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By Jill Ross, HealthAtoZ contributing writer
Forgetting where you put keys happens to everyone now and then. Mary Menna realized this. But when her husband, Danny, a retired Michigan steelworker, asked her the same question four times one afternoon, she began to wonder if he had a real memory problem.
"I thought, 'Wow. What's going on here?'" recalls Mary, a retired special education teacher. She suspected Danny had Alzheimer's disease, a progressive loss of memory so severe that it interferes with a person's ability to function.
Once a specialist had diagnosed 83-year old Danny as having the early signs of Alzheimer's he was enrolled in a clinical trial of a new drug derived from the bulbs of daffodils.
That drug, Razadyne® (galantamine hydrobromide), was approved by the Food and Drug Administration (FDA) and joins several other drugs already on the market to help slow the cognitive decline of Alzheimer's disease, which affects an estimated 5 million Americans.
Like the other medications - Cognex® (tacrine), Aricept® (donepezil), Namenda® (memantine), Exelon® (rivastigmine tartrate) - Razadyne is indicated for mild-to-moderate cases of Alzheimer's (such as Danny Menna's), explains Gary Small, M.D., Director of the UCLA Center on Aging.
The FDA also has approved Namenda for treatment of moderate to severe dementia.
Helping patients function better
Most Alzheimer's drugs work to slow the progression of the disease by inhibiting the production of the enzyme, cholinesterase, which breaks down acetylcholine - a neurotransmitter responsible for transmitting signals involved in memory and cognition. Researchers have found that Alzheimer's patients have an extremely low level of acetylcholine. Memantine regulates the neurotransmitters glutamate through the NMDA receptors in the brain.
Unlike the other Alzheimer's drugs, galantamine also affects nicotinic receptors in the brain. Nicotine, researchers have found, enhances the brain cell release of acetylcholine. Galantamine has been linked to beneficial effects on patients' ability to think and their daily functioning. The latter, experts say, is often the paramount concern for many patients and their families.
"Families and patients don't care about improvement of a couple points on pencil and paper tests," Small says. "What they care about is that the patient isn't asking the same question over and over and is able to dress themselves. Those are the meaningful gains you see with this medication."
Mary Menna says she has seen some slight improvement in her husband's condition during the past four-and-a-half years. He's capable of doing a word jumble and sorting out mixed letters. He writes checks, and he can drive - with Mary providing the directions.
"When you're 83, you don't expect to be 40," she says. "He's like a dancer who doesn't dance as fast."
Mary urges other families in similar situations to get help quickly if they notice that an older family member or relative is showing signs of memory problems. Small agrees the sooner people seek medical help, the better.
"As far as the prevention and treatment of Alzheimer's is concerned, drug discovery and pharmacology are very important," Small says. "We can keep people out of the nursing home, give families a year - maybe more - something we never did before." The drugs, he adds, are not a cure, but they can stabilize an Alzheimer's patient and slow the mental decline.
How to stay mentally sharp
The Alzheimer's Association recommends that people make "brain healthy" life choices to help keep your brain healthier as you age and potentially reduce the risk of Alzheimer's disease or other dementia. Those choices include:
- Increase intake of protective foods. Certain foods may reduce the risk of heart disease and stroke, and appear to protect brain cells including.
- Dark-skinned fruits and vegetables that have the highest levels of naturally occurring antioxidants. This includes the vegetables kale, spinach, brussels sprouts, alfalfa sprouts, broccoli, beets, red bell pepper, onion, corn and eggplant. Fruits with high antioxidant levels include prunes, raisins, blueberries, blackberries, strawberries, raspberries, plums, oranges, red grapes and cherries.
- Cold water fish including halibut, mackerel, salmon, trout and tuna contain beneficial omega-3 fatty acids.
- Some nuts are good sources of vitamin E, an antioxidant, including almonds, pecans and walnuts.
- Vitamins may be helpful. Vitamins, such as vitamin E, or vitamins E and C together, vitamin B12 and folate may be important in lowering the risk of developing Alzheimer's. A brain-healthy diet will help increase your intake of these vitamins.
- Stay mentally active. Mentally stimulating activities strengthen brain cells and the connections between them, and may even create new nerve cells.
- Remain socially active. Social activity not only makes physical and mental activity more enjoyable, it can reduce stress levels, which helps maintain healthy connections among brain cells.
- Stay physically active. Physical exercise is essential for maintaining good blood flow to the brain as well as to encourage new brain cells. It also can significantly reduce the risk of heart attack, stroke and diabetes, and thereby protect against those risk factors for Alzheimer's and other dementias.
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This article was reviewed and updated June 2007.
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