer's Disease: Everything You Need to Know (Your Personal Health)

"An essential read for clinicians and caregivers."
- Peter J. Whitehouse, Alzheimer Center, Cleveland, Ohio

Alzheimer's disease affects 4 million Americans. As the proportion of elderly in our population increases, the devastating illness will afflict as many as 14 million Americans by 2050.

Since this title was first published in 1998, research and treatment of Alzheimer's have progressed, offering a new understanding of the disease and hope for patients and their loved ones. This revised edition includes the latest developments in the care and treatment of Alzheimer's patients, and provides advice on how families can cope.

Alzheimer's Disease features: - How to distinguish Alzheimer's from normal aging - Common signs and symptoms - Diagnosing Alzheimer's - Caring for someone with Alzheimer's - Coping with anger, denial, and depression - What Alzheimer's does to the brain - Treatments for Alzheimer's - Related dementias, such as Pick's disease - Legal issues

Supplemented by diagrams, charts and case studies, Alzheimer's Disease is designed for quick reference and in-depth study. It is a thoughtful and compassionate guide to this complex condition and an important update of one of the most popular titles in the Your Personal Health series.

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About the Author:

William Molloy, MD, is a Professor of Medicine at McMaster University and director of the Memory Clinic at Hamilton Health Sciences Corporation. He is co-author of the first edition of Alzheimer's Disease: Everything You Need to Know (1998) as well as Common Sense Geriatrics, Let Me Decide, Vital Choices and Caring for Your Parents in Their Senior Years, and co-author of Set Me Free and The Ideal Detail.

Paul Caldwell, MD, is a general practitioner. He is co-author of the first edition of Alzheimers Disease, the author of Sleep: Everything You Need to Know and the co-author of Eating Disorders.

Excerpt. Reprinted by permission. All rights reserved.:

Chapter One
The First Case of Alzheimer's Disease

On a cold and colorless November afternoon in 1901, a distraught husband brought his wife to the mental asylum in Frankfurt am Main for treatment. She was examined by a young German neurologist, and even at that first encounter he was perplexed by her, unable to understand or diagnose her strange symptoms and behavior. In all his medical training and experience he had never seen a case quite like this. The woman was obviously suffering from a severe alteration in her mental function, similar to what he had often seen in the very old and senile. She had the same memory loss, the same difficulty with speech, the confusion and the general feebleness of reasoning. Yet she wasn't senile. She wasn't even very old. Her problem couldn't be diagnosed as "senile dementia" -- she was only 51!

Across the desk from him in the chilly examining room sat the woman, a housewife from Munich whose first name was Auguste. She appeared much older than her age. Her hair was disheveled, her clothes unkempt, and in her eyes was a wild, animal-like fear he had seen before in the mentally infirm and the truly insane. Her husband looked worn, almost haggard, but there was good reason for this. He had just finished describing his wife's unusual behavior over the last several months, and the story was heartbreaking.

She had been perfectly healthy for most of her life, had never been in the hospital, had rarely been sick. She'd worked as a laborer in a factory till they were married and children came. Now she was a Frau at home. She had been not only healthy but also happy, of even temper and trusting disposition -- until she began to change.

He hadn't noticed it at the time but, looking back, he saw that the first hint of a problem had been her jealousy. They had enjoyed a good marriage -- she had always been devoted to him. But for some reason he could not understand, she had begun to grow distrustful of him, had accused him of being unfaithful to her and angrily confronted him on several occasions. These outbursts were violent and irrational. The poor man had pleaded his innocence in front of his frightened children and professed his love, but his wife would not be satisfied. The jealousy was bad enough, but soon she began to suspect him of tricking her, and became even more agitated. He realized after a while that her memory was the problem. She would forget where she had left things -- inconsequential things, such as her daughter's mittens -- then fly into a rage when she couldn't locate them and accuse him of stealing and hiding them from her. These confrontations occurred frequently, with much shouting and furious agitation directed at him, for he was the object of her wrath. Such explosive fits of temper were completely out of character for his wife. Sometimes he would find things hidden in bizarre places. One time he found her hairbrush in the oven, and another time he found his pipe tucked away in the clothes for the laundry. Several times she got lost when out walking in the neighborhood. Once she went to the butcher shop half a block away, where she had shopped for years, and got quite frightened when she couldn't find her way home. He had to accompany her to be sure she was safe whenever she left to do errands.

The situation worsened. She became confused and disoriented within the confines of their small apartment -- she couldn't remember where the bathroom was and she forgot the names of simple household objects such as the bed or the icebox. She could no longer cook. Not only could she not remember recipes, she couldn't remember what to do with pots and kitchen knives. She couldn't even set the table. And she had difficulty with the simplest tasks, such as dressing herself. It wasn't that she was physically incapable. Her hands and legs were still strong, and she thrashed about when she was angry -- her poor husband had to hold her to stop her from beating him, so he could attest to her strength. But she had lost the will to do these simple tasks, or perhaps the under-standing of the purpose behind them.

Then one night the screaming started.

Her sleep had been getting slowly worse over the months. As nighttime approached, she'd become more confused and agitated. When she finally did fall asleep (usually quite late) she often awakened later and left the bed. Her husband would follow in the dark to be sure she was safe, and watch her wander around the small apartment. Sometimes she would just stand still in the hall, or sit in a chair with a bewildered look on her face. The night she woke up screaming, she would not be soothed. The sound was unnatural, hideous. She was certain that she was about to be murdered and kept yelling, "No! No! Stop! Please!" The neighbors banged on the door to offer assistance and the husband had to assure them that his wife was simply having a bad dream.

The days that followed were agonizing. She'd pace the apartment for hours on end, sometimes dragging small pieces of furniture or bedclothes with her. Then suddenly she would pause in her wandering, cock her head as if listening and shout an answer to some voice only she heard.

The couple's life was in ruins. At last the husband had brought his wife to the hospital for examination.

The portly neurologist reviewed his notes and considered the case. Although Auguste's mind was clearly gone, she had no infirmity in her body. The diagnosis wasn't insanity, nor was it any of the other mental diseases he had seen so often before. This wasn't the general paralysis of the insane seen in syphilis, or the dementia of schizophrenia. Nevertheless, it was clear that the pitiable woman in front of him had a rapidly progressive mental disease, and that she could no longer be looked after safely at home. He signed the admission papers, and she was led away into the asylum.

This encounter between the German neurologist and the Frau produced the first detailed description of a dementia, or loss of thinking power, that had not been recognized before, one that afflicted the middle-aged and those in their prime. We know the woman only as "Auguste D." Her personality is lost to history; her particulars, aside from the details of her illness, are forgotten. The name of the doctor, however, has become a household word. He was Dr. Alois Alzheimer.

Dr. Alzheimer

Alois Alzheimer was born in 1864 in the village of Markbreit, just outside of Wurzburg in southern Germany. Following secondary school, the young Alzheimer studied medicine at the universities of Wurzburg and Berlin. He graduated in 1887, after writing his final-year thesis on the functioning of the wax-producing glands of the ear. Alzheimer spent his first six months as a physician accompanying a mentally ill woman on her travels. This kind of posting was common for young physicians, and the experience gave him an interest in psychiatry and brain disorders. At the time physicians hotly debated whether the causes of mental illness were medical -- that is, related to some disease of the brain or nervous tissue causing malfunction -- or psychological, rooted in emotional trauma, as the influential Viennese psychiatrist Dr. Sigmund Freud claimed. Later Alzheimer obtained a job as medical officer at the mental asylum in Frankfurt am Main. By the time he met Auguste D., Alzheimer was 37 and had already established himself as a leading neurologist. He had published studies on epilepsy, brain tumors, syphilis, hardening of the arteries of the brain and other topics, and was known for his meticulous correlation of the clinical course of his patients -- their complaints and his findings in hospital -- with the changes that he observed after their deaths when he examined their brains under the microscope at autopsy.

Auguste's Fate

For the next four years Auguste lived in the insane asylum in Frankfurt where Dr. Alzheimer was the admitting neurologist. They were years of anguish for both her and her fami

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